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Inspection on 11/12/07 for Cliff House Nursing Home

Also see our care home review for Cliff House Nursing Home for more information

This inspection was carried out on 11th December 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Cliffhouse House continues to provide a friendly, warm, and comfortable home for the residents. Several of the residents have been at the home for a number of years and stated they were happy and settled there. The home is generally well decorated and a comfortable environment is provided. One resident spoken to stated that it was not home but as near as you could get. Residents are able to personalise their rooms and bring in their own belongings. The residents were positive about the meals provided at the home and stated that they were provided with choice and variety The staff are supportive and the residents were positive about the help they receive in maintaining their independence. The home is run around the needs of the residents and daily routines are flexible. Residents have built up firm relationships with the care staff.

What has improved since the last inspection?

All the requirements from the previous inspection have been fully complied with by the time of this inspection. The Registered Provider continues to invest in the home. There have been no major service changes

What the care home could do better:

Continue with the investment and maintenance programme.

CARE HOMES FOR OLDER PEOPLE Cliff House Nursing Home Cliff Hill Clowne Chesterfield Derbyshire S43 4LE Lead Inspector Nancy Bradley Key Unannounced Inspection 09:30 11th December 2007 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 Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 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. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cliff House Nursing Home Address Cliff Hill Clowne Chesterfield Derbyshire S43 4LE 01246 810246 01246 570094 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) Springbank House Limited Tracey Jane Leech Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2006 Brief Description of the Service: Cliff House is situated on the outskirts of the village of Clowne, reasonably near to shops, public transport and other local facilities. The home is registered to provide personal and nursing care for up to 40 older people. Cliff House comprises an older, converted building with a newer purpose built ground floor extension. There are good views over the surrounding countryside and an accessible garden. Fees at the home range from £367.00 per week residential care care, and £513.30 per week for nursing care. Additional charges are made for hairdressing, podiatry and newspapers. This information was provided at the time of the site visit. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection and took place over six hours. The inspector spoke with the Registered Manager and members of staff on duty. During the site visit the inspector made a tour of the home, spoke with several residents and joined the residents for lunch. The inspection activity during this site visit was to assess the service against the key National Minimum Standards and these are identified through the report. There were thirty-five residents in the home on the day of the inspection; the home currently has a no vacancies. Additionally, time was spent in preparation for the visit, looking at the service history, the previous inspection report and the Annual Quality Assurance Assessment questionnaire. The home has an open door policy for family and friends. Records were examined relating to the residents and the general running of the home. The Commission for Social Care Inspection send out the “Have Your Say” questionnaires to residents who confirmed they were very happy at the home and were looked after by the staff. The Homes Statement of Purpose, Service user Guide and Commission for Social Care Inspection report are all displayed in the main entrance to the home. What the service does well: Cliffhouse House continues to provide a friendly, warm, and comfortable home for the residents. Several of the residents have been at the home for a number of years and stated they were happy and settled there. The home is generally well decorated and a comfortable environment is provided. One resident spoken to stated that it was not home but as near as you could get. Residents are able to personalise their rooms and bring in their own belongings. The residents were positive about the meals provided at the home and stated that they were provided with choice and variety The staff are supportive and the residents were positive about the help they receive in maintaining their independence. The home is run around the needs Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 6 of the residents and daily routines are flexible. Residents have built up firm relationships with the care staff. 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. The summary of this inspection report can be made available in other formats on request. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 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 Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that potential residents needs are fully assessed and met prior to admission. EVIDENCE: The records of four residents were examined including two residents assessed as needing nursing care and a resident recently admitted to the home. The majority of the residents who are admitted to the home have their needs assessed through the care management system or a hospital assessment if nursing care is required. Care plans had been produced from the assessment information. There was evidence on file to show that care needs assessments are reviewed on a regular basis by the referring agency. Discussions with residents during the visit confirmed they had received information about the home before moving. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 9 At present the home is not providing intermediate care as stated in Standard 6 of the National Minimum Standards. