Inspection on 24/02/09 for Clere House

This inspection was carried out on 24th February 2009.

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.

Other inspections for this house

Clere House 20/10/06

Clere House 19/01/06

Clere House 30/08/05

Clere House 01/03/05

Clere House 09/09/04

Clere House 02/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Clere House Pippin Close Ormesby St Margaret Great Yarmouth Norfolk NR29 3RW     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: Andy Green     Date: 2 4 0 2 2 0 0 9 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. that people have said are important to them: They reflect the things 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 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 24 Information about the care home Name of care home: Address: Clere House Pippin Close Ormesby St Margaret Great Yarmouth Norfolk NR29 3RW 01493731291 01493733180 clerehouse@norfolk.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Norfolk County CouncilCommunity Care care home 22 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Clere House is a single storey, residential care home providing care and accommodation to up to 22 older people and is owned and run by Norfolk County Council. All bedrooms are single rooms and contain a washbasin and there is communal use of an adapted, walk-in shower room, two bathrooms, eight toilets, two lounges, conservatory and a large lounge area that is divided into two areas and a dining room. There is a small, well-kept garden with seating in a patio area to the front and the rear of the property and roadside parking. The home is situated in a residential area, within the rural village of Ormesby-St-Margaret. Local amenities include shops, a Care Homes for Older People Page 4 of 24 Over 65 2 20 0 0 Brief description of the care home medical centre, post office and pubs. There is a bus service to both Great Yarmouth and Norwich. Care Homes for Older People Page 5 of 24 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: We, the Commision for Social Inspection, undertook an unannounced inspection on 24th February 2009. The home completed an AQAA (Annual Quality Assurance Assessment) which is a self audit tool to give the home an opportunity evaluate how they are meeting standards and regulations. We spoke with the manager, care staff and residents to gather their views regarding the services offered in the home. A number of records were inspected including care plans, training records, staff files, medication records and fire testing records. A tour of the building and grounds was also undertaken. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? 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 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 7 of 24 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 8 of 24 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. The admission procedure and written information enables residents and staff to make a decision on whether the home can meet assessed needs . Evidence: The home has a Statement of Purpose, Service User Guide and Terms and Conditions. The Service User Guide has been recently reviewed to ensure that it contains relevant and up to date information. The home ensures that as much information as possible is obtained from a prospective resident, their family and other professionals so that the persons needs can be fully met. The prospective residents family or friends are welcome to visit the home during the assessment period, and the manager or one of the care coordinators often visit residents in their own home. Residents are admitted on a one-month trial basis. There were twenty one residents in the home on the day of inspection. Residents spoken with confirmed that they had visited the home prior to admission Care Homes for Older People Page 9 of 24 Evidence: and that they and their relatives had received information about the home. Relatives also confirmed that staff had made them feel very welcome when visiting the home. Care Homes for Older People Page 10 of 24 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. The personal care and support needs of residents are recorded in care plans which are regularly reviewed. Evidence: Four care plans were inspected and they contained a variety of relevant health, social and personal care information. Each care plan had an information sheet including a photograph, next of kin, GP and care manager details. Individual personal care is divided into clear sections giving staff guidelines regarding the required care needs. Examples included;mobility,weight records, bathing, continence, dietary requirements and assistance with eating, sight & hearing, foot care and skin care reviews. Visits from health care professionals including speech & language therapist, GPs, district nurses, physiotherapists, community psychiatric nurses, dentist,occupational therapist and optician are separately recorded. The staff complete daily records of care and support given during the day. Care Homes for Older People Page 11 of 24 Evidence: Risk assessments are in place including moving & handling, bathing, environment, and accessing the community.choices, past history, list of falls, visiting professionals, and the signature of the resident. End of life wishes are also recorded. Medication policies and procedures were seen and a member of staff was observed safely administering medication and the records held continue to demonstrate that medication is administered, recorded and stored correctly. When administering medication the staff member wears a tabard stating Do Not Disturb Whilst Giving Medication. It was noted that one of the residents is currently refusing all medication and the GP and community psychiatric nurse are aware of this and are working with the home to monitor the situation. This is recorded in the residents care plan. Residents spoken to said that staff were kind, friendly and treated them with respect both when providing care and when socialising with them. Two relatives visiting the home were also positive regarding the care and support they had seen being provided in the home. Care Homes for Older People Page 12 of 24 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. There are social and creative activities and a choice of meals that provide to reflect the preferences of the residents. Evidence: Daily activities are reviewed with residents at the residents meetings. Examples of activities included singing, reading newspapers, paid musical entertainers, hairdressing, board games and quizzes. The manager stated that it was often hard to motivate residents to do more than watch the television. Staff spoken to said that they always tried to sit and talk to residents or organise an activity. However, the workload and variety of care needs of the more frail residents could often reduce social time with residents. It is recommended that the manager research creative ways in which activities can be improved and that a dedicated activities coordinator could be beneficial for the home. Visitors to the home are welcomed and two relatives spoken with were positive and