Inspection on 30/12/08 for Clevedon Court Nursing Home

This inspection was carried out on 30th December 2008.

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

Clevedon Court Nursing Home 11/01/07

Clevedon Court Nursing Home 18/03/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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 26/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Clevedon Court Nursing Home 32 Dial Hill Road Clevedon North Somerset BS21 7HN     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: Melanie Edwards     Date: 3 0 1 2 2 0 0 8 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 26 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 26 Information about the care home Name of care home: Address: Clevedon Court Nursing Home 32 Dial Hill Road Clevedon North Somerset BS21 7HN 01275872694 01275342444 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Clevedon Court Nursing Home Ltd Name of registered manager (if applicable) Mrs Gaynor Allen Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: May accommodate older persons (category OP) who require nursing care. May accommodate up to 43 persons. Date of last inspection Brief description of the care home The home is currently being renovated and upgraded. An extension to the side of the main building has been completed offering a very good standard of accommodation. Clevedon Court enjoys a quiet position that offers panoramic views over the town and bay. The accommodation is being upgraded to a high standard and two double bedrooms have been converted to increase the communal space and provide a new lounge and dining room. A passenger lift provides easy access to all areas of the home. A decked patio has been created to the rear of the home and a new office and staff room have been built adjacent to this. Smoking is permitted only in this staff room. The current fee range is around 650.00 pounds. Care Homes for Older People Page 4 of 26 care home 43 Over 65 43 0 Care Homes for Older People Page 5 of 26 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 met nineteen of the residents at the home. We met the deputy manager who was on duty, two registered nurses and Mrs Allen who was on leave but came in for part of the inspection.We spoke to four care staff and the cook. We spoke to them about their work and how they help and support the residents. We looked at four residents care records and care plans.We also read a range of records that relate to the day to day running and management of the home. We have refer to these records directly in the report. Care Homes for Older People Page 6 of 26 We saw the majority of the environment , the only areas that were not checked were a small number of bedrooms. We found that the home was operating within the required conditions of registration set down by us. The conditions of registration detail the type of care and the needs of residents and the numbers of residents who may stay at the home. 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 8 of 26 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 9 of 26 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. Residents have the information to make an well informed choice about living at the home. Residents are not provided with intermediate care at the home. Residents needs are being assessed and assessment records are being reviewed regularly to show needs can still be met. Evidence: To find out what information there is available about the home for prospective residents and their representatives, we looked at a copy of the service users guide and the statement of purpose. Residents and people who visit are given their own copy of the guide so they have information about life in the home. The statement of purpose Care Homes for Older People Page 10 of 26 Evidence: and the service users guide contain information about the service provided the qualifications of the staff employed, and the accommodation. The philosophy of the home and how the service aim to meet residents needs is also included. The complaints procedure is in each service users guide so residents know how to complain about the service. We read four residents assessment records to see how well needs are being assessed. The assessment records we saw contained a satisfactory level of information and showed the residents needs had been assessed. The actions taken to support the person had also been recorded in the assessment records. The assessment records we read were being regularly reviewed and updated. Assessment records are regularly reviewed as this information helps decide what care and support residents will need. We talked to the deputy manager about how residents needs are assessed. They explained that the home has a key worker system and a registered nurse will be allocated to take responsibility for residents nursing assessment and care plan. The home is not registered to provide intermediate care for residents. Care Homes for Older People Page 11 of 26 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. Residents care plans generally demonstrate how needs are met. Residents health needs are met. Residents are treated respectfully and are well supported by the staff. Evidence: We read in depth four care plans to see how residents are supported with their needs. We found the care plans to be reasonably informative and they showed how to meet the nursing needs of the person. The care plans set out what actions staff must follow to assist the resident to meet their needs. However we did not see any care plans to support the end of life care needs of residents. We discussed this with the deputy manager and we advised that where needed there should be a care plan to show how to support and maintain the quality of life for residents requiring end of life care and support. We did notice that the deputy manager was sensitive and very supportive to Care Homes for Older People Page 12 of 26 Evidence: relatives whose family member had recently died. We read a sample of residents daily records to see if staff monitor residents health and wellbeing. We saw a good level of information in the records to show staff do closely monitor residents health