Inspection on 30/11/05 for Clayfield

This inspection was carried out on 30th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Clayfield 07/09/06

Clayfield 15/02/06

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Clayfield Clayfield 3-4 Clayfield Villas Victoria Road Barnstaple Devon EX32 8NP Lead Inspector Andy Towse Unannounced Inspection 30th November 2005 12:15 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 Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 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. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Clayfield Address Clayfield 3-4 Clayfield Villas Victoria Road Barnstaple Devon EX32 8NP 01271 374066 01271 374066 clayfield@piltonia.supanet.com 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) Mrs Lynette Sylvia Hollick Mr Antony John Hollick Mrs Lynette Sylvia Hollick Care Home 12 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (12), Old age, not falling within any other category (12) Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14/2/05 Brief Description of the Service: Clayfield was formerly two Victorian houses which have now been converted into one residence. The home is well maintained both internally and externally. It is situated within easy access of the resources of Barnstaple. The home is registered for 12 older adults who may also have dementia or mental health problems. Accommodation is on two floors which are accessible to all residents by either stairs or a chair lift. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. Information contained in this inspection was obtained from discussion with the proprietors, staff and residents as well as from documentation, including care plans kept at the home. The home has been under new management for the relatively short period of under three months. During that time the new owners have started to introduce a key worker system, upgrade care plans and prepare policies and procedures as well as initiate some changes in the physical environment, such as an additional wc downstairs and a dishwasher for the kitchen. What the service does well: What has improved since the last inspection? What they could do better: Taking into consideration the short time at which the new owners have been managing the home much has been accomplished and those areas where Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 6 improvement would be beneficial have already been identified by the owners. Examples of this are the installation of radiator covers, automatic closers for some fire doors, and keys for bedroom doors. 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. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 7 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 Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home ensures that it can meet the needs of residents by carrying out its own assessment and taking into account assessments carried out by relevant professionals. EVIDENCE: The files of three more recently admitted residents were inspected. They all contained assessments. In one instance the admission had been from hospital leaving little time for the home to arrange an assessment prior to the admission. This resident was by necessity assessed by the home on the day of admission. However this resident’s file also contained comprehensive shared assessment documents which had been compiled by professionals such as an occupational therapist, a staff nurse and a psychologist. Relatives of this resident visited the home to view the room prior to the admission. Other files contained pre-admission assessments which had been compiled by the registered manager. The registered manager is introducing a new system of care plans, including, where appropriate, separate night care plans. Care plans covered personal Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 9 care, diet, oral health, continence, foot care, sight, hearing and communication and were written in a format which included a description of the problem and its causes, goals of care, the steps needed to achieve the goals and the signature of the staff member who had compiled the report. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 10 Care plans showed that residents’ health, personal and social care needs were being addressed and that care practices ensured that residents were treated with respect. EVIDENCE: The new manager is introducing care plans. These were seen on all the resident’s files which were examined. They are comprehensive and, where appropriate separate night care plans have been compiled. There is in place a system for reviewing the care plans each month. Discussion with staff showed that they were involved with the care plan review and that this was an integral part of their key worker responsibilities. As stated, this is a new system of care planning and is an improvement on the existing system. Residents currently do not sign their care plans to show their involvement and agreement to them, however this was discussed and will become a feature of the system when it becomes more established. When asked, a staff member said that if residents wanted to see their care plans they would be allowed to do so. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 11 Care Plans showed that there was a focus on promoting resident’s health. Records showed that the home used advice and support from a healthcare professional to facilitate the treatment of a resident’s pressure sore. A resident with diabetes receives an appropriate diet. There is reference in care plans to resident’s oral health, continence and mobility. Resident’s are encouraged to be involved in their own healthcare and one resident was able to show details of forthcoming hospital appointments and was clearly knowledgeable about her health needs. Residents have a choice of general practitioner. Care plans stated the term of address preferred by the resident and staff were aware of this and complied with it. Residents can use the home’s cordless phone to make and receive telephone calls in private. To ensure privacy the bedroom which is shared has a set of screens. Residents can choose how they want to dress, but a staff member said that staff would be available to advise and assist if required. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15 Residents are encouraged to live as independently as they are able EVIDENCE: Residents are encouraged to be as independent as possible and to lead as valued lives as they are able, which was seen by residents, often assisted by staff, carrying out domestic tasks around the home. The home continues, with some adaptations, the activities set up by the previous owners, details of which are displayed in the library at the home. This comprised a list of activities which would be available on a daily basis and included arts and crafts, dominoes,, memory games, sing-a-longs, scrabble and ‘weather permitting’ assisted walks. The library itself comprises a quiet area off the main dining room, where there is an accessible and very large collection of large print books which are available for all residents to use. The home has contacts with the local church to enable residents to continue their religious observance. The home would arrange for any resident who wished to attend church. The registered manager prefers not to hold money on behalf of residents, preferring that residents take responsibility for their own financial affairs, or if that is not feasible, relatives do so. