Inspection on 11/12/06 for Clifton Court

This inspection was carried out on 11th December 2006.

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.

Other inspections for this house

Clifton Court 06/02/08

Clifton Court 13/03/06

Clifton Court 19/10/04

Clifton Court 19/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Clifton Court Lilbourne Road Clifton On Dunsmore Rugby Warwickshire CV23 0BB Lead Inspector Martin Brown Key Unannounced Inspection 11th December 2006 10:30 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 Clifton Court DS0000004223.V301712.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. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clifton Court Address Lilbourne Road Clifton On Dunsmore Rugby Warwickshire CV23 0BB 01788 577032 01788 547915 di@cliftoncourt.freeserve.co.uk 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) Crosscrown Limited Diane Walmsley Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th March 2006 Brief Description of the Service: Clifton Court Nursing Home is a large care home situated in the village of Clifton upon Dunsmore, approximately 3 miles from Rugby town centre. The home was once a hotel, and is set in its own grounds with views across open fields at the back. The home is registered to provide care for 40 elderly persons over the age of 65years that require personal and nursing care. The home also provides shortterm respite care for service users in the same category. The accommodation is mainly single rooms; there are 3 double rooms. All rooms are en suite. The accommodation is over 3 floors, which can be reached by stairs or passenger lift. As the home was once a hotel there is a large reception area with large lounges and dining areas on the ground floor. The current fees range from £456 per person per week to £495. Newspapers, toiletries, hairdressing and chiropody are extra. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been made using evidence that has been accumulated by the Commission for Social Care Inspection. This includes information provided by the home, questionnaires returned by residents and relatives, and a visit to the home. Two feedback cards were returned by relatives, one was very positive, whilst the other, whilst generally positive, commented that she sometimes had to ask, rather than be told about, her mother’s care, and that sometimes it was ‘not easy to talk to someone’. Eleven questionnaires were returned from residents. These were generally very positive. All the respondents were unanimous that the home was always clean and fresh, whilst other questions, regarding getting good care and support, staff being available, activities being available, meals being enjoyable, and knowing who to speak to if unhappy about anything, got the response ‘always’ or ‘usually’ in approximately equal measures, with two people saying they ‘sometimes’ knew who to talk to, and one person only enjoying meals ‘sometimes’. One person thought all the staff to be very good, ‘bar one’. A number of people identified the ‘activities lady’ as someone who was good to talk to. The pre-inspection questionnaire was completed and returned by the manager. The inspection visit was unannounced, and took place on 11th December 2006, between 10.30am and 5.30pm. A tour of the premises was made, relevant documentation was looked at, staff and residents spoken with, and observations of the home in action were made. A sample of residents were ‘case tracked’, that is, their records and experience in the home were examined in detail. The manager was not present, so staff records were not available, but the nurses and senior care were helpful with information. The manager was spoken to at length, two days later, via the telephone, regarding outstanding issues arising from the inspection. Staff, management and residents were welcoming, helpful, and friendly throughout. What the service does well: The home provides a service much appreciated by residents in a tranquil spot with extensive views over fields and countryside. Several residents spoken said they enjoyed ‘nice views’ from their rooms. Residents were complimentary about the staff, who were observed at all times helping and responding to residents in a polite, respectful and friendly manner. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 6 Residents and visitors said that the service was friendly and accommodating to visitors. The atmosphere throughout the home throughout on the day of the inspection was positive and friendly, with support being provided in a discrete and unfussy manner. Where residents did have concerns, they were clear that these were in a context of overall satisfaction with the staff and the home. ‘Marvellous’ was a typical comment on the home. The home has previously won praise for its commitment and support in employing staff perceived to have disabilities. These staff were observed showing good practice, and comments from other staff and residents in this respect were positive. Residents spoken to were appreciative of the food and of the work of the activities organiser. What has improved since the last inspection? What they could do better: The home needs to ensure that all care plans are regularly reviewed and that changing health needs are clearly recorded so that actions necessary to meet them take place and are understood by all those involved. The home could be more ‘pro-active’ in finding out what issues concern residents, rather than waiting to be told. For example, the service may benefit by looking at why some residents feel that staff are less responsive to call bells at certain times, and whether the current dining arrangements are to the liking of all. Whilst the administration of medication was generally seen to be satisfactory, the service must ensure that medication is not kept beyond its expiry date, and is properly disposed of. Where residents have particular allergies, these must be clearly shown. The home is heavily reliant on the presence of the manager, and may benefit from a clearer structure in respect of who takes on responsibilities in the manager’s absence. The car park should be adequately lit, and in good repair. