Random inspection report
Care homes for older people
Name: Address: Clemsfold House Guildford Road Broadbridge Heath Horsham West Sussex RH12 3PW one star adequate service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Suni Chotai Date: 2 4 1 1 2 0 0 9 Information about the care home
Name of care home: Address: Clemsfold House Guildford Road Broadbridge Heath Horsham West Sussex RH12 3PW 01403790312 Telephone number: Fax number: Email address: Provider web address: clemsforldhouse@sussexhealthcare.org sussexhealthcare.org Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Shiraz Boghani,Dr Shafik Hussien Sachedina care home 48 Number of places (if applicable): Under 65 Over 65 0 0 dementia mental disorder, excluding learning disability or dementia Conditions of registration: 48 48 The maximum number of service users who can be accommodated is: 48 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - DE Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home Clemsfold House is registered to provide personal care for up to forty eight people. Registration categories allow for forty eight people who have dementia and mental disorder over sixty five years of age. This includes up to eight service users in the
Care Homes for Older People Page 2 of 9 2 9 0 9 2 0 0 9 Brief description of the care home category DE over the age of forty and under sixty five years. Current service users over the age of sixty five not falling within any other may still be accommodated but no others in this category may be admitted. The categories of registration will undergoing review by the South East Registration Team as part of the Modernising Registration Agenda. Clemsfold House is a detached property situated in a rural area about three miles from Horsham. It has a well maintained, accessible garden. Dr S Sachedina and Mr S Boghani privately own the service. Mrs D Holmes is the registered manager responsible for the day-to-day running of the home. The weekly fees for the home range from #492.24 to #650 for an ensuite single room, the CSCI was informed of the current fees on the 1st November 2007. Fees do not include charges for extra services such as chiropody and hairdressing. Details of these are available from the manager. Care Homes for Older People Page 3 of 9 What we found:
Suni Chotai and Geraldine Yates, both Pharmacist Inspectors from CQC inspected the medicines management in the home following concerns identified at previous inspections. We looked at medicine management policies and procedures of the home and found that some aspects lacked detail which was the practice of the home when asked but not included in the written procedures of the home. We found that the storage provision, although safe, was not adequate in amount of space available to meet the needs of the home. The medicine storage room did not allow access to some of the cupboards as it was full with medicine to go back stacked on the floor. The manager was informed to give this matter some consideration. The Controlled drugs cupboard was full at the time. Records relating to controlled drugs were complete and accurate. One record made by the local pharmacist was entered as per guidance for pharmacist which does not coincide with guidance for Care Homes. The home must ensure records are completed in accordance their own policies. We looked at training certificates of staff authorised to give medicines and saw that staff had had recent training on safe medicine handling. We checked 15 medication administration record [MAR] charts out of 36. We saw examples where medicines dosage directions were hand written which were not initialled and dated and on one such hand written dosage, we saw an error which led to an incorrect dose being given. We saw that medicine prescribed mid cycle and therefore hand written had not been transferred to the next cycle and therefore would be not given. When we asked about this medicine we were told that this medicine was given as staff knew that it was due but had not been signed for as given because there was no place on the chart to sign this. We saw that when medicines were prescribed to be given only when needed there were care plans around the use of these medicines, however this was not always the case. For one newly prescribed medicine, to be given only when needed, a care plan was not available to inform staff when to give this medicine. This medicine was prescribed as a variable dose and care staff would need guidance on what amount to give depending on observations noted. We saw that when medicines are regularly refused a review had taken place so that the doctor can reassess and if appropriate prescribe the medicine as it is given. We noted that records are kept of medicine received, carried forward to the next four week cycle or disposed off so that a audit would be possible. However the disposal record is completed just before medicine are removed for disposal from the home and not at the point when medicines are not needed. This could be a potential risk of abuse as the medicine would not be missed if misappropriated. When a variable dose is prescribed the actual amount given was not always recorded. The MAR charts had photos of the resident and a short information profile relating to them. Sample signatures of staff authorised to give medicines and codes to use for non administration of medicine were seen. We watched medicines being given to people at lunch time and saw that good practise was followed. Care Homes for Older People Page 4 of 9 What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 9 13 13 (2) The registered person 22/08/2009 must ensure that a record is kept of the amount of medication that is given where there is a variable dosage and why and when an as required medication is given and its effect. This will ensure that the individual receives the correct medication and helps to monitor their health. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 To ensure that hand written MAR charts are accurate before commencing the use of the chart So that the health, welfare and safety of people in the home is maintained 31/12/2009 2 9 12 To have a person centered care plan which includes information on medicine to be taken only when needed In order to give guidance to staff and so that there is consistency in the use of medicines 31/12/2009 3 9 13 To ensure that the medicine administration chart reflect the current treatment directions so that people receive the treatment that is prescribed for them by their doctor. 31/12/2009 Care Homes for Older People Page 7 of 9 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 Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 9 of 9 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