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 13 Residents can bring in items of furniture and any other artefacts of sentimental value. Observation of bedrooms confirmed this. The registered manager operates a flexible menu system. There is choice at every meal time. All residents can eat in the dining room, but can eat elsewhere if that is their choice. Residents are asked each day regarding their choice of meal and specialist diets, such as those for diabetics, are available. Residents spoken to confirmed that they enjoyed the food available. Tables were seen to be well presented. The dining room itself is well furnished and provides a pleasant setting for meals, with staff assisting being courteous and polite to those dining. The new owners have increased the seating arrangements so that all residents can now, if they choose, dine in the dining room. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents’ are protected by an appropriate complaints procedure and the owners’ commitment to staff training relating to the protection of vulnerable adults. EVIDENCE: The new owners have drawn up a new complaints procedure. It is currently a draft format. It includes timescales, contact details for the CSCI and the right of the complainant to contact the CSCI at any time during the complaint process. In addition the home has a complaints and compliments book in the dining room in which residents or visitors can put down their thoughts. This Standard was not fully inspected as part of this inspection. However the new owners have a commitment to training. Training packs have been developed for staff. These were seen to contain information about the Protection of Vulnerable Adult. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24, 25, 26 The home is a well maintained environment which meets the needs of residents. Issues such as the absence of door locks to bedrooms and safety guards to radiators have already been identified as areas by the new owners, which need attention. EVIDENCE: This home is well maintained both internally and externally. It is situated within easy access of all the facilities of Barnstaple. It has a rear, enclosed courtyard which is paved and has flower borders and seating arrangements. In the summer it is a quiet and accessible haven for residents. The registered manager has a plan for improvement within the home which does include fitting locks to all bedroom doors. Since her arrival a new and separate wc has been installed on the ground floor and a dishwasher in the kitchen. The additional wc means that there are now two wcs on the ground floor which is more suitable to the needs of residents. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 16 Furnishings and carpets are of a good quality throughout the home and there is a high standard of hygiene and cleanliness throughout. The laundry is bright, clean and spacious. It is however accessed mainly through the dining area. The registered manager said that all laundry brought through the dining area was first placed in plastic bags to ensure there was no risk of contamination. This was seen to be the case when two staff were seen, separately, taking laundry, which had been bagged, through the dining area. Previously, a deep freezer had been sited in the laundry. In the interests of hygiene the new managers have placed it elsewhere in the home. Residents have free access to all communal areas of the home and can choose when to seek the privacy of their own rooms. Bedrooms were seen to meet their needs and to have been personalised in a manner chosen by their occupants. Although bedrooms do not currently have keys the registered manager has made enquiries regarding this and intends to install these as part of her programme of developing the home. One bath was clearly seen to have been fitted with a temperature control device to protect residents and the other baths were said to have had this safety device fitted. The home was warm and comfortable throughout. However, it was noticed that radiators in bedrooms were not covered. The owners were aware of this and intend to rectify this situation. They have in the meantime ensured that the potential of injury is reduced as all beds are situated away from radiators. The manager intends to risk assess residents and install radiator safety covers commencing first, with those residents most at risk. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,29 Staff are benefiting from the commitment to training demonstrated by the new owners. Whilst the safety of residents is protected by no staff working unsupervised until they have police checks, staff files still need further information in order for them to meet National Minimum Standards requirements. EVIDENCE: The new manager has a commitment to training. She is using staff training workbooks compiled by Edexcel. The workbooks contain information relating to the care of older adults. The content of the workbooks is linked to NVQ units so will assist the home’s intent of having staff trained to NVQ 2 level. Currently of the 12 care staff employed at the home, three have attained NVQ level 2 and a further staff member is working towards NVQ level 3. The files of recently appointed staff were inspected. Whilst police checks had been applied for these had not yet been returned. Staff for whom CRBs had yet to be received did not work unsupervised. Whilst all the files contained requests for two references, in one only one reference was available. Staff files did not contain copies of birth certificates or passports as required by legislation. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,35, The home is run by a competent manager whose experience in care and training is complemented by her academic qualifications. EVIDENCE: The registered manager is a qualified nurse, a qualification complemented by an honours degree in health care. She has attained her NVQ level 4. She was the registered manager of a large nursing home caring for older adults for over two years prior to purchasing Clayfield. The registered manager does not take responsibility for resident’s personal allowances or other monies. These currently are the responsibility of either the resident or their relatives. When relatives are responsible for a resident’s monies the home invoices them for such services ie chiropody. Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 19 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 X X 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x 3 3 3 X x 3 1 3 STAFFING Standard No Score 27 X 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X x Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 20 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 OP25 Regulation 13(4) Requirement That pipe work and radiators in bedrooms are guarded or have guaranteed low temperature surfaces and that such work is undertaken using risk assessments identifying those most at risk and safeguarding them as a priority. Staff records should contain details as required under Regulation 17 (2) Schedule 4, which includes receipt of two written references and copies of items of personal ID. Timescale for action 31/03/06 2 OP29 17(2) Sced 4 31/01/06 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 Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 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. Extracts may not be used or reproduced without the express permission of CSCI Clayfield DS0000065556.V259413.R01.S.doc Version 5.0 Page 22 - 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. 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