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Inspection on 02/12/08 for Claybourne Residential Home

Also see our care home review for Claybourne Residential Home for more information

This inspection was carried out on 2nd December 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Claybourne is a care home that specialises in the care of older people with dementia. The environment is designed to give maximum opportunities for people to wander both inside and within the safe and enclosed gardens. Staff receive training to give them greater awareness and understanding of the needs of people who have dementia. Visitors told us: "The home is excellent and staff are caring and understanding". Peoples` needs are assessed before they come to live at the home. Assessment of peoples` needs, gives confidence that staff are aware of their needs and will be able to meet them. People are encouraged to visit the home prior to them deciding to come and live there. People receive good standards of care and support meeting their individual needs and choices. Health care needs are met by the home. People told us that the food is "good and a choice is always available". It is particularly noteworthy that staff are encouraged to eat alongside people living at the home and they describe the food as: "excellent". Activities take place every day and there are good links with community groups including local churches and schools. The Home has an experienced Manager who provides appropriate and effective leadership. The manager and staff act on any concerns that are made, giving confidence that people are listened to and feel safe living at the home. The homes has robust staff recruitment and selection, which minimises the risk of unsuitable people working at the home and protects people living there. Knowledgeable and friendly staff provide care at the home. Staff, are committed to caring for the people at the home. One person told us; "The staff are excellent and very caring".

What has improved since the last inspection?

The home has new care records which are "person centred" and more fully represent people`s individual needs, choices and capabilities. Requirements made at the previous inspection in relation to the storage of medicines have been met meaning that the home ensures that medicines are now safely and appropriately stored. Activities have been developed since the previous inspection. More activities are available for both groups of people and individuals who use the service.

What the care home could do better:

