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Inspection on 21/04/08 for Clarondene Residential Care Home

Also see our care home review for Clarondene Residential Care Home for more information

This inspection was carried out on 21st April 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The residents were comfortable and relaxed in their home and staff were well aware of their individual needs Residents had individual care assessments recorded which demonstrated that their health, personal and social care needs were being considered. They were being treated with respect and dignity and their right to privacy was upheld. Activities were provided at the home that generally benefited residents. The home encouraged family contact and provided residents with meals which were varied and which they enjoyed. Residents were living in a comfortable environment that was clean and hygienic.

What has improved since the last inspection?

The provider hopes to move the service forward in a number of ways and has identified several areas for improvement many of which link specifically with the requirements and recommendations made following the previous inspection.

CARE HOMES FOR OLDER PEOPLE Clarondene Residential Care Home View Road Lyme Regis Dorset DT7 3AA Lead Inspector Lesley Jones Unannounced Inspection 21st April 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clarondene Residential Care Home Address View Road Lyme Regis Dorset DT7 3AA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01297 442876 01297 442025 alia@alcurtis.fsnet.co.uk Ms Mary Alison Curtis Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th December 2007 Brief Description of the Service: Clarondene residential care home is registered to provide care and accommodation for a maximum of 12 residents. At the time of the inspection there were only seven individuals in residence. The home has been registered to Ms Alison Curtis, the proprietor, since January 2006 and she takes an active role in the management of the home. The home has not had a registered manager since April 2006 but employs a designated home manager. The home is situated in a quiet residential area of Lyme Regis. There is a steep walk to the town centre, which offers all the amenities of a small historic coastal town. A small parking area is available at the front of the home and a large town car park is situated nearby. The front door to the home is located at the side of the house and is accessed by a steep flight of steps. There is also a raised driveway to the home’s back entrance/kitchen door, which has an uneven surface but the proprietor said that improvements are planned for the near future. The proprietor’s private accommodation is located on the first floor close to private rooms used by their elderly mother. Neither the Proprietor nor their mother have a kitchen and so they share the home’s registered kitchen and basically eat what the people who use the service eat. The home has an assisted bathroom and a separate assisted shower room, which has recently been upgraded to a high standard. There is a small, enclosed and levelled front garden with flower borders and lawn at the side of the home near to the front entrance: this is easily accessed through patio doors from the lounge area. Garden furniture is available outside for residents to sit, relax, and enjoy the warmer weather and potted plants provide an attractive display. Additionally, there is a back garden but residents rarely use this as it can only be accessed by a series of steep steps. The fees for the home range from £350 to £450 per week. Additional charges Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 5 include hairdressing, chiropody, and newspapers. See the following website for further guidance on fees and contracts. http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_c hoos.aspx Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use the service experience adequate outcomes. This inspection was undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. Key standards were assessed according to the Care Home for Older People National Minimum Standards. Key inspections are aimed at making sure that the individual services are meeting the standards and that outcomes are promoting the best interests of the people living in the home. The site visit to the home was carried out over one day by two inspectors. The main focus of the visit was to review improvements made since the last inspection completed in December 2007 and the well being of the residents. Time was spent touring the building, talking to the two care staff on duty, two visiting community nurses and observing the people who live at the home and reviewing a selection of assessment, care plans, medication records, staff files and all documentation specifically relating to requirements made at the previous inspection. The provider and staff were very helpful and demonstrated a pro-active approach to ensuring that the people living at Clarondene were being supported to the best of their abilities and resources and the inspector would like to thank all those involved in the inspection for their support and assistance. Information inspected during the visit included: Three care plans. Three medication charts. Records of the management of controlled drugs. Risk assessments. Staff training and recruitment records. The Statement of Purpose and Service user Guide is currently being reviewed and the amendments were discussed. Minutes of staff and residents meetings. Discussions took place regarding safeguarding adults and the complaints procedure, and the progress made since the last inspection. What the service does well: The residents were comfortable and relaxed in their home and staff were well aware of their individual needs Residents had individual care assessments recorded which demonstrated that their health, personal and social care needs were being considered. They were being treated with respect and dignity and their right to privacy was upheld. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 7 Activities were provided at the home that generally benefited residents. The home encouraged family contact and provided residents with meals which were varied and which they enjoyed. Residents were living in a comfortable environment that was clean and hygienic. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The statement and Purpose and Service user Guide requires updating to reflect the current services, facilities and staffing arrangements at Clarondene. The service gives sufficient verbal information with regards to what it can offer to prospective residents enabling them to make an informed choice. There have been no admissions since the last inspection so it was not possible to inspect this standard. We did however, discuss the process with the provider who demonstrated knowledge of the principle of good practice. Intermediate care is not offered at Clarondene Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 10 EVIDENCE: A Statement of Purpose and Service User Guide need to be produced, which should be available to prospective residents and their representatives, this work is in progress, which the provider agreed to complete within three months. These documents need to be specific to the home and clearly set out the philosophy and objectives of the service. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had individual care assessments and plans recorded which demonstrated that their health, personal and social care needs were being fully considered. The home has appropriate systems in place for managing residents’ medicines. Residents have their health and personal care needs met in a dignified and safe manner and their right to privacy upheld. EVIDENCE: The provider and staff team have worked hard and have succeeded in improving the quality and content of the residents’ care plans. Three resident files were examined and each contained their personal photograph and entries were signed and dated. Each file included Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 12 comprehensive care assessment and plans relating to specific areas of their daily living. There were clear goals and actions for staff to take in order to meet individual needs. The care plans recorded a range of matters such as preferred bath time, bed time, as well a food likes and dislikes and favourite activities. Personal histories and the reason for the person moving to Clarondene were also included and provided valuable social history. Record of contact with health care professionals was were well recorded on the individual file. Residents’ dependency level was recorded and risk assessments were in place for moving and handling, nutrition, tissue viability. All files checked evidence that the information was being reviewed monthly. The provider is keen for different members of staff to review the plans to ensure the review is practical and not such performed as a routine task. A good rapport was observed between care staff and people using the service. Currently staff are able to meet individual needs. Evidence in the care plans show that visits from community nurses; doctors and people who deal with wound care are contacted appropriately and when needed. There was positive feedback about the care provided from a visiting community nurse who also stated that the home readily sought advice and support. The medication system and administration was inspected and provided sufficient evidence to demonstrate that people have their medication needs met. Medicines, including controlled drugs, were being securely stored. Photographs of residents were in place beside the Medication and Administration Record (MAR) sheets. All staff have recently completed training (provided by Boots the chemist) in the administration and handling of medication. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides activities based on individuals wishes. The flexibility of the home enables people to maintain contact with their family and friends. Residents receive good home cooked fresh food, which provides a balanced and varied diet. EVIDENCE: People who use the service continue to receive visitors whenever they wish. A record is maintained of all visitors to the home. The home encourages friends and relatives to keep in contact. There are planned activities, and participation is recorded in the resident’s individual files. These range from singing and bingo, gentle exercise, ball type games and outings or simply sitting and talking. There is recorded evidence to demonstrate that the activities are based on the persons past and interests. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 14 At the residents’ meeting held on 26/03/08 feedback was sought on all catering within the home and the overall comments were very positive. Discussion with the cook confirmed that fresh food is available and used daily in the cooking and that she was very aware of peoples’ preferences and choice was available. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are protected from harm by staff who have completed appropriate training. Information in the Service user Guide advises residents and relatives how to complain. EVIDENCE: Information in the Service User Guide advises residents and relatives how to complain. The provider confirmed she was in the process of updating this information. The provider agreed with the suggestion that a separate complaints leaflet should be posted on the notice board alongside the existing information about advocacy. No formal complaints have been made to either the provider or through CSCI in the last twelve months. Since the last inspection training completed by staff in safeguarding adults has now been verified and certificates were available on individual staff files. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 16 Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, comfortable, and homely environment. The home has been decorated and furnished to a good standard. There are sufficient communal areas and bathroom facilities to meet residents’ needs. Residents’ rooms are personalised to reflect their individual tastes. EVIDENCE: The home is decorated and furnished to provide a homely, comfortable environment. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 18 The home has nine single bedrooms and one double bedroom situated on the ground floor. It was evident that residents continue to be encouraged to personalise their rooms with items of furniture, pictures, and possessions from their former homes. Two bedrooms have en-suite WC’s and the remaining rooms are fitted with vanity units and washbasins. The hot water is regulated by the means of individual thermostatic regulators. Staff use internal ramps to aid residents mobility around the home. The home was clean and hygienic, with no unpleasant odours. The washing machines had sluicing cycles. Since the last inspection staff have completed infection control training however, the provider must ensure good practice is implemented within the home at all times especially as the laundry is sited off the dining area. Care staff are responsible for keeping the home clean. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Short falls in staff training previously identified have now been addressed with staff successfully completing mandatory training. Staff training must now progress to ensure the home can reach the ratio of 50 trained members of staff with NVQ level 2 or equivalent. Further training linked to residents’ specific needs has been booked to ensure staff develop appropriate knowledge and skills to meet the needs of the residents. EVIDENCE: Residents are currently cared for by sufficient staff who are competent and know how to meet individual needs. The home currently has seven residents. There are two care staff on duty throughout the waking day. This is supplemented by the provider, the full time cook and office assistant. The provider recruits staff following the standards and ensures that references and statutory checks are completed. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 20 The provider has demonstrated a commitment to staff training and has invested a considerable amount in purchasing a package, which is practical, and meets identified training needs. In addition to this training the provider has established links with Dorset County Council to access other relevant training. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The provider is committed to providing good care in a homely atmosphere, to ensure the welfare and the best interests of the resident are met within the framework of the standards. Since the last inspection the manager designate has left and the provider has now made a commitment to undertake all aspects of managing the home. The provider has made progress in meeting the majority of the requirements identified at the last inspection. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 22 EVIDENCE: The provider was able to demonstrate that good progress has been made in meeting the requirements and recommendations of the previous inspection and these have been commented in the body of the report. Actions taken include staff restructuring to include the appointment of an experienced deputy manager to oversee the care provided. The provider is studying for the Registered managers Award and the deputy is completing National Vocational training to level 4. The provider has scheduled individual supervision sessions throughout the year and two staff meetings have been held since the last inspection. The provider has developed links with other homes in the area to share training, advice, and professional support. Comprehensive risk assessments were available and specifically linked to residents needs and there was evidence from the records that these were reviewed monthly. Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 2 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 2 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 x x x 2 x 2 Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4, 5, 16, Sch1, Sch.4 (1)(2) Requirement Timescale for action 31/07/08 2. OP16 22 Sch. 4(11) 3. OP28 18(1)(a, b, c) Sch.2 (4) 8,9,10 4. OP31 The provider must ensure all residents have access to an up to date Statement of Purpose and Services User Guide. Please note the provider is aware of this and has started to revise the existing documents. 31/07/08 The provider must ensure that there is a simple, clear, and accessible complaints procedure, which includes the stages and time-scales for the process, and that complaints are dealt with promptly and effectively. Please note the provider is aware of this and has started to revise the existing policy and procedures. A minimum ratio of 50 trained 31/12/08 members of care staff (NVQ Level 2 or equivalent) is achieved. The provider must register with 31/07/08 the Commission demonstrating they are qualified, competent, and experienced to run the home and meet its stated purpose, aims and objectives. DS0000065695.V361477.R01.S.doc Version 5.2 Clarondene Residential Care Home Page 25 5. OP33 24 6. OP36 18(2) 7. OP38 13(4)(5) The provider must establish and maintain a system for evaluating the quality of the services provided at the care home. Please note the provider has commenced work on meeting this standard. The registered person must ensure that staff receive regular formal supervision. Please note the provider has commenced work on meeting this standard and all supervision sessions have been booked though not at the time of the inspection implemented. The provider must ensure good practice at all times in the management and control to prevent infection and communicable diseases. 31/07/08 31/07/08 31/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Clarondene Residential Care Home DS0000065695.V361477.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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