needs. However we saw entries in one record that were subjective and negative in tone and did not accurately explain what had been happening to the person concerned. We discussed this with the deputy manager and a registered nurse. We observed the registered nurses on duty providing leadership and guidance to the care staff they were working with. We also observed both registered nurses spend time with residents. Both registered nurses spoke to residents and assisted them in a patient and respectful way. We also saw the care staff on duty supporting and helping the residents with a really warm, kind and friendly attitude. We noticed that the staff and the residents have built up warm and close relationships. The residents we met gave us some good feedback about the attitude of the staff. For example one person said ,the staff are caring and efficient, another comment made was, the staff are very good and the staff are good. We noticed that the staff knocked on residents bedroom doors before they went into their rooms. This is a good way to maintain residents privacy. We checked in detail procedures for administration storage and disposal of medication. We did this to see if the systems are safe.Residents medicines are supplied by a local pharmacy and the staff said that they have good support from the pharmacy to help them manage medication. We checked the medication administration charts of six resident who live on the ground floor. We saw a photo of the person maintained with each record. This should ensure medication is administered correctly to the person named on the chart. The administration charts were up to date and in order. We saw that the Nurses had signed for medication administrated or recorded the reasons for any omissions. We checked the controlled drug record and this was in order. We checked one residents supply of controlled drugs.We found the records were correct. This helps show medication stock is well organised. Care Homes for Older People Page 13 of 26 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. Residents are provided with a nutritious and well cooked diet. Residents can do a variety of social and therapeutic activities that are suitable for their needs. Residents are supported to receive visits from family and friends Evidence: We noticed that the home had been really well decorated with Christmas decorations and Christmas trees.This is a really good way for residents to be able to enjoy the Christmas season in the home. The home employ two activities coordinator who five days a week. The activities co coordinators put on a range of activities for residents. We saw a timetable of social activities planned to take place. This helps to ensure residents are aware of current activities taking place. Activities that are planned for the near further include drives out into the community,arts and crafts sessions, games musical afternoons and one to one quality time spent with residents who are mostly in their own rooms. We also saw art works made by residents well as photos of social events on display in the home. There is also a library with a range of books for residents to read. Care Homes for Older People Page 14 of 26 Evidence: There is a hairdressing room used for residents hairdressing needs. There is a hairdresser who visits each week. We saw residents have visits from their family and friends during the inspection. Visitors told us that the staff are welcoming and friendly.We were also told that residents could have lunch with their visitors. The home has a relaxed and flexible visiting policy this benefits residents as this means they can keep in contact with family and friends. Residents who we asked told us that they are able to choose what time they get up and what time they go to bed. Residents said they are asked about the meal options and their likes and dislikes. We checked the residents menu to find out if residents are provided with a well balanced diet.The meal options seen were nutritionally well balanced and varied. There are alternatives available each day and staff ask residents what they wish to eat each day. Special diets can be well catered for and there are a variety of special meals provided for residents who need them. Care Homes for Older People Page 15 of 26 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. Residents complaints will be responded to promptly and taken seriously. Residents are protected from abuse. Evidence: Residents are given their own copy of the complaints procedure. We saw copies of the procedure in residents rooms. This helps to make sure residents have the information they need to make a complaint. The complaints procedure includes the contact information for us if a person wants to contact us directly. Residents we met told us that they see Mrs Allen daily and she walks around the home to see them. Residents said they could speak to her about any concerns they may have. There is a policy in place relating to the issue of protection of vulnerable adults from abuse. The policy is to help to guide staff to take the correct course of action if they ever have to respond to an allegation of abuse. We saw evidence that the majority of the team have done training in the understanding of the principle of the protection of vulnerable adults from abuse. The staff spoke knowledgeably about the subject of abuse and how they protect residents. Mrs Allen has booked the remaining staff onto safeguarding training to take place early Care Homes for Older People Page 16 of 26 Evidence: next year. Care Homes for Older People Page 17 of 26 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. Residents live in a safe well maintained and suitable place for their needs. Evidence: Clevedon court care home is a spacious building built over three floors that can be reached by stairs or lift. The building is over one hundred years old and it is situated in the town of Clevedon. The home is situated in its own contained garden area. The home is near to local shops a church and the sea. Residents we met spoke about how they like the home environment. We saw the majority of bedrooms and all the communal living areas. Rooms were satisfactorily decorated and