Inspection on 20/03/06 for Clifftop

This inspection was carried out on 20th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Clifftop 02/08/07

Clifftop 03/10/06

Clifftop 30/08/05

Clifftop 16/02/05

Clifftop 22/06/04

Clifftop 04/03/04

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Clifftop 8 Burlington Road Swanage Dorset BH19 1LS Lead Inspector Gloria Ashwell Unannounced Inspection 20th March 2006 12:15 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 Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 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. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Clifftop Address 8 Burlington Road Swanage Dorset BH19 1LS 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) 01929 422091 01929 424299 Mrs Christine Harrison Mrs Patricia Pride Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Room Nos. 2 and 3 may be used as doubles. Date of last inspection 30th August 2005 Brief Description of the Service: Clifftop Care Home is a large detached Edwardian property set in its own grounds, overlooking the sea, on a prominent cliff top position in a quiet residential area of Swanage in close proximity to the town and local amenities. The home has been registered to Mrs Christine Harrison since 1996 and is personally run by her, together with registered manager Mrs Trish Pride. Clifftop is registered to accommodate a maximum of 32 elderly persons in 28 single rooms and 2 double rooms. All rooms have en-suite hygiene facilities and there is a passenger lift serving all floors. The home caters for residents with varying general needs related to old age, but does not provide nursing care other than that which can be met by the District Nursing Service. There are attractive views of Swanage Bay from the communal lounges and some bedrooms. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was one of the two statutory inspections required in accordance with the Care Standards Act 2000. The previous inspection was on 30 August 2005; since that inspection no complaints against the home have been received or investigated by the Commission. The inspector spoke to 10 residents and 2 visiting relatives, and together with the manager considered other evidence relating to the National Minimum Standards, as described in this report. In recognition of the circumstances and history of this home, which is known to routinely meet most National Minimum Standards this inspection was relatively brief in duration and focussed on discussion with residents and assessment of only the most essential standards. Standards assessed and found met during the previous inspection were not reassessed during this inspection; this report should therefore be read in conjunction with the report of the previous inspection. What the service does well: The home provides good care to residents who are mainly of low and medium levels of dependency. The premises are comfortable and attractive, with a spacious lounge, a conservatory and a separate dining room. Staff are kind and helpful to residents. Residents are treated with respect, their privacy is protected and they are encouraged and assisted to maintain contact with the local community. Residents feel safe and well cared for and enjoy living at Clifftop. Meals are appetising and of good quantity and quality. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 6 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. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 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 Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 is not applicable because the home does not provide intermediate care. When a new resident moves into the home they are provided with a statement of terms and conditions giving knowledge of the fees and what they do and do not cover. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them; the home then writes to the prospective resident confirming the ability to properly care for them. EVIDENCE: The inspector examined records of pre-admission assessment written by the manager when she assessed a prospective resident, from information provided by relatives and health and social care professionals. The records indicated that the needs and circumstances of the person had been comprehensively assessed. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 & 9 (Standards 8 & 10 were found met at the previous inspection) The standard is delivered in accordance with a written plan of care although the require improvement to ensure that staff have all information necessary to guide/direct their work. Medicine storage and handling is properly carried out to ensure that residents receive medicines as prescribed but arrangements for recording must be improved to ensure that all medicines held in the home are properly accounted for. EVIDENCE: Assessments of nutritional needs and skin care circumstances are not carried out so these essential aspects of information are not available to form the basis of the plans of care recorded for each service user. One of the care plans sampled made insufficient reference to the management of the service users diabetes, failing to state indications of possible deterioration in condition and the action to be taken in such event. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 10 This report contains a requirement for the improvement of care plans, to ensure staff have sufficient written information to guide and direct their work. Medicines prescribed by doctors are safely stored and carefully administered to residents by staff who have received training in this work. Medicine administration records (MARs) did not state Medicine administration records (MARs) had not been reliably completed to record each occasion of medicine administration (some charts bore a number of ‘blank’ boxes where staff had not signed to confirm the administration of prescribed medicine) and handwritten amendments to the printed MARs were not signed, dated and countersigned by a person who had checked the entry for accuracy. In addition to the requirement to improve medicine recording standards this report contains recommendations for the recording of a running balance for Temazepam, to ensure that amounts of this medicine received by the home can be properly accounted for, and for the recording of a list of each medicine prescribed for each service user, and the reason for this prescription. It is additionally recommended that a thermometer be kept in the medicine storage trolley, to ensure that the temperature does not become excessive. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 14 (Standard 15 was found met at the last inspection) The quality of daily life in the home is good with residents assisted to maintain contact with family and friends and to retain as much independence and control over their lives as possible. EVIDENCE: The inspector spoke to a number of residents and the visiting relatives of 2 residents; all expressed satisfaction with the home, including the meal provision, staff, premises and freedom of choice encouraged by the home. The response to the inspector’s enquiry of one resident if the home was satisfactory was “I wouldn’t be here if it wasn’t…. (Staff) couldn’t be more considerate…and of course you’ve got the wonderful views and the conservatory…(Food) is very good and you get what you want…” Visitors are welcome at any time and residents can go out of the home whenever they wish, and for as long as they wish. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 (Standard 16 was assessed and found met at the previous inspection) The home does not have an appropriate policy/procedure for the prevention of abuse although staff have received training in this subject. In consequence, although staff have received instruction they do not have appropriate written guidance to assist them in properly reacting to allegations or suspicions of abuse. EVIDENCE: The manager showed to the inspector a written procedure which provided incorrect guidance, directly conflicting with the accepted procedures as described in the Department of Health document No Secrets: www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolicyAndGuidance/Publication s The inspector explained the significance of the inaccuracies and the risks at which they placed residents. This report contains an associated requirement, and the recommendation that the registered manager and staff undertake training in the understanding of abuse, and its consequent management. Following receipt of the draft inspection report the provider wrote to the inspector stating “all staff have had accredited abuse training”. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 were found met at the previous inspection EVIDENCE: Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 & 30 (Standards 27 & 29 were found met at the previous inspection The home does not meet the recommended standard for at least 50 of care staff to hold a National Vocational Qualification in care but a number of staff are considered by the home to hold equivalent qualifications/experience. EVIDENCE: New staff undergo Skills for Care induction training. At present only 1 of the 9 care staff currently employed by the home hold a National Vocational Qualification in care; none are at present training for this qualification – the standard is for at least 50 of the care staff to hold an NVQ. However, the home employs 5 care staff from overseas countries and following receipt of the draft inspection report the provider wrote to the inspector stating that “their qualifications are to NVQ standard 3”. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 35 The registered manager is suitably experienced and skilled to properly undertake her role and responsibilities. Residents are satisfied with the home and feel staff care for them well and put them at their ease. The home has implemented a quality assurance system to ensure that residents remain satisfied with all aspects of the home. With the exception of the personal allowances of some residents, the home does not manage the finances of residents. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 16 EVIDENCE: The home periodically issues ‘user satisfaction questionnaires’ to ensure awareness of the opinions of service users. The home provides safe-keeping for small amounts of money for some residents, transactions are confirmed by receipt. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 17 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X X Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? Yes 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. Standard OP7 Regulation 15(1) & (2) Requirement The registered person shall ensure that residents care plans contain sufficient detail to provide clear guidance to staff on the actions to be taken to meet their care needs. The care plans of service users with diabetes must provide comprehensive reference and guidance to management of the condition. Comprehensive assessments including for nutritional and skin care needs must form the basis for care plans. Handwritten entries in medication instructions must be signed and dated by the writer and countersigned by a member of care staff who has checked the entry for accuracy. There must be robust evidence that medicines are accurately administered and recorded in accordance with the instructions of the prescriber and with current guidelines for the control and administration of medicines. DS0000026784.V286085.R01.S.doc Timescale for action 20/04/06 2. OP7OP7 13 20/04/06 3. OP9OP9 13 20/04/06 4. OP9OP9 13 20/04/06 Clifftop Version 5.1 Page 19 5. OP1818 13 The home must develop, implement and thereafter properly adhere to effective and appropriate Adult Protection procedures. A similar requirement was included in the previous inspection report; the timescale of 30/11/05 has not been met. 20/05/06 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. 2. 3. Refer to Standard OP9OP9 OP9OP9 OP9OP9 Good Practice Recommendations The home should record a running balance for Temazepam, to ensure that amounts of this medicine received by the home can be properly accounted for. The home should keep a list of each medicine prescribed for each service user, and the reason for this prescription. A thermometer should be kept in the medicine storage trolley. Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 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 Clifftop DS0000026784.V286085.R01.S.doc Version 5.1 Page 21 - 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!