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning and review system in place, which ensures that residents’ individual needs are met. EVIDENCE: During the site visit the care records of four residents were examined in detail. Care plans are compiled following the initial assessment. Residents’ records included an individual care plan covering all the assessed needs of the resident. Care records provide sufficient information for staff to know how to meet residents care needs. There was evidence to show that care plans and risk assessments are review by the Registered Manager on a monthly base. Residents’ daily records were up to date. Discussions with residents confirmed that they were consulted about their care plans and had signed to show their understanding and agreement with the care planned. Residents are given the opportunity to be involved in the care plan review process. Direct observation and discussions with care staff confirmed they had sufficient knowledge about the care needs, personal preferences and wishes of the residents. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 11 The home had recently introduced a booklet for residents and their families to complete which detailed the important events in the residents’ lives, their personal likes and dislikes, social interests and people important to them. The personal care and health needs of the residents were recorded in care plans. Information relating to visits from health care professionals such as General Practitioners, Dentists, Podiatrists and Opticians were recorded. All the required documents had been completed; particularly assessments about areas of risk affecting the welfare and safety of the residents, for example falls, nutritional requirements and tissue viability The staff were observed routinely knocking on residents’ bedroom and bathroom doors before entering. The residents spoken with considered that the staff working at the home were good and that their privacy and dignity was respected. Conversations between residents and staff were appropriate and respectful taking account of any residents’ communication needs. The arrangements for receipt, storage, administration and disposal of medication were also examined and found to be satisfactory. There was a clear audit trail of all prescribed medication used at the home. The Registered Manager confirmed that the qualified nurses at the home administer medication. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides activities and stimulation in line with the wishes and preferences of the residents. The meals offer both choices, variety and cater for any special dietary requirements. EVIDENCE: There was an activities co co-ordinator at the home and there was evidence of a programme of activities, including entertainers, trips out to shops and the theatre, a regular exercises to music session, games, one to one discussions and a regular church service. Discussion with the activities co-ordinator indicated that she had a satisfactory understanding of the residents needs. Several of the residents stated they preferred to stay in their own rooms and watch television or read the newspaper. Residents spoken with during the inspection were very positive about living at the home. The daily routine is flexible and they were able to make decisions about how they spend their time during the day There are no restrictions on family and friends visiting the home and visits are recorded in the daily logs and visitors’ book. Discussion with residents confirmed that they were able to receive visitors either in their own rooms or in the main lounge area. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 13 The residents are all encouraged to personalise their rooms as they wish and bring in their own possessions. The inspector joined the residents for lunch and the residents stated they were very happy with the meals provided. Residents’ individual preferences were considered and condiments are routinely offered. Residents are made aware of menus, and have opportunity to comment on these. Catering staff indicated that they had sufficient knowledge to meet individual residents’ dietary needs Menu records were seen showing a balanced and varied diet, all meals provided by the home are recorded. Drinks and fruit are available throughout the day. Residents stated that they liked the changes being made to the dinning area. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to safeguard resident’s welfare and ensure that their concerns are listened to and acted upon. EVIDENCE: The home has its complaints procedure on display giving information to both residents and families. The procedure contains the current contact details, address of the Commission for Social Care Inspection and informs the complainants that they are able to contact the Commission at any stage of the complaint if they wish to do so. Discussions with the residents confirmed that they are fully informed about the complaints procedure and would have no hesitation in putting their concerns to the Registered Manager. On examination of the complaints record all complaints are responded to within a twenty-eight day period. The Commission for Social Care Inspection has received no complaints about the service since the last inspection. The home has a policy and procedures in place for the safeguarding of adults. Staff spoken with and records examined confirmed they had received training and were aware of the procedures to follow if an issue of safeguarding was suspected. As discussed with the Registered Manager the policy and procedures needs to be updated to reflect the changes of emphasise to safeguarding. There has been no reported incident of safeguarding of adults since the last inspection. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and well-maintained environment, which suits their needs and promotes their independence and privacy. EVIDENCE: The Inspector carried out a full tour of the home, accompanied by the Registered Manager. All communal areas were inspected together with staff facilities. Residents’ bedrooms were inspected with their agreement and all rooms had been decorated and furnished to their personal choice and were being personalised. The home was maintained to a good standard and the home had been decorated to provide a more homely feel. This includes attractive curtains at the windows, matching furniture, residents’ memorabilia and appropriate pictures. Residents spoken with at the time of the site visit stated they were very happy with the standard of accommodation provide at Cliff House. They particularly like the open plan lounge and new dining area. There is evidence to show that the Registered Provider is continuing to invest in the fabric of the building and as discussed with the Registered Manager the Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 16 carpet in the main foyer needs to be replaced and must be added to the refurbishment programme. Close Circuit Television is fitted in the entrance for security purposes only. The home has satisfactory hygiene and infection control procedures in place. The laundry was suitably equipped, clean and tidy. There was a mechanical sluice provided. Staff had received training in the control of infection. The home was very clean and fresh smelling throughout. Residents and visitors spoken with said the home was always clean. Staff training records showed that staff had received induction training and that all the required training was up to date. Staff spoken with confirmed that they had received training such as fire safety, safeguarding of adults tissue viability and moving and handling. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has robust recruitment policy and procedures in place, which protect residents. The home has an enthusiastic and effective staff team that works positively with the residents to improve their wellbeing. EVIDENCE: Staff rotas and discussions with the Registered Manager indicated that that there were usually five care assistants plus one qualified nurse on duty during the day and four care assistants and one qualified nurse on duty at night. An additional assistant is on duty during the late afternoons to provide help around teatime. There are also kitchen, domestic and laundry staff who work every day. The majority of the care assistants had either achieved or were working towards NVQ level 2/3 (National Vocational Qualification) in care. The Annual Assurance Assessment questionnaire returned before the inspection stated that 75 of care staff had already achieved the NVQ in care. This was well above the national minimum standard of 50 of care staff. The records of four members of staff were seen, including a newly appointed member of staff. The records had all the required information, including two written references, Criminal Records Bureau disclosure, photograph, and recent form of identification. There was evidence of good practice in Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 18 recruitment procedures, such as keeping interview notes and following up written references by speaking to the referees. The records seen were well organised and stored securely. As part of providing a full employment history applicants need to provide an accurate chronology of their work record with the days date month and year. From recent staff recruitment records examined, applicants were only providing the year in one instance. As discussed with the Manager when gaps in employment are investigated this should be fully explored and be formally recorded on interview minutes. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well organised home which is run with their best interest in mind. EVIDENCE: The Registered Manager and has been in post since April 2006. She is a qualified nurse and had several years experience of managing another care home for older people. Residents, visitors and staff spoken with were positive about the Registered Manager and expressed confidence in her ability to manage the home. The Registered Manager has a relevant job description setting her role and responsibilities. The home has robust quality assurance procedures in place. The Registered Manager carries out an annual quality assurance audit of residents and staff. Any issues raised are addressed by the home. The Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 20 Registered Manager reported that generally the responses are positive from both residents and staff. Personal money was held by the home for some residents who were unable to manage their own money and who had no relatives to do this for them. Since the last inspection, a regular audit of the records by the provider and the Registered Manager has been introduced. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. This was provided by way of the Annual Quality Assurance Assessment. Systems were in place for monitoring and maintaining the hot water temperatures. Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 21 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 22 NO Are there any outstanding requirements from the last inspection? 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. 1. 2. Standard OP19 OP29 Regulation 23 19 schedule 2 Requirement The carpet in the main corridor to be included in the refurbishment plan. All staff employed must comply with the home policy and procedures on recruitment and provide a full employment history Timescale for action 31/03/08 31/01/08 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 There should be formal evidence of the involvement of residents and their representatives in care planning and review. Review the safeguarding policy change the wording from abuse All applicants should provide the days date month and year when providing a full employment history. 2. 3. OP18 OP29 Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 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 © 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 Cliff House Nursing Home DS0000002051.V341944.R01.S.doc Version 5.2 Page 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. 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