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: Val Sevier Date: 2 9 0 9 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 10 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 10 What we found:
We carried out an unannounced visit to the home 29th September 2009 we arrived at 11.30 and we left at 3.30pm. The registered manager Mrs Doreen Holmes was available and assisted us with the visit. The reason for this inspection was to look for evidence that the home had complied with the requirements made following the last visit on June 22nd 2009, and to see if they had taken action in response to the serious concerns letter sent to the home following that same visit. We had made three requirements for action for the administration and recording of medication, one requirement regarding staff recruitment and the serious concerns letter was in relation to strong malodour at the home. What the care home does well: What they could do better:
The reason for this visit was to look for evidence that the home had complied with the
Care Homes for Older People Page 4 of 10 three requirements made regarding the administration, record keeping and availability of medication. You were required by the 22nd August 2009 to: 1) Ensure that medication is administered at the times and in the amount that it has been prescribed, or are reviewed to ensure appropriate medication is given. 2) 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. 3) Ensure that prescribed medication is always available for the individuals living at the home. We looked at the medication administration records for the dates of 31st August 2009 to 27th September 2009. We saw that the pharmacist from the chemist who supplies the medication for the home had carried out an audit on 18th August 2009 and had sent a copy of the report to the home. For one individual we saw that Zoplicone 7.5mg could be offered as needed to the individual. The manager Mrs Holmes told us that this could be given up until midnight. We saw that a code M had been used which meant make available. We asked what that meant and were told popped from blister pack and offered. If necessary this can be re offered if not taken. There was no record whether this had been re offered to the individual or outcome for example was the medication destroyed. We found there were six gaps where there was no record that medication had been offered or administered. We saw that the code F meaning other reason had been used for one individual who was prescribed Co codamol four times a day there was no explanation of what F meant. For another individual we saw that the medication administration records showed that the between the 31st August 2009 and 27th September 2009 there was one signature for Oxprenolol which was prescribed to be given twice a day. The signature indicated that it had been given once in the morning for that period. The manager and inspector checked the blister pack and found that the medication was gone. The manager also said that the individual concerned would tell the manager if they had not received their medication We saw that staff had recorded not needed for Movicol, which had been prescribed to be taken regularly, however there was no record of why staff felt it was not needed. One individual is prescribed Ketoconazole shampoo there were no signatures to indicate that it had been used, this was discussed with the manager. We saw that one individual was prescribed Omeprazole two tablets at night, we saw that between the 17th September and 22nd September F had been recorded and no explanation. We saw that for one individual they are prescribed Dipyridanole 200mg one tablet twice a day. We saw one occasion that E refused and destroyed code had been used. From the 1st September to 27th September we saw that code F had been used and that the
Care Homes for Older People Page 5 of 10 medication was unavailable. For the period of 28th September to the day of the visit the 29th September we saw that there was a signature on the 28th indicating that the medication had been given. We also saw a record for two days that 28th and 29th September that there was no stock of Viscotears for one person. We discussed these issues with the manager who confirmed to us that staff had had training in medication administration in March 2009 and had also had a training pack to update them over the summer. It is clear that the requirements have not been met and further action will be considered by the commission. 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 6 of 10 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 medication is administered at the times and in the amount that it has been prescribed, or are reviewed to ensure appropriate medication is given. This will ensure that the individual receives the correct medication and helps to monitor their health. 2 9 13 13 (2) The registered person 22/08/2009 must ensure that prescribed medication is always available for the individuals living at the home. This must be done to ensure the health needs of the individual are cared for. 3 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 Care Homes for Older People Page 7 of 10 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 to monitor their health. Care Homes for Older People Page 8 of 10 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 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 9 of 10 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 10 of 10 - 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!