We have advised that instructions are available for medicines prescribed "as required" this will ensure there is less risk of any error. The Home Manager has told us of future plans and developments that she has identified for the home.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Claybourne Residential Home Turnhurst Road Chell Stoke-on-trent Staffordshire ST6 6LA     The quality rating for this care home is:   two star good 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. Lead inspector: Amanda Hennessy     Date: 0 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Claybourne Residential Home Turnhurst Road Chell Stoke-on-trent Staffordshire ST6 6LA 01782790500 F/P01782832642 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Rachel Starkey Type of registration: Number of places registered: Methodist Homes for the Aged care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: 45 DE(E) Minimum age 50 years on admission The Care Manager achieves the Registered Managers award by 31 March 2006 Date of last inspection Brief description of the care home Claybourne specialises in the care of older people who have a dementia. The home provides care and accommodation for up to 45 older people. The service is owned by the Methodist Homes for the Aged, (MHA), which is a national voluntary organisation. The ethos of the service is inspired by Christian values. Claybourne provides a high standard of environment and facilities for people with dementia. The accommodation is divided into three wings, each of which is equipped with a large lounge/diner/kitchen one unit also has a separate quiet lounge. Centrally there is a large open plan sitting area, used for activities and entertainment. People are able to move freely throughout the home and have easy access to the safe and enclosed gardens that surround the service. The service is situated in Chell, near Tunstall and is accessible to a wide range Care Homes for Older People Page 4 of 26 45 Over 65 45 Brief description of the care home of local community facilities. Car parking is available on site. As no information is provided in this report about fees the reader is advised to contact the service direct for this information. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. The means the people who use this service experience good quality outcomes. This unannounced inspection was carried out over one day by one Inspector and lasted seven and a half hours. Our previous inspection of this service was undertaken on 31st January 2008. Time spent visiting the service was seven and a half hours. As it was unannounced the service or the provider did not know we were going. Feedback at the end of the inspection was given to the home’s manager. Information for the report was gathered from a number of sources: a questionnaire- Annual Quality Assurance Assessment Care Homes for Older People Page 6 of 26 (AQAA) was completed by the homes manager and sent to us before the inspection; We looked at the premises, records and documents. We had discussions with the manager, care staff, people who live at the service and their visitors to gain their views on what it is like to live in and receive care at the service. We looked at how the service has responded to any concerns, how it protects people from abuse and how staff are recruited and trained. We also looked at the number of staff available to care for people who live at the home. Four people who live in the home were ‘case tracked’. Casetracking involves establishing people’s experiences using the service by meeting or observing them, discussing their care with staff, looking at care files, and focusing on outcomes of the care that they receive. Tracking peoples’ care helps us understand the experience of people who use the service. What the care home does well: What has improved since the last inspection? What they could do better: We have advised that instructions are available for medicines prescribed as required this will ensure there is less risk of any error. The Home Manager has told us of future plans and developments that she has identified for the home. Care Homes for Older People Page 8 of 26 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have required information to enable them to make the decision that the home is suitable to meet their needs. Evidence: All people who come to live at Claybourne Residential Home have a comprehensive assessment of their needs before agreement is made that the home would be suitable for them. People are encouraged to visit the home before they choose to come to live there. The Manager told us it is frequently their relatives who visit on their behalf. We saw staff showing people around the home during our visit. We also spoke to relatives who told us that they had visited the home before their relative had moved there. People told us: Claybourne was recommended to us. When we visited we were impressed by the empathy that staff show to people who live here. and We find that everyone is so Care Homes for Older People Page 11 of 26 Evidence: friendly. The home specialises in the care of people with dementia. We found that the environment and layout of the home, leisure opportunities available and staff knowledge and training supports this and will be further identified during this inspection report. The home does not provide intermediate care and does not intend to. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that their health and personal care will be based on their individual needs and their rights of privacy and, dignity will be respected. Evidence: We looked at care records for people who live in each unit. We found that following an assessment of needs a plan of care is developed. Care records seen gave good instructions for staff about peoples needs and how they should be met and are regularly reviewed. We found that care plans were person centred, this means that they reflected their individual needs, capabilities and choices. One persons care recorded identified: I can walk about unaided but will often attempt to sit on a chair only to miss it. Their plan of care went on to describe how staff should support the person to maintain their independence whilst also reducing the risk of them falling. Care records detailed what time people preferred to go to bed and get up: I like to go to bed about 11.15 but am unsettled at night which can mean that I am very sleepy during the morning. Care records also identified people preferences for male or Care Homes for Older People Page 13 of 26 Evidence: female staff to provide their care. The service has records to show how they monitor peoples health for example their weight, risk of pressures sores and difficulties eating and drinking. Care records also showed that people are visited by other health professionals such as Doctors, District Nurses, Chiropodists, Opticians and Dentists when needed. Relatives told us that they are always informed when their relative has been seen by a Doctor or other Health professionals. Yes they always get the Doctor quickly for Mum and let us know what the Doctor said. The management of medicines is good with improvements made as required since our previous visit to the service. Staff all have additional training to give medicines and then have a practical assessment to check and agree their competency. There is a record of all medicines that are received into the home, people have received or have been disposed of. We did advise that when medicines are prescribed as required, the instructions for these medicines should be clear which was not the case for two peoples medicines that we saw. Throughout our visit to the service we observed staff to be sensitive in their approach to people living in the home, treating them with respect and affording their rights of privacy and dignity. Relatives told us: I am always impressed with staff and how they treat everyone. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to make choices about their life at the home within their capabilities and are enabled to maintain relationships with their friends and relatives. Evidence: Records show that every effort is made to establish peoples social and recreational interests. We found that activities that take place in the home are centred around peoples interests. Activities and forthcoming events are identified within the homes monthly newsletter and are also displayed on noticeboards throughout the home. On the day of the visit people were involved in making hats for the Christmas party in the morning and a group ball game and a singalong took place for all units in the main foyer of the home. Other less formal activities include people living in the home involved with washing up and cleaning tables. The local vicar also visited and chatted to individuals. The service is owned by Methodist Homes for the Elderly. A Methodist chaplain visits the home each week although people from other faiths are welcomed and are able to receive the spiritual support that they choose. The home also has good links with a number of other community organisations including local schools and colleges. and Care Homes for Older People Page 15 of 26 Evidence: various local churches. The home also contacts the local advocacy service when appropriate to enable people to have a voice and a choice in their life at the home. Visitors told us that they are able to visit the home whenever they like and always find staff welcoming to them. We found mealtimes to be relaxed and unhurried. We saw staff to be attentive to peoples needs and gave assistance when needed. Dining tables were attractively presented with condiments available. There are at least two hot meal choices available at each mealtime. . We were also able to see those people who had a pureed meal had each element of their meal pureed separately making it appear more attractive. We were impressed as staff told us that they have their meals with the people. Staff described the food as: excellent . We also had a meal with people living at the home and found it to be delicious and all home cooked. People also told us: Yes I do like the food here. We were also told that people are able to make their own drinks and snacks at any time throughout the day and night. We did see people making their own drinks and a sandwich during our visit. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are listened to and can feel assured that the home will act in their best interests and protect them from harm Evidence: The home has a Complaints Policy which is followed in the event of any dissatisfaction. The complaints policy is displayed throughout the home. The Manager told us that she encourages people to use it for any concerns which cannot be immediately resolved by staff. The manager told us that she has had four complaints about the service in the last twelve months all of which were responded to within 15 working days. We have not had any complaints about this service. The manager told us that she monitors all complaints to ensure that lessons are learnt and required action is taken. All complaints about the home are also referred to the services governing board. The manager has told us that the home has a robust Protection of Vulnerable Adults policy that conforms with the Local Authority safeguarding policy. The service has a whistle-blowing policy and there is also a free phone facility for both staff and people living at the home to report any concerns. Staff are all trained in abuse awareness. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides suitable accommodation for people who live there, it is clean, homely, well maintained and a safe place to live. Evidence: Claybourne provides an accessible and safe environment that meets the needs of people who live there. The Manager told us that there is a rolling programme of decoration and maintenance. We found that all areas were homely, clean and pleasantly decorated and furnished.The home consists of three separate units leading off a large central recreational area. People living at the home were observed to move freely throughout the home. The three units are called Churchill, Wedgewood and Doulton and almost identical in style and design. Each unit can accommodate fifteen people. All bedrooms are single and have ensuite facilities. Each bedroom door has its own lock, door number and letter box and at the side of each bedroom door are photographs to help the occupant find their room. Each unit has a spacious lounge/ dining room with a kitchen area. One unit also has an additional small lounge. One visitor told us that his family were able to use this room when they had a birthday party for their relative. Care Homes for Older People Page 18 of 26 Evidence: The service has extensive enclosed and safe gardens where people living at the home are able to wander. The Manager has plans to convert an outside summer house into a small general store where people will be able to go and collect a paper or other items themselves. The garden also has bird tables outside each unit. People told us that they enjoy watching the garden birds and squirrels which regularly visit the bird tables. There is a separate main kitchen and laundry which we did not look at. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has knowledgeable staff who understand and meet peoples needs. Recruitment and selection procedures protect people using the service. Evidence: We found that the home have sufficient and appropriately skilled care staff who are supported by laundry, domestic and kitchen staff to meet the needs of people using the service. Staff we spoke to spoke fwere positive about support and training they receive and were knowledgeable of peoples needs. As already highlighted within this report we observed good staff personal interactions and relatives consistently told us about the excellent staff who work at the home. The home has 63 of its care staff with a care qualification (National Vocational Qualification level 2 or above) and is above the minimum requirement of 50 . The Manager has told us that this percentage will increase to over 75 once care staff currently in training complete their care qualification. This gives assurance that the home has knowledgeable and well trained staff. The recruitment of staff is completed to the required standards. All required checks are Care Homes for Older People Page 20 of 26 Evidence: undertaken before staff start working at the home such as criminal records check and references. The manager also keeps a record of staff interviews. This means that the home undertakes all required actions to reduce the risk of unsuitable people working at the home. We were told that new staff have induction training that meets Skills for Care standards. New staff also told us of training that they had to enable to fulfill their care role. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has effective leadership and appropriate systems in place to keep people safe. Evidence: Rachel Starkey has been the manager of Claybourne since 1st March 2007. She is a qualified mental health nurse, has considerable experience in the care sector and required management qualifications to manage a care home. The manager told us that she is supported by three Deputy Managers. The Manager sent us their Annual Quality Assurance assessment (AQAA) when we asked for it. The AQAA gave us detailed information about the service and told us of achievements that they had made in the previous year and areas that they wish to develop further. The Service has a quality assurance programme which includes the results of surveys of people using the service and their relatives. External audit of the service are also undertaken. The quality assurance programme identifies actions that Care Homes for Older People Page 22 of 26 Evidence: the service will undertake to further develop services that it offers. The service has appropriate arrangements in place for the safekeeping of peoples money when requested to. We found that there were records of all transactions and receipts were available to confirm that transactions. Staff told us that they have regular supervision and records seen also confirmed that that supervision covers all aspects of practice. The home has an up to date health and safety policy for safe working practice witin the service. Staff receive training and regular updates in all mandatory training. Maintenance contracts were randomly selected and were found to be up to date. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 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 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 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 9 There should be instructions available for when medicines are prescribed to be given as needed. Care Homes for Older People Page 25 of 26 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 © (2008) 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 26 of 26 - 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. 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