Inspection on 27/01/06 for Cleeve Court

This inspection was carried out on 27th January 2006.

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

Other inspections for this house

Cleeve Court 30/11/06

Cleeve Court 16/08/05

Cleeve Court 07/09/04

Cleeve Court 14/04/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Cleeve Court Cleeve North Somerset BS49 4PF Lead Inspector Alison Murray Unannounced Inspection 27 January, 2006 09:30 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 Cleeve Court DS0000020274.V270170.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. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cleeve Court Address Cleeve North Somerset BS49 4PF 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) 01934 876494 01275 464470 Cleeve Rest Limited Mrs Linda Susan Gill Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 29 persons aged 50 years and over requiring nursing care Staffing Notice dated 08/11/1999 applies Manager must be a RN on parts 1 or 12 of the NMC register Date of last inspection 16/08/05 Brief Description of the Service: Cleeve Court provides nursing care for up to 29 older people. The home is situated in the village of Cleeve, and can be accessed by car or bus. This would be required for easy access to local shops and social venues. The home is a converted older property, set within large, attractive grounds. It offers 22 single and 4 double rooms on three floors. A total of 9 rooms have en suite facilities. There is a lift for residents to all floors. Cleeve Rest Limited owns Cleeve Court. Mr Paul Bliss is the responsible individual for the company. He owns a number of care homes in the area. Mrs Gill was appointed as the home manager in February 2004. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive unannounced inspection. During the four hours spent in the home, the inspector spoke with 13 of the 26 residents. Staff were not formally interviewed, but observed as they went about their work. Some care records were reviewed, but the main focus of the inspection was the day-today experience of the residents. Mrs Gill, the registered manager was on holiday, so Mr Caine, the Operations Manager was in charge of the morning shift, and Mrs Knight, the deputy manager in charge of the afternoon shift. What the service does well: Residents feel that they are well looked after. They are confident that staff have the skills and knowledge to meet their needs. There was evidence of a good rapport between staff and residents. Residents are enabled to spend their time as they see fit. One person said that she had fancied ‘a lie–in’. Staff had given her breakfast in bed, and returned to help her wash and dress before lunch. The staff team is well established. They work together effectively, and have forged good links with local health professionals. The standard of support given to terminally ill residents is particularly good. The standard of accommodation at Cleeve Court is good. Rooms are attractively decorated in keeping with the character of the property. Residents are encouraged to personalise their rooms with pictures and small items of furniture. They said that repairs are carried out promptly. All those consulted were keen to praise the housekeeping staff. The home was commendably clean and tidy. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 6 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. Cleeve Court DS0000020274.V270170.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 Cleeve Court DS0000020274.V270170.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. Standard 6 does not apply Residents’ needs are comprehensively assessed before admission to Cleeve Court. EVIDENCE: Either Mr Caine or Mrs Gill visits prospective residents before they move into the home. During this visit, they tell the person about Cleeve Court, and assess their care needs. The records of a resident admitted since the last inspection contained evidence of a comprehensive assessment. Mr Caine had consulted with this person’s family and other health professionals to ensure that care needs were met. He had written to confirm that staff in the home were able to meet these needs. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 9 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, 9, 10 and 11 Residents feel that staff have the skills and competence to meet their health and personal care needs. The staff have forged good relationships with other health professionals to ensure that the residents have access to a good range of services. The standard of support given to terminally ill residents is commendable. EVIDENCE: A significant number of the current residents are very frail, and were being nursed in bed. They all looked very comfortable, and care staff were observed to visit regularly to check on their condition and offer drinks. Care charts confirmed that their fluid and diet intake was being monitored. All these residents were being nursed on pressure relief mattresses, although this was not reflected in the care records. There was a very good rapport between staff and residents, with lots of friendly banter between them. Residents said that all the staff were polite, and treated them with respect. All those observed during the inspection sought permission to enter residents’ rooms. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 10 Several of the residents have complex health needs. Care records showed that staff had taken advice from other health professionals to ensure that these needs were met. One person has been admitted for terminal care. The hospice staff visit regularly to offer support to the both the resident and staff. Records demonstrated that this resident had been actively involved in care decisions, and had negotiated with the GP and consultant what interventions would or would not be acceptable. This was well documented, so all staff were aware of the resident’s wishes. Another person has long standing leg ulcers. She said that staff are good at applying the compression bandages she needs. One of her legs has healed completely, whilst the other is progressing well. Care documentation was well completed, with evidence of regular reviews. A review of the medicine administration records confirmed good practice. Since the last inspection, Mrs Gill has carried out an audit of the residents’ nutritional needs. A detailed assessment has been carried out in respect of each person. Any identified needs, have been referred to the GP or community dietician, and remedial action taken. Staff gave examples of increasing protein intake to help wounds to heal, and adding butter or cream to increase the calorific value of meals, for those who needed ‘building up’. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 11 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, 13, 14 and 15 Residents enjoy the activities offered at Cleeve Court. Their family and friends are encouraged to visit. The standard of food provided is good. Residents who are unable to eat independently are given appropriate support. EVIDENCE: Residents said that they were able to arrange their day as they saw fit. One person told the inspector that she had ‘fancied a long lie’. Staff had given her a cup of coffee in bed, and then assisted her to wash and dress just before lunch. When the inspection started some of the residents were listening to a story tape in one of the lounges. Other residents said that they preferred to spend time in their room, rather than in the communal areas. They said that they were never made to feel a nuisance. An occupational therapist works in the home two days a week. She provides one to one activities with the residents. A community physiotherapist visits regularly. There is no formal plan of activities, but residents said that they really enjoy the parties and ‘special events’ arranged by the staff. Photographs of these were displayed in the entrance hall. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 12 All the residents said that family and friends are actively encouraged to visit, and take part in the day-to-day activity of the home. They appreciate the support of the local community. Residents said that they liked the food served at Cleeve Court. The lunchtime meal looked and smelt appetising. A large number of the residents require help to eat. Staff gave this assistance discretely, without appearing to be at all rushed. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 13 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 confident that any complaints or concerns would be addressed. EVIDENCE: All those consulted said that they would have no hesitation raising a complaint or concern if they felt it necessary. They were sure that Mrs Gill would do everything she could to address these. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 14 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, 22, 23, 24, 25 and 26 Cleeve Court provides good all round accommodation. The standard of housekeeping is commendable. EVIDENCE: Two maintenance workers were carrying out small repairs whilst the inspection took place. They said that staff record non-urgent problems in the maintenance book. They check this on each visit, and carry out the necessary repairs. Residents said that they rarely had to wait long to get things fixed. Accommodation is arranged over three floors. A passenger lift offers easy access to the majority of the home. A small number of rooms are accessed by a chair lift. Staff said that this is taken into account when residents are assessed. The home is attractively decorated, in a style in keeping with the age of the building. Many of the rooms enjoy views over the landscaped grounds and surrounding countryside. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 15 Individual bedrooms are well personalised. Many residents have chosen to bring pictures or small items of furniture to the home with them. Staff have arranged for equipment to be provided as necessary. One resident said that she had an electrically operated bed, so that she could sit herself up at night. Another person had a reclining armchair, so that she could sit in comfort. The home was commendably clean and tidy. Residents said that this was always the case, and praised the efforts of the housekeeper. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 16 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): Staffing levels meet the needs of the current residents. EVIDENCE: It was evident that staffing levels were appropriate to the needs of the residents. Staff said that they were kept busy, but still had time for a chat with the residents. During the inspection, call bells were answered promptly. Residents said that this was usually the case. Staff recruitment and training records were not inspected. Notices around the home indicated that staff have access to a good range of training events. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 17 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): These standards were not assessed. N/A EVIDENCE: N/A Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 18 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 4 DAILY LIFE AND SOCI4AL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 x 3 3 3 3 3 3 3 4 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations The use of pressure relief equipment should be documented in the care records. Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Cleeve Court DS0000020274.V270170.R01.S.doc Version 5.0 Page 21 - 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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