This inspection was carried out on 21st June 2005.
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.
CARE HOMES FOR OLDER PEOPLE
Clifton Manor Residential Care Home Rivergreen Clifton Nottingham NG11 8AW Lead Inspector
Sharon Rosenfeld Unannounced 21 June 2005 09:30 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 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 Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Clifton Manor Residential Care Home Address Rivergreen Clifton Nottingham NG11 8AW 0115 984 5859 0115 984 5859 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) R & K Care Limited Mrs Deborah Kelly Andrews Care home 46 Category(ies) of OP Old age, x 46 registration, with number of places Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: NONE Date of last inspection 14 December 2004 Brief Description of the Service: Clifton Manor Care Home is a purpose built unit situated within a housing estate in a suburb south of Nottingham city centre. The accommodation is on two floors with access provided by both stairs and a lift. The home is adjoined to Clifton Manor Nursing Home which is registered separately by the Commission for Social Care Inspection (CSCI). Local shops are close by as are public transport services to Nottingham. The home provides accommodation and personal care to a maximum of 46 older people over the age of 65 years. Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection mainly focussed on the standards relating to the residents perceptions of the quality of acre provided. Evidence of the quality of services was gathered by direct and indirect observations of care practice, through conversations with four residents, and the Registered Manager. The main method of inspection used was called case tracking which involved selecting four residents and tracking the care they receive through the checking of their records, discussion with them and observation of care practices. What the service does well: What has improved since the last inspection?
Some of the requirements set at the previous inspection have been positively actioned. A review has taken place of the manual handling plans and risk assessments. The arrangements to ensure good communication systems are in place between District Nurses and the staff at the home has been developed and is contributing to better health care for the residents.
Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 6 The system for securing controlled drugs at the home has improved. 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. Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 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 standard(s) 1, 3. The Statement of Purpose does not provide information in sufficient detail so as to leave the purchaser of care in no doubt about whether or not the home is suitable and able to meet their particular needs. New residents move into the home without being assured their needs can be met. EVIDENCE: The Statement of Purpose was updated on 8th March 2005 however it does not clearly describe the range of needs the home provides services for. It does not tell the reader about the specific arrangements in place for residents to engage in social activities, hobbies and leisure interests; for respecting their privacy and dignity; for consultation about the operation of the home; the fire precautions and the arrangements for dealing with reviews of care plans. The number and sizes of the rooms in the home must also be recorded in this document. One person was admitted outside of the registration category of the home. Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 10. The care plans generally cover all aspects of assessed need. Consultation and greater detail about how individual needs are to be met is however required. The staff do not consistently follow the directions written in the care plan relating to falls management and this could put individuals at risk. One resident said their healthcare needs are consistently well met. Not all residents spoken with feel that they are treated with dignity and respect. EVIDENCE: Four residents files were examined. All of them contained pre-admission needs assessments and care plans. The care plans seen corresponded with assessed needs. One person is registered blind. This care plan could be expanded to include the involvement of specialist organisations and the arrangements of the health authority to monitor this deteriorating condition. The care plans relating to personal care are generic in nature and therefore do not demonstrate that consultation has taken place with residents to determine their preferences about how their care needs are met. Nor do they offer
Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 10 specific instructions to carers on the action they must take to meet individual personal care needs. This must be addressed as care plans are reviewed. One person falls regularly. There is a care plan to address this however the footwear worn by the individual was poorly fitted. The Registered