complimentary about life in the home and found the staff encouraging and friendly. They both commented that the meals in the home were of good quality. Care Homes for Older People Page 13 of 24 Evidence: The food provided continues to be of a good standard and residents spoken with stated that they enjoyed most of the meals. Special dietary needs are recorded and catered for. Observation of the main meal, menus and records revealed that they were balanced, wholesome and varied and that records were kept of any alternatives provided to aid in the monitoring of the nutritional health of each resident. The cook consults on a regular basis with residents and staff and she has undertaken nutritional screening training. Care Homes for Older People Page 14 of 24 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. The home has an active procedure on the protection of vulnerable adults that protects residents and supports the investigation of any cause for concern. Evidence: There has not been any complaints received by the home or CSCI since the last inspection and records demonstrated that any concerns or complaints would be investigated with the appropriate action taken. The residents spoken to and their relatives stated that if they ever had reason to complain they would speak to staff or the manager and felt confident that the problem would be resolved efficiently and to the satisfaction of all involved. The legal rights of residents are protected and records demonstrated that some residents have advocates and are encouraged to take part in the local and national elections by voting. Residents are protected from abuse, neglect and self-harm by the objectives, policies and procedures of the home which are also in line with local authority safeguarding procedures. Personnel records showed that staff continue to have regular training in safeguarding adults to ensure that they can recognise, prevent and deal with any potential abuse appropriately. Conversations with staff indicated that they would have no hesitation in reporting any abusive behaviour. Care Homes for Older People Page 15 of 24 Evidence: Care Homes for Older People Page 16 of 24 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 standard of the environment within the home is satisfactory and provides residents with an attractive, safe and homely place in which to live. Evidence: A tour of the building was undertaken and showed that residents live in a home that is comfortable and decorated to a reasonable standard in most areas. Since the last inspection of the home a new bathroom has been built which has improved facilities for residents. The lounge and eight bedrooms have also been redecorated. A new conservatory has been added adjoining the dining area which provides further communal space and access to the garden area. A new hoist which, incorporates a weighing scales, has been purchased which has proved to be extremely helpful for residents and staff. A number of residents bedrooms were seen and they were clean, tidy and personalised to suit the individual residents preferences. Residents confirmed that they found their bedrooms and general environment to be comfortable and homely. Relatives also confirmed that the home was clean, comfortable and met their relatives needs. The laundry room has been refurbished including new flooring, decoration and a new washing machine and tumble dryers. Care Homes for Older People Page 17 of 24 Evidence: There is a part time handyman who works five hours per week and he attends to minor repairs and refurbishments. However, there are still areas in some corridors where some of the walls are cracked, chipped and worn or tired looking. The manager stated that these areas are due for refurbishment during the next few months. Care Homes for Older People Page 18 of 24 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 homes procedure for recruitment and training of staff provides safeguards to offer protection for the people living the home. Evidence: The home ensures that there are robust recruitment procedures in place. Personnel records evidenced that apprpriate checks are carried out. Criminal Records Bureau checks, references, application form, personal details, proof of identity and a photograph of each staff member were seen to be held in the files of five staff members. The manager also stated that any gaps in employment are pursued during the interview process. There is an ongoing programme of training which is coordinated via the local authority. Records demonstrated that staff members have a variety of experience and skills and examples of training included; safeguarding adults, health & safety, food hygiene, medication, first aid and fire safety. The manager stated that courses in NVQ at level 2 and 3 were in place and that the majority of staff were NVQ trained. Two staff spoken with confirmed that they received an induction and ongoing training throughout the year. Care Homes for Older People Page 19 of 24 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 manager provides leadership, guidance and direction to staff to ensure that residents continue to receive a good standard of care. Evidence: The manager continues to provide supportive leadership with the assistance of senior care staff. She has been in post for ten years and has achieved NVQ level 4 and the Registered Managers award. She has a NEBS management qualification and is completing an NVQ level 3 regarding supporting people at the end of life. Residents, relatives and staff stated that the home was well run and records demonstrated that residents are protected by the management and administration procedures carried out in the home. Policies and procedures have been produced and a sample were seen regarding the services provided. Staff spoken to stated that they enjoyed working as a team and that they received Care Homes for Older People Page 20 of 24 Evidence: supervision every two to three months to ensure that their work practice and development is continuously monitored and recorded. A Quality Assurance system is in place that takes into account the views of everyone living, visiting and working in the home however. Last years quality audit generated an action plan and examples included; staff supervision, improvements to the lighting and redecoration. The manager continues to monitor financial budgets for the home in conjunction with Norfolk County Council who are the providers of the home. The servicing and testing of all equipment had been carried out and relevant and timely certificates were held to ensure that the health and safety of residents is protected. Suitable fire alarm and emergency lighting checks are in place. Care Homes for Older People Page 21 of 24 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 22 of 24 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 12 It is recommended that a wider range activities are provided to meet the needs of the residents. Care Homes for Older People Page 23 of 24 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 © (2009) 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 24 of 24 - 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!