Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Clarendon Mews Grasmere Street Leicester LE2 7FS The quality rating for this care home is: The rating was made on: one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Lesley Allison-White Date: 1 8 1 1 2 0 0 8 Information about the care home
Name of care home: Address: Clarendon Mews Grasmere Street Leicester LE2 7FS 01162552774 01162552785 clarendon-mews@carehomes.uk.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Greentree Enterprises Ltd care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability 25 0 7 Over 65 0 40 0 Conditions of registration: The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Dementia - Code DE. Old age, not falling within any other category - Code OP. Physical disability - Code PD. The maximum number of service users who can be accommodated is 40. Date of last inspection Brief description of the care home Clarendon Mews is a residential care home. It is registered to provide accommodation for a total of forty older people. The registration also allows for up to forty people to live in the home that has dementia (under category DE). It also allows for people who are physically disabled (under category PD) to live in the home. Clarendon Mews opened in 2002, after a full refurbishment. The home is situated in Leicester, close to Care Homes for Older People Page 2 of 13 the Royal Infirmary. Bedrooms are located on three floors of the home; a passenger lift services all these levels. Thirty-eight bedrooms have en suite provision; some of those have a bath or shower as well. There are lounge and dining facilities on all three floors of the home. There is a large secure garden within the grounds of the home. The home is well situated for transport routes to the centre of Leicester, and there are local shops within a short distance of the home. Parking facilities are available on the premises. Fees are set according to the minimum (£286.00 per week) and maximum (£396.00 per week) banding levels of the local social services departments. The Commission for Social Care Inspection (CSCI) and Employers Liability certificates were displayed in the hallway near the entrance to the home. Care Homes for Older People Page 3 of 13 What we found:
This is an overview of what the inspector found The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We came to this quality rating at the last key inspection. The focus on inspections undertaken by the Commission for Social Care Inspection is on outcomes for individuals and their views of the service provided. The inspection took place on a Tuesday. It took eight hours to complete. At the time of inspection there were fifteen people living at the care home with one person in hospital. The method of inspection used is known as case tracking. An individuals care record is looked at in detail. Relatives present on the day of inspection for individuals who live a the care home were also encouraged to speak with the inspector. This random was alerted by concerns raised from a member of the public and a health and social care professional. What the care home does well: What they could do better:
Information affecting the well being of individuals has not always been sent into the Commission. It is a legal requirement to complete Regulation 37 forms and an assessment of the accident and incidents as they arise must follow. A Regulation 37 form is completed for any deaths, illnesses or other events that has a poor outcome for any individual at the home. Such incidents would include a temporary loss of heating to parts of the home. Two people were case tracked. One of the individuals had a disability affecting one side of their body. They were able to speak and express them self. The care plan stated Care Homes for Older People
Page 4 of 13 that they liked to be in bed at 6.30pm and up at 7am. It also stated that they needed the help of one staff member to help them to eat their meals. The inspector observed the individual having their meal. The meal was eaten by the individual in bed, a family member was present. Staff had previously had problems with the family and appeared over bossy towards the individual at meal time and tried to persuade them to be fed by the staff member. This individual insisted on taking their meal independent of any help. They asked to be sat up right in bed to do so. Staff assisted the individual to be moved into an upright position. In doing so however they had to manually move the bed which did not have wheels on it. This is a health and safety issue for both staff and the individual being moved. The individual chose not to get out of bed. The meal was given to them placed on a pillow without any protection to the individuals skin from the hot food, no apron or serviette was offered to wipe their mouth afterwords. The meal kept sliding to one side. There was no place guard around it. There was no table available for the individual to rest the plate on. Visibility in the room was poor. (It was a dark day and an energy saving light bulb was used to light the room). This is a situation for management to review. There was no bed rail risk assessment in the care plan or the provision of bed rail protectors for the bed rails if used. The staff at the home should contact the District Nurses for advice and help in this matter. They should also speak with and explain the use of bed rails to the individual and close family member and gain their consent. A key worker system is operated at the care home. However this person was new and would have benefited from a staff member taking a special interest in them to ensure that their needs were being met. This would also help them to settle in and feel more comfortable when needing or asking for help. The individual told the inspector that they were afraid of falling and this was one of the reasons that she did not want to be out of bed. They also thought that the Doctor was visiting on that day. Another person case tracked had a key worker. Neither the individual or the family members who spoke with the inspector were able to say who the key worker was. It is recommended that the role of the key worker is reviewed if it is to be of benefit to the individual who lives at the care home. Clutter in two bedrooms was seen. Both rooms contained equipment that was no longer used for the individuals. The inspector was told that the night staff were now trained to give medications. In this way individuals at night in pain can be given their medicines when they need it without waiting for someone to come in specially during the night or having to wait for the morn ing shift. Both bedrooms had medication in them in the form of prescribed creams. The medications were not stored in a safe manner. Creams were left available to anyone who wanders around the home giving them easy access to it as well as putting themselves or others at risk. A relative confirmed that individual residents do wander into bedrooms and their relative has snacks and small items of food that the family bring in for them placed on top of their wardrobe because of this. This was seen on inspection. Oral medications of the individual residents case tracked and a few others were seen and checked. Some people did not have a photograph on their medicine record. It Care Homes for Older People Page 5 of 13 would help any newer staff to recognize individuals more easily if assisting with medicines. This was discussed with the new manager who said that photographs of individuals was in progress. Staff need to consider