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 7 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. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 8 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 Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 9 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assessed to be sure that their needs can be met by the home. EVIDENCE: The assessment of the most recent admission was looked at and talked through with staff. This person had been visited and assessed by the home, an assessment had been received from the previous carer, and the home was able to demonstrate how needs could be met. Relevant assessment and preassessment information were in place. The resident had left the decision concerning the choice of home to her relatives, and this had been made on the basis of geography as well as care considerations. The person concerned confirmed that relatives had made the choice, and that she was agreeable to them making a decision in her best interests. Discussions with other residents during the inspection confirmed that geography was often a prime consideration in choosing the home, and that they had frequently trusted relatives to find a suitable home. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 10 One relative spoken to advised that following very poor experiences in two previous homes, she had chosen Clifton Court after checking out twelve others on her mother’s behalf, and found it to be ‘very good’ and was ‘100 certain that my mother is now in the right place’. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 11 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): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ health, and personal care needs are not always clearly set out in individual plans of care, and this can compromise the effectiveness of the home in meeting their needs. The majority of residents feel that their needs are well met by a caring staff team. EVIDENCE: A sample of four care plans was initially looked at, along with one other, where attention was drawn to particular care needs. Care plans are produced and reviewed by local social services workers on a yearly basis. Staff advised that all residents are social services funded and therefore receive yearly reviews. The manager later advised that there are some privately funded residents at the home, and that the home’s own, more detailed care plans cover these, as well as Social Services funded residents. All the files looked at had annual reviews, save for the person recently admitted. In additional to initial assessments carried out by the home, reviews of specific risks, such as mobility and wheelchair use, were seen, and areas of individual Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 12 concern, such as nutrition, were recorded on charts in a ‘score’ form and reviewed monthly. One resident spoken to had arthritis and foot problems. A doctor had visited and arrangements for follow-ups made, but the resident stated that nothing had happened since. The doctor’s visit was recorded in the resident’s file, under ‘visits by professionals,’ as having occurred at the beginning of the previous month. There was no evidence of the conditions being recorded as part of an on-going care plan. The nurse recognised that action regarding the doctor’s visit was now overdue and would arrange to follow it up. Another resident’s file showed an ‘acute care plan’ giving details of a condition and how it was being managed, while a relative spoken to said that the staff had managed her mother’s skin care ‘very well’. A sample of medication records was looked at. Medication is stored appropriately and dispensed by the trained nurses in a lockable trolley. There is now a proper, lockable, medication fridge for medication that is required to be kept at cool temperatures. Medication was found to have been left in the fridge in the staff room. This medication was seen to be out of date, and was then removed, ready for safe disposal. Medication Administration Record Sheets looked at were seen to be accurate in their recording of medication dispensed. There was a photograph of each resident in front of each set of records, showing their name, date of birth, and allergies. In the majority of cases looked at, ‘allergies’ was recorded as ‘nil’, with a few giving a specific allergy. In two records looked at, the space was left blank. The care plan of the person concerned, who had been at the home for over a year, clearly indicated an allergy to penicillin. The nurse amended this once she had confirmed this with the care plan. There was no information regarding preferred ways of taking medication, and no evidence that a person had given consent for the home to manage their medication. The nurse was aware of the purpose of most, but not clear on all, medications. Controlled medication was seen to be administered and recorded appropriately. Staff were seen to knock on people’s doors before entering. One staff switched on a light upon entering a room to bring in a cup of tea, only thinking to ask the occupant if he wanted the light on, on her way out. Staff were observed and heard to help and support people in a polite and respectful way, notably at mealtimes, where staff helping residents with eating did so discreetly and without hurrying people. One relative commented that ‘staff are very patient at mealtimes.’ Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 13 A call bell system operates in the home. Some residents said that staff do not always answer immediately, and that just before mealtimes was sometimes a difficult time to get a response. One person felt that staff would sometimes ask ‘what do you want?’ in a manner that indicated impatience. The majority of residents spoken to were full of praise for staff, and those that expressed reservations did so in a context of overall satisfaction. When a resident rang for assistance, a nurse responded in 45 seconds. Two people spoken to advised that they preferred to spend the majority of their time in their room. One person preferred her door to be open, and an automatic fire closure device has been fitted to enable this to be done safely. One resident raised concerns about a member of staff having been unpleasant on one occasion. This is dealt with under the complaints section. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 14 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): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home works, through its activities organiser, to organise both group activities and individually tailored activities to meet the needs of all residents. Residents can enjoy a variety of activities, both in groups and individually. There is always scope to offer a bigger and wider range of activities to suit everyone’s needs and to stimulate those most in need of it. Residents enjoy appetising meals, but some residents may be put off eating communally by the nature of the large, shared mealtime experience. Where someone’s cultural needs are markedly different to that which is usually met by the service, the service relies to some extent on support by relatives to meet those needs. EVIDENCE: The home has a full-time activities organiser. There is an activities folder which details individual residents’ likes and dislikes and responses to activities. The activities organiser talked of her current work, and how she was spending time on ‘reminiscence’ with one person to help stimulate her recollections. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 15 Residents spoke of outings and activities organised in the home. One relative, although broadly very appreciative of the home, felt that some residents would benefit from more musical stimulation and the greater involvement of children and dogs in the home. The manager later advised that visits by children and dogs, as well as musical entertainment, are regular features of the home. In the afternoon, a dozen residents were sitting in a lounge, with the television on, with only one person observed actively watching it, with the others either dozing or just sitting. There is a piano and an organ in the dining room, but I was advised, at present there is no one to play either of them. Residents and relatives said that the home was very welcoming to residents, always ready to offer drinks to visitors, and being aware of the importance and value of family and other visits to residents. The home is some distance from the local village, and from the town of Rugby, but a mini-bus is available for shopping and similar trips. A meal was taken on a table with three residents, who were all complimentary about the food. I was informed by them that a choice of main meal is offered, except on Wednesday and Sundays, when there is a roast, as ‘everyone likes roast.’ The choices on offer that day were both well presented, and the meal sampled was tasty. There was no choice of pudding, unless fruit or a diabetic option was required, but this was of no concern to anyone spoken to, who all said that they were happy with the puddings provided and with the choice offered at dinner and at teatime. One person remarked that it ‘was like being in a hotel’. Staff assisted those who needed help in a polite and friendly manner. Other residents noted this. A number of residents eat in armchairs, rather than dining chairs. These have castors, so they can be moved to the tables. There is one dining room, so that there are a large number of people eating together. Some residents prefer to eat in their own rooms. One resident said that the main reason he did this was because the meals, involve helping a large number of people into the dining room, helping people to eat where necessary, and helping them out again, could take ‘an hour and a half, sometimes’. He said he would be more likely to eat communally in a smaller setting. Residents spoken to said that drinks were provide at regular intervals throughout the day. This was not enough for one person, who wish for a ready supply of drinks, this is being resolved by the purchase of a flask for use in his room. The cook was aware of those people with special dietary requirements, and was able to detail how these were met. One person was a vegetarian. This was catered for, but the cook acknowledged that her family, who visited daily, often brought in foods particular for her cultural needs. Staff advised that conversation with this person was minimal, because they had no–one who spoke her language, but that she was able to make her needs known. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 16 Staff advised that the family visit daily, and that any confirmation is sought from them that everything is satisfactory. The consistent message from a number of staff was that the home was able to meet this person’s care needs, and that she expressed, through her family, her satisfaction with the home, and that she wished to stay at the home, and that their cultural and social needs were met through frequent contact with the family. The manager later advised that translators had been provided at reviews to ensure that this person’s views were independently presented. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 17 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): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although discussion with management and resident showed that complaints raised were responded to, there was little recorded evidence of this available. Residents, particularly those less able or willing to raise concerns, may benefit if staff and management are more pro-active in seeking out issues of concern to residents. EVIDENCE: The complaints folder was seen. This was empty. Residents spoke very positively of the staff and said that if they had any concerns they would speak to staff, a nurse or the manager about it. Residents filling in the questionnaires were positive about staff, although one wrote ‘couldn’t better the staff- bar one’. This resident spoke to me regarding an incident with a member of staff that she had then told another member of staff about, ‘although she didn’t want a fuss making’. She advised that this person had not been involved with her care since. Her complaint, I was told by the staff concerned, had been relayed upward to the manager. The manager advised, in later discussion, that this issue had been raised with the staff concerned and that suitable action had been taken, and recorded. The manager also advised that in many instances, residents did not readily raise issues that concerned them, or that issues raised were responded to and resolved by staff. An example of this concerned a resident who raised in the residents’ questionnaire the issue of wishing to have more drinks in the morning. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 18 This had been resolved by the provision of a flask. Another resident had told me her television reception was not very good. This was later resolved. There had been details of a complaint received earlier in the year. This had been resolved with the full involvement of Social Services. Again, the manager advised that she had full records of these stored securely and confidentially. Although recruitment files were not seen on this occasion, in the absence of the manager, it was noted on the previous inspection report that they had improved, and the pre inspection questionnaire filled in and returned by the manager indicated that all staff are properly recruited with satisfactory Criminal Records Bureau checks being requested and received from all staff. Staff spoken to were aware of whistle-blowing procedures and what to do in the event of abusive practices being witnessed or reported. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 19 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): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from a clean and well-maintained environment. A programme of maintenance is tackling current and anticipated shortfalls. EVIDENCE: The home was seen to be clean and well maintained during this unannounced inspection. Communal carpets were in good condition, save for the carpet on one stairway, used primarily by staff, which although not frayed, is faded and worn. The maintenance man, who was busy that day replacing fans, advised me that a programme of maintenance is in place, and that bedrooms are being re-carpeted and re-decorated when they become vacant, and he showed me one such room. He also advised that a program of window repairs is underway, with windows being replaced as required. One carpet runner was broken; I was advised that this was to be repaired within the next day. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 20 All open doors had alarm-activated closures on them. One resident was able to have her door safely left open with the addition of one of these. All toilets and bathrooms looked at were seen to be clean and tidy, those bedrooms of residents visited were clean and personalised according to individual wishes. Residents’ responses in questionnaires all stated, without exception, that the home was always fresh and clean. Staff explained the laundering and sluicing procedures satisfactorily. Sluice rooms were seen to be clean and odour free. The home was free from unpleasant odours. A slight odour was evident in some areas early on, but this had gone once the cleaning rounds had finished. Outside, there are a number of potholes near the car park, and damage to the verge, caused; I was informed, by lorries. The lights were not working in the car park, making it hazardous for pedestrians at night. