Inspection on 06/02/08 for Clifton Court

This inspection was carried out on 6th February 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Clifton Court 11/12/06

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 Patricia Flanaghan Key Unannounced Inspection 10:00 6 February & 12th March 2008 th 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.V345012.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.V345012.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 Ltd Ms Janet Elizabeth Pavlou Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th December 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. We were told that the current fees range from £436 per person per week to £532. Newspapers, toiletries, hairdressing and chiropody are extra. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by us is upon outcomes for people who live in the home and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. An ‘expert by experience’ participated in this inspection. This is a person who, because of their shared experience of using services, visits a service with an inspector, to help them get a picture of what it is like to live in, or use the service. The expert by experience takes the opportunity on the inspection visit to talk to residents, visiting families and staff. Their findings are also included in this report and used as evidence when deciding on the quality of service provided at the home. Before the inspection the manager of the home was asked to complete an Annual Quality Assurance Assessment (AQAA) detailing information about the services, care and management of the home. Upon the receipt of this a number of questionnaires were sent out to residents and their families to ask their views about the home. We received completed surveys from fourteen residents and eight relatives. Information contained within these surveys, plus the AQAA are detailed within this report where appropriate. Three people who were staying at the home were ‘case tracked’. The case tracking process involves establishing an individual’s experience of staying at the home, meeting or observing them, discussing their care with staff and relatives (where possible), looking at their care files and focusing on outcomes. Tracking people’s care helps us understand the experiences of people who use the service. Records examined during this inspection, in addition to care records, included staff training records, staff duty rotas, complaint records, health and safety records and medication records. We spoke with people living in the home, staff and five visitors. Residents were observed during lunchtime to ascertain choices given and to view meals made available. A tour of the home was Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 6 undertaken to view specific areas and establish the layout and décor of the home. What the service does well: What has improved since the last inspection? The manager told us in the AQAA that the following improvements have been made. • More activities have been introduced, • Improvement and changes to menus, • Regular meetings with minutes available in different formats, • Named nurses and choice of key worker, • Improved laundry service, • New carpets and decoration to rooms. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 7 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. Clifton Court DS0000004223.V345012.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.V345012.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. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The case files of three people identified for case tracking were examined to assess the pre-admission assessment process. The deputy manager said that it was usual for her or the manager to visit people who are considering moving into the home to undertake an assessment of their needs and abilities. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 10 Each of the files examined contained information gathered during a preadmission assessment that identified all of the person’s needs. The preadmission assessment is supplemented by a further assessment of long term needs on the day of admission. Files also contained pre-admission information provided by professional health and social care agencies and incorporated into care plans. One relative said in their completed survey; “When choosing a care home for my relative I found this one the most comfortable, friendly and homely one in the area.” Clifton Court DS0000004223.V345012.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 and 10 Quality in this outcome area is good. People living in the home are treated respectfully and are protected from harm by the safe management of medicines. Care plans are available for each of the identified needs of residents and staff recognise and respond to changes in the health and well being of people living in the home. This means that people living in the home can be confident their health and personal care needs will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are admitted to the home because they have been assessed as having a primary health care need that requires nursing care. In some instances there are additional needs that result from Alzheimer’s disease or other conditions of dementia. This was noted on one of the care planning records inspected. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 12 The deputy manager identified that the majority of people living in the home have medium or high dependency nursing care needs; this was confirmed by observation and meeting with residents. The case files of three residents identified for case tracking were examined. All the case files in the home have a standard ‘layout’ and are methodically structured in a way that allow staff ease of reference to information about each person. Each person had a plan of care, daily records and monitoring records. Care plans were generally based on information secured during the initial care needs assessment which is kept under review. Two of the care files contained a detailed profile about the person’s life history and enduring interests and relationships. This good practice should help staff to understand the background of individuals and assist them to give ‘person centred’ care. Each person had a plan of care with information about the actions staff need to take to meet most of their identified needs. Care plans are based on the initial assessment of peoples’ needs and there is evidence that they are reviewed and updated. Files examined included actions to meet the psychological needs of people with dementia. For example, one person had a care plan describing strategies to minimise challenging behaviour. This should enhance the quality of life for this person by reducing their agitation and anxiety. The home was able to demonstrate, through individual healthcare records, that residents were in regular contact with General Practitioners and other health care specialists whenever they need to be. Some people had bedrails in place and there was evidence that the decision to use them had been discussed with relatives and to demonstrate they are used in the best interests of residents. Care plans were in place to minimise the risk of entrapment. The systems for the management of medicines in the home were examined. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 13 A monitored dosage (‘blister packed’) system is used. Medication is safely stored in locked trolleys and a medicines fridge is available with daily recordings of the temperature which is within recommended limits. The medication of people involved in case tracking were audited and demonstrated that medicines had been accurately administered as prescribed. Medicine administration records were accurately maintained. The facility for storing controlled drugs (CD) is satisfactory. The contents of the controlled drug cabinet were audited against the controlled drug register and were correct. The home does not store excess medication. Arrangements are in place for the safe disposal of medicines that are no longer required. During observation of working practice it was evident that staff are knowledgeable about the likes and dislikes of people living in the home and were kind, caring and attentive towards them. The expert by experience noted that staff appeared to take a long time to respond to call bells. She commented: “A call bell was ringing continuously at one point. I timed this as three quarters of an hour. The Deputy Manager explained that the bell would ring on each floor when activated with all calls ringing on the main board outside the Office.” The expert by experience was asked to observe how staff treated residents. Her comments are as follows: “One member of staff observed speaking to resident from the bedroom doorway with resident in wheelchair at far end of bedroom; this caused the member of staff to speak loudly to the resident, for all to hear. In general I found staff treated residents with respect though some did not allow for choice. One example of this was when residents were brought into lounge area for exercise (this would have normally taken place in dining room but there was a staff meeting on so lounge was used) The lounge had become very crowded and a gentleman in an wheeled armchair with legs extensions on was being pushed into the lounge and on seeing a lot of residents in the lounge turned chair around and took him to his room via the lift, saying to another member of staff “he doesn’t take part anyhow”. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 14 Visiting relatives were asked about the standard of care being provided to the person they were visiting. Comments included they are all very kind and caring and they look after her very well, we have no complaints. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 15 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 and 15 Quality in this outcome area is good. The home has a planned programme of activities led by an activities coordinator so that people in the home can maintain their enduring interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs an activities co-ordinator for 30 hrs each week with responsibility for devising a programme of individual and group activities for the benefit of people living in the home. Residents were observed to spend time in the privacy of their own rooms or join others in communal areas for company or meals. We talked to the activities co-ordinator about the way she plans the programme of activities. It was evident that she had collected information about the interests of people living in the home and tried to plan activities to match their preferences. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 16 The expert by experience reported: “There is an Activities Co-ordinator who works every weekday, arrives before lunch time and assists with lunch and then carries out a number of activities in the afternoon. These consist of Bingo, Exercises, cake making, quizzes, card games etc. I was able to observe exercises being carried out and was impressed by the number of residents who took part, though unfortunately on this afternoon there was a staff meeting and exercises had to take place in the lounge which was a little cramped. There is a piano and organ in the dining room which is the normal place for activities. When questioned, those that were able to communicate said they enjoyed the activities. A Hairdresser attends the Home once a week, usually on a Friday. It was very evident that the more able residents had their hair done and the less able were looking untidy as if hair was not cared for.” A resident commented, “I like activities”, and spoke about how much she had enjoyed the Christmas celebrations in the home. In our surveys, we asked people if there were activities they could participate in and their responses were as follows: Q. Are there activities arranged by the home that you can take part in? Always 6 Usually 3 Sometimes 5 Never The expert by experience observed the lunch time meal. Her report is as follows: “The dining room is facing the front of the building, with a raised area near the windows; this is reach by two steps or a small ramp. There are arm chairs in this area. The dining room tables are mostly round seating four or five residents. These tables have plenty of space between them, with bright yellow table clothes and some with baskets of silk flowers in. Condiments are also on each table. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 17 Those residents in wheelchairs are left in these whilst having their lunch, and the residents in Armchairs with large castors on are also wheeled into the dining room and stay in their chairs to eat lunch. The only covering to protect clothing is small serviettes, and for those residents requiring help with feeding, this is not always adequate. The Meal on the day (Wednesday) was a lamb roast, which appeared to be enjoyed by all. (They have a choice of meals; the cook goes around all residents in the afternoon to ask what they would like for the next day’s main meal). Cold drinks are also available at lunchtime. Tea or coffee is available mid morning and mid afternoon, but I ascertained that if residents want a drink at any other time they only have to ask. Some residents (the more able) I observed had their lunch time drink in a glass were as the less able had very old looking plastic mugs. There are a number of residents who like to have their meals in their rooms, though this is often due to health problems. The dining room is near the kitchen, and residents from all three floors are brought down to the one dining room. I observed the lunch time meal and spoke with several of the residents, all of whom said they enjoyed the food and it is good. Staff told me that they have a Roast Meal on Wednesdays and Sundays and a buffet tea on these days. I did observe care staff trying to feed two residents at a time. The Fire Door for the dining room is a double door with cross bar opening, behind vertical blinds, leading to the front of the building and driveway. The more able residents I observed used this meal time as a social event, having a chance to chat to friends in the Home.” People told us in the surveys returned to us: Q. Do you like the meals at the home? Always 9 Usually 4 Sometimes 1 Never Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 18 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 and 18 Quality in this outcome area is good. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a formal complaints policy which is included in the service users guide and is accessible to residents and their relatives. Residents were observed to be familiar with the senior staff on duty and felt confident to make requests. This suggests residents would be confident in raising concerns with staff. We received one complaint about care and environmental issues in the home and this was referred to the manager to investigate. We saw evidence that the concerns received by the home had been appropriately investigated and the complainant was satisfied with the outcome. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 19 The home maintains a complaints register. We examined this and found that two complaints have been recorded since the last key inspection. These were investigated within the home’s complaints policy timescales. The residents who expressed their views during the visit remarked they had no complaints about how they were being cared for and neither had any of the relatives who also commented. There is a policy and procedure detailing the action to be taken by staff to ensure the protection of vulnerable adults. The information guides staff on the procedures to follow if they saw or suspected evidence of abuse. Staff interviewed demonstrated an awareness of the procedure to be followed when responding to allegations of possible abuse. Staff remarked that they had never had cause to be concerned about the care and support given to residents. There have been no safeguarding referrals made to Social Services about any of the people using this service. Training records show that the majority of staff have received abuse awareness training. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 20 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, 24 and 26 Quality in this outcome area is adequate. People living in the home are provided with comfortable surroundings to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People can choose to spend time in a number of communal areas; the large reception has a seating area, two lounges and a dining room. The home is traditionally furnished and decorated to a satisfactory standard although parts of it is worn and in need of refurbishment or replacing. Some armchairs looked grubby and would benefit from renewal. We observed residents making use of all of the communal areas and moving freely around the home throughout the day of this visit. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 21 The rooms of people involved in case tracking were viewed. We saw that residents had taken the opportunity to personalise their space with their own belongings such a small pieces of furniture, photographs and soft furnishings. Each room looked as though it ‘belonged’ to the person living in it. The quality of the furnishings and fittings in residents’ rooms varied but were generally satisfactory. The expert by experience noted that “ there is an urgent need for a storage area for equipment and areas of maintenance to knocked corners of rooms and corridors. Fire Doors leading into bedrooms are looking very tatty. The carpets on the upper floors are in urgent need of replacing and the outside of the building required decorating.” A range of adaptations and equipment are available to meet the assessed needs of residents including hoists, adjustable height beds, accessible baths and shower rooms, although grab rails were not available along all corridors. Call systems in rooms are accessible to residents. Specialist pressure relieving mattresses were available for those people with an identified need for them. The laundry room is equipped with sufficient commercial equipment to manage the soiled laundry for the home and is satisfactory for the control of infection. Residents clothing appeared well cared for. One relative told us, “my mother’s clothes are always clean, which means they (staff) must be looking after them.” There was protective clothing such as gloves or aprons in the laundry room ensuring the risk of spreading infection is minimised. The home has dedicated ancillary staff who keep the home very clean and free of unpleasant odours. As this is a home that provides nursing care there are strict protocols in place to ensure that the prevention of cross contamination and infection control are well managed. Staff were observed to wear disposable gloves and aprons when carrying out personal care tasks and regularly washed their hands. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 22 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 and 30 Quality in this outcome area is good. There are sufficient numbers of staff on duty to meet the needs of people living in the home and robust pre employment checks safeguards people from risk of harm from abuse. This judgement has been made using available evidence including a visit to this service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff within the home were observed to be friendly, caring and supportive to residents and there were many positive comments made about the staff both during the inspection and within comment cards received from residents and their relatives. • • “All the staff are very good, very nice” “The girls are marvellous, always smiling” On the day of the inspection visit there were 3 registered nurses and 6 care staff on duty, plus an activity organiser, 2 catering staff, 3 housekeepers, a maintenance man and an administrator. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 23 A sample of staff files were reviewed to check the adequacy of the recruitment Procedures. The personnel files of two recently recruited staff were examined and both contained evidence that satisfactory checks such as Criminal Record Bureau (CRB), Protection of Vulnerable Adult (PoVA) and references are obtained before staff commence employment in the home. Robust recruitment procedures and pre-employment checks should protect the vulnerable people living in the home. Files contained evidence that new staff follow an induction programme. The home has a training coordinator who is allocated one day per month to undertake ‘in house’ training, source external training opportunities for staff and monitor the progress of training targets for the home to make sure staff have the necessary knowledge and skills to care for people living in the home. A training matrix is maintained and this demonstrates that mandatory training is available in fire safety, moving and handling, food hygiene, infection control and abuse awareness. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 24 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 and 38 Quality in this outcome area is good. The manager is committed to improving the service and providing good quality care for the people living in the home and has developed good systems for seeking the views of others to support this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is a first level registered nurse and is suitably qualified to run the home. She is experienced in the care of older people. The deputy manager is also a registered nurse and both the manager and deputy are committed to providing good quality care for the people living at Clifton Court. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 25 At the time of the inspection visit the manager had been seconded to a ‘sister’ home and the deputy manager assisted us with the inspection process. We met with the manager after the initial inspection visit and gave her a brief feedback. Regular recorded residents’ meetings are held. The minutes of the meeting held in October was seen and the deputy manager said management had addressed or were addressing some of the suggestions raised by residents at the meeting. A further meeting was planned for 08/02/08 when the management wished to implement some changes to the staffing of the home. At this meeting residents and their families felt the proposed changes were not beneficial to the residents. The home agreed not to implement any changes, but would work with residents, families and staff on how best to rotate staff within the units without compromising on the quality of care provided to residents. This shows us that the views of people who use the service is promoted. The personal monies of people living in the home are kept securely in separate bags and accurate records of income and expenditure are kept. An audit of two residents’ personal monies was found to be correct. We obtain information on the AQAA before inspections. This information includes confirmation that all necessary policies and procedures are in place and are up-to-date. These are not inspected on the day but the information is used to help form a judgment as to whether the home has the correct policies to keep residents’ safe. A sample of records were examined to assess the home’s systems for maintaining equipment and services. These were all in order. We saw people being transported in wheelchairs without footrests being attached. This compromises the safety of the people being transported by increasing the risk of entrapment of a person’s feet or legs if they are unable to hold them up while the wheelchair is moved. The home needs to undertake an assessment of all wheelchairs in the home to be carried out and suitable footrests attached. For people who refuse to use wheelchair footrests safely and appropriately, risk assessments must be carried out for each individual person. Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 26 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 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 2 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 3 X X 2 Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 27 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 OP38 Regulation 13(5) Requirement Safe care practices related to moving and handling must be used at all times. This includes: • Residents must be transferred in wheelchairs safely. Footplates must be fitted to wheelchairs. • Risk assessments should be completed for residents who request not use footplates when using a wheelchair. These practices could result in injury to residents if not carried out appropriately and safely. Timescale for action 30/04/08 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 OP10 Good Practice Recommendations The support needed by residents at mealtimes should be DS0000004223.V345012.R01.S.doc Version 5.2 Page 28 Clifton Court assessed so that the need for any additional staff or aids to help them eat their meal in a way, that maintains their dignity is identified. 2 OP10 Care and attention should be given to residents clothing and appearance to ensure that they are clean. This will protect residents from the risk of cross infection and support them to maintain their dignity. Details and plans for ongoing refurbishment in the fabric of the home, updating of the décor and replacement of furniture should be maintained in the home. This will ensure that residents are living in a homely, attractive and well-maintained home environment. The car park must be made safe, by uneven surfaces being levelled, and by ensuring lighting is adequate at all times. 3 OP19 4 OP19 Clifton Court DS0000004223.V345012.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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.V345012.R01.S.doc Version 5.2 Page 30 - 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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