how they approach and meet the needs of individuals and to ensure that individual needs are accurately reflected in the care plan. In this way privacy and dignity will be demonstrated as met. On the day of inspection no activities were seen to be done with or between individuals living at the home. The staff were able to show activities that had been bought for staff to do with individuals such as board games with large pictures and prints on them. One persons relatives who was case tracked said that they chose not to take part in many activities. It is important however to provide people with activities that will prevent loss of abilities. Many of the individuals who spoke with the inspector felt that they were able to exercise their choices and to maintain control over their lives. However, staff should remember to offer choices to everyone regardless of their state of disability. One person commented that they disliked the fact that a radio was put on as it spoiled conversation and provided unnecessary noise when dining. This may be something that can be discussed at a meeting with the individuals who live at the home. A notice board in the hall way contained the complaints procedure. The address and contact numbers for the Commission for Social Care Inspection should also be included and displayed. Visibility and lighting in the bed rooms was at a low level as energy saver light bulbs were used in them. A risk assessment needs to take place for each room and to involve the individuals and staff also. Room lighting may be compromising staff moving and handling techniques and residents falling in their bedrooms. The manager should also consider individuals who need better lighting for reading in their rooms and to ask individuals what they prefer. One concern raised was that staff were not easily identifiable by name badges. This was true. On the day of inspection two staff members did not have name badges or names on their uniforms. The provider provides staff with up to two uniforms. Issues that needed addressing have been included in the requirements set. They include the moving and handling of the individual who was in bed where the staff was seen lifting the bed to move it as it had no wheels on it. There are issues with regard to both staff health and safety and that of the individual who they moved in the bed. There is a need to review the amount of clutter in individual rooms where equipment is no longer needed. A review ofall lighting within the home to include bedroom lighting also. There is a need to ensure that risk assessments for all the rooms with regard to the type of lighting provided for individuals to use and for the safety of the staff who work in these areas be reviewed. All doors should be checked to ensure that they open and close in accordance with fire Care Homes for Older People Page 6 of 13 safety measures. One door was seen that did not have a door handle on it and relied on a rope to open and close it. An immediate requirement was issued for this to be corrected. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 13 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 8 14 (2) (b) It is important to ensure that 30/06/2008 information relating to the people living at the home is evaluated as necessary to reflect their current needs as potentially the wrong diagnosis and treatment could be offered. Care Homes for Older People Page 8 of 13 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action 1 19 13 4) The registered person 22/11/2008 shall ensure that a) all parts of the home to which service users have access are so far as reasonably practicable free form hazards to their safety. All doors should be checked to ensure that they open and close in accordance with fire safety measures. On door was seen that did not have a door handle on it and relied on a rope to open and close it. An immediate requirement was issued for this. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 3 14 The registered person shall 20/02/2009 not provide accomodation to a service user at the care home unless so far as it shall have been practicable to do so c) there has been appropriate consultation regarding the assessment with the service user or a representative of the service user. Individuals must wherever possible be included in their assessments. In this way Care Homes for Older People Page 9 of 13 information about them is likely to be more reflective of their needs 2 7 13 Unnecessary risks to health 20/02/2009 or safety of service users are identified and so far as possible eliminated. Advice from relevant health care professionals is needed to ensure that assessments against the risk of falls from beds are made. 3 8 13 20/02/2009 The registered person enables service users to have access to specialist medical, nursing, dental pharmaceutical, chiropody and therapeutic services and care from hospitals and community health services according to need. A specialist assessment is required to ensure that appropriate equipments is provided to individuals who need this. This will include beds with wheels on them, tables for meals when taken in bed, plate guards for people who have a disability affecting a particular part of the body as examples. 4 9 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. All medications including prescribed creams should be stored in a safe manner. They should not be available to anyone who wanders around the home as they may put them self or others Care Homes for Older People
Page 10 of 13 20/02/2009 at risk. 5 10 12 The registered person shall 20/02/2009 make suitable arrangements to ensure that the the care home is conducted (a) in a manner which respects the privacy and dignity of service users. Individuals need to be offered an apron to wear at meal times, to have serviettes to wipe their mouths after eating, to be able to eat their meals without the fear of it falling off their plate or dish. In this way staff will be able to demonstrate that the privacy and dignity needs of individuals are being considered on each occasion. 6 12 16 20/02/2009 (n) Consult service users about the programme of activities arranged by or on behalf of the care home, and provide facilities for recreation including, having regard to the needs of service users, activities in relation to recreation, fitness and training. It is important to provide people with activities that will prevent loss of abilities. 7 25 23 (2) The registered person 20/02/2009 shall having regard to the number and needs of service users ensure that - (p) ventilation, heating and lighting suitable for service users is provided in all parts of the care home which are used by service users. A risk assessment of the lighting should involve the individuals or their Care Homes for Older People
Page 11 of 13 representative and staff members to ensure that the dim lighting is not a contributory factor in the incidence of falls and injuries to individuals living at the care home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 16 The current contact details of the Commission for Social Care Inspection should be displayed within a prominent place within the home as part of the complaints documentation. As part of the homes quality assurance, meetings held with residents should include the opinions, outcomes and actions taken tp meet the needs of the people who live at the care home. 2 33 Care Homes for Older People Page 12 of 13 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 13 of 13 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
