Random inspection report
Care homes for older people
Name: Address: Cliffdale Shrewsbury Road Pontesbury Shrewsbury Shropshire SY5 0QD two star good service 18/11/2008 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: Deb Holland Date: 2 3 1 2 2 0 0 9 Information about the care home
Name of care home: Address: Cliffdale Shrewsbury Road Pontesbury Shrewsbury Shropshire SY5 0QD 01743790261 01743792493 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Usha Odedra,Rajan Odedra care home 27 Number of places (if applicable): Under 65 Over 65 27 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 27 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 27 Date of last inspection Brief description of the care home Cliffdale is a private care home registered to provide care and accommodation for up to 27 older people. It is situated in the village of Pontesbury, some 8 miles south west of Shrewsbury, within easy reach of all local amenities and set in pleasant gardens. Accommodation is available on first and second floors accessed by a shaft lift. 1 8 1 1 2 0 0 8 Care Homes for Older People Page 2 of 9 Brief description of the care home Details about fees should be obtained directly from the home. Care Homes for Older People Page 3 of 9 What we found:
This unannounced inspection was carried out following receipt of an anonymous, detailed complaint which related to a number of areas of the operation of the home. The complaint stated that it was from an ex-employee who stated that they had serious concerns about practices at Cliffdale. The complaint was copied to other organisations, including Social Services, and it is understood that Adult Protection procedures will also be triggered. One of the areas of concern was whether people were being attended to appropriately at night, and whether residents have access to their call bells. We found that people we saw did have their call bells (this was at 10am) and people we spoke to did not raise any concerns about their care at night. We asked that the manager be particularly vigilant in talking to residents about their care at night, to consider ways of monitoring staff performance at night, and that the provider should make this issue a focus for their visits to the home under Regulation 26. The complaint also stated that people did not have access to professional support when needed. We found no evidence to support this, and there were instances described when residents had needed medical intervention recently and this had been sought. It was also suggested that medication was not being managed correctly, that there were mistakes in the homes records and that controlled drugs had not been disposed of. We found no evidence to support this; medication records seen were completed and there were no controlled drugs on site. The home had undergone a medication audit by Shropshire PCT in October 2009 and no concerns were identified. Staff who adminster medication attend an accredited course and only seniors deal with medication. This means at the moment that there are nights when staff do not have access to medication and could not give medication if required, for instance, painkillers. If this was needed, the manager would be called in. The complaint also stated that the quality of the food provided to residents was not good. We found no evidence to support this, the home purchases its food from local sources and the food store contained a wide range of good quality produce. It was also stated that activities do not take place. As our visit took place during the Christmas period, it was evident that lots of seasonal activities were taking place and it was identified through the residents fund that entertainment is brought in from time to time. The complaint described various problems with the facilities within the home, such as the availability of hot water and whether the homes lift is safe. We found that there had been a problem with hot water supply to the first floor but that this has now been resolved. The home does not have hand wash basins in all areas such as WCs but there are hand washing facilities close by for people to use. Work that was required following water leaks has been done. There are areas of the home which would benefit from refurbishment and re-decoration but these are not making people unsafe. We found that an engineer had been asked to check on the homes passenger lift and had certified it to be safe. There is work required in the kitchen to upgrade the facilities and make it easier to keep clean. Care Homes for Older People Page 4 of 9 The complaint raised concerns about staff conduct, particularly at night, which we asked the manager to investigate and monitor. The home has tried to recruit more staff, and at present some of the night staff do have limited English. We asked about their ability to deal with emergencies and were told that the manager is on call and would respond if there was an emergency situation. Because of staff leaving and absences due to sickness the home is short staffed and some staff are working long hours. It was stated that staff have been appointed without the appropriate checks being done. We looked at the recruitment files for the three most recent appointments to the home and found no evidence of this. Staff files that we saw were well organised and showed evidence of good recruitment practice, induction and training provision. Staff are due to do 1st Aid training in January 2010. It was suggested in the complaint that the residents fund was being used inappropriately. We looked at the accounts for the fund and found that it had been used for events such as buying quiz material, paying for entertainment and bingo prizes. It is also used to purchase a Christmas present for each resident. We saw the minutes of a residents meeting in October 2009 where people were asked what they would like to spend the fund on. The complaint also stated that residents were being put at risk through lack of health and safety measures such as checking the fire safety systems and providing badly fitting and unsafe bed rails. We found no evidence of these; although the fire safety file was a bit muddled it recorded regular checks were taking place and the bed rails that we saw were securely fitted, did not pose entrapment hazards and had protective bumpers. We have not made any requirements as a result of this inspection. There are some areas where we have asked that the manager be especially vigilant, particularly as it is acknowledged that there are staff shortages and some shifts may be covered by combinations where there is both limited experience and limited English. What the care home does well: What they could do better:
At the moment the home is suffering from staff shortages down to some people having left, sickness absence and a failure to be able to recruit. This has resulted in some shifts, particularly at night, being covered by staff who are less experienced and have a limited ability to communicate in English. The manager is conscious of these issues and is trying to manage the situation as best she can. There are on call arrangements in the case of emergency. None of the residents we spoke to during the inspection confirmed any of the concerns raised about staff conduct detailed in the complaint, but we have asked that the homes manager and provider be especially attentive to these areas and monitor them closely.
Care Homes for Older People Page 5 of 9 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 9 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 9 of 9 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