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 21 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that they are helped by sufficient numbers of properly recruited and trained staff. The service could do more to ensure that staff responses to residents is speedy at all times. EVIDENCE: Two Registered General Nurses, with six care staff, and support staff, staffed the home on the day of the inspection. Staff were clear on their roles, with nurses dealing with medication and nursing issues and taking the management role in the absence of the manager/matron. A nurse advised that this was necessary as there was no deputy. A number of records could not be accessed in the absence of the manager. It was not made clear how such records could be accessed in the event of the prolonged absence of the manager. The manager later advised that the training manager would have access to these. Residents spoke very highly of the staff throughout; the only reservation was that at times there were not enough to answer call bells quickly. Residents’ general view was that this was because of particular demands on staff times, before and during meals, rather than any general shortage of staff. One relative commented on the staff tendency to toilet residents before the main meal, rather than after, and wondered whether this would be more beneficial the other way round. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 22 The NVQ assessor was in the home during the inspection, as part of her assessment. She advised that six people were currently undertaking NVQ level 2 as part of a strategy to have all staff qualified to that level. She commented that the home was ‘committed to training’ and that she had observed ‘good practice’ both in the home generally and in the kitchen, as part of her assessments. The pre-inspection questionnaire returned by the manager detailed satisfactory CRB checks. The manager, in a telephone conversation, advised that recruitment procedures are robust and that references are requested and kept for all new recruits. The manager also advised that the training manager carries out and records supervision six times a year, and that she herself does yearly appraisals on all staff. Records of these could not be seen on the day of the inspection, in the absence of the home manager and the training manager. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 23 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): 31,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service promotes and protects the health, safety and welfare of residents and staff. It was not entirely clear who was the senior person in the absence of the manager. EVIDENCE: The manager was not present during the inspection. The nurses on duty were able to answer many queries, but did not have access or knowledge to particular pieces of information. Staff, residents and relatives spoken to said that the manager is approachable and will listen to concerns. The manager later advised over the phone that quality audits and surveys were completed, but in the absence of the manager on the day of the inspection, these were not available. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 24 Questionnaires returned, and comments on the day of the inspection by residents and relatives showed a general satisfaction with the service. Residents’ finances are managed by themselves, relatives or legal advocates. The manager advised that they may handle small amounts of cash at residents or relatives request, and that that this is appropriately and accurately recorded. The pre-inspection questionnaire completed and returned by the manager stated that all required safety checks were up to date. A tour of the premises, discussions with staff and residents gave no reason to believe that the home was run and maintained in anything other than a safe manner. A staff accident book was available. Details of accidents concerning residents could not be located on the day of the inspection. The manager later advised that these were being audited at that time and had not been returned to their usual storage. She further advised that there had no falls requiring medical attention for over a year. The Commission in the last year has received no notifications of this type. Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 25 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? no 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 12,13 Requirement The registered manager must ensure that care plans describe each resident’s current needs to ensure that staff have clear accurate information. All medication must be stored appropriately, and appropriately disposed of when expiry dates have passed. The home must ensure that details of any allergies residents may have in regard to medication are accurately recorded in the medication folder. The car park must be made safe, by uneven surfaces being levelled, and by ensuring lighting is adequate. Timescale for action 17/01/07 2. OP9 13(2) 17/01/07 3. OP9 13(2) 17/01/07 4. OP19 23 17/02/07 Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 27 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 OP9 Good Practice Recommendations Brief details of the purpose of individual medication, and of residents’ preferences in respect of how it is taken, recorded in the medication folder would be of benefit to staff and residents. It is recommended that the home considers whether smaller eating areas might encourage more residents to eat communally. It is recommended that the home does further work to ensure it can meet the cultural needs of all its residents, and does not have to rely excessively on families for this. It is recommended that the red stair carpet be renewed. It is recommended that the service makes it more transparent who deputises and takes responsibility in the absence of the manager. 2. 3. 4. 5. OP15 OP15 OP19 OP31 Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Clifton Court DS0000004223.V301712.R01.S.doc Version 5.2 Page 29 - 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!