maintained. The environment was clean and tidy throughout and we saw staff working hard cleaning the home. All the bedrooms are for single use and thirteen of them have en suite facilities. On the day of the inspection we saw building work taking place outside the home, to upgrade bedrooms to have more en suite facilities. We asked residents about the building work and none of them said they were at all troubled by the work taking place. We could see that residents rooms have been made to look more personal and homely with photos mementos and small items of furniture. We found the standard of furniture and fittings to be of a high standard. There are dining areas and a lounge on Care Homes for Older People Page 18 of 26 Evidence: each floor of the home . We saw residents were sitting in communal rooms and looked very relaxed and comfortable in the surroundings. We saw specialised equipment and adaptations are in place throughout the home to help residents and visitors who may have reduced mobility. Care Homes for Older People Page 19 of 26 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. Residents are cared for by a sufficient number of competent trained staff. Overall the recruitment procedures are safe and protect residents. Evidence: We looked in detail at the number of staff on duty to find out if there is enough staff to meet residents needs. We saw there are a minimum of two registered nurses and eight care staff on duty in the morning and two registered nurses and five care staff in the afternoon. At night there will be one registered nurse and three care staff on duty. There are domestic staff on duty most days,catering staff , a full time maintenance person and an administrator. Mrs Allen works full time and works a range of different hours and shifts to fit in with the needs of the home. We looked at training records of the staff team to see if staff are keeping up to date in their knowledge of the needs of residents. There was good evidence that staff had attended training sessions and updating over the last twelve months. We could see good information to show that day staff do a detailed and comprehensive induction program before they start work we could not see this information in the record of one of the night nurses on the day of the inspection. However Mrs Allen was able to provide us with this information after the inspection. Care Homes for Older People Page 20 of 26 Evidence: Many of the care staff have done NVQ in care training .Other staff are going to be booked on this training in the following year. This benefits the residents as it means care staff have done good training to help them to support people well. We checked the staff recruitment records of three staff to see if the home carry out the required employment safety checks on staff before they start work. We saw two references taken up for all new staff before they start work as well as criminal records bureau disclosures checks and protection of vulnerable adult first checks. This demonstrates residents are protected by the homes recruitment procedures. Care Homes for Older People Page 21 of 26 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. Residents live in a home that is well run. Residents finances would be better protected by improving the system for handling residents money Residents health and safety is satisfactorily protected. Evidence: Mrs Allen has many years of experience caring for people with a range of needs .She is a first level registered nurse. She has been the registered manager of the home for a significant number of years. We were told by a number of residents they see Mrs Allen every day and she will walk round the home and make time for them. This demonstrates Mrs Allen makes sure she is available for residents. Mrs Allen is supported in her work by a full time deputy manager who is also a registered nurse. Care Homes for Older People Page 22 of 26 Evidence: Mrs Allen reviews the quality of service using an audit system. We looked at the survey forms used to audit tool used was looked at. Mrs Allen has recently reviewed and audited the care and the service. We found that residents records were satisfactorily maintained, up to date, legible and in order. The records relating to the management of the home were also satisfactorily maintained up to date and in order. Individual records and the homes records were kept secure in the and are available to staff when needed. We have referenced other records elsewhere in the report. We checked the finance records of three residents .The home will hold residents money for safekeeping if needed to. We could see when we checked the records that the cash and record totals are kept securely. However the staff who take out money on behalf of the residents, are not always signing to confirm how much money has been taken out. We also saw that there are not always receipts for items bought on behalf of the residents. We advised that for the protection of the resident and the staff who handle the money there should be signatures and(where ever possible) receipts for the things that have been bought. We found that the environment looked satisfactorily maintained throughout. There are regular health and safety audits of the whole environment and equipment and furniture. The staff do health and safety training in range of areas including food hygiene fire safety and infection control.This helps staff maintain a good understanding of health and safety principals and practices. The kitchen staff have won a 5 star good food safe award from North Somerset Council Inspectors. This shows the kitchen staff follow very safe food hygiene practices. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 35 36 There must be a safe system 07/01/2009 in place for the handling of residents money on their behalf. Residents financial protection 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 2 7 7 Residents should have end of life care plans in place if needed. Residents daily records should be written in an objective and non judgemental way. Care Homes for Older People Page 25 of 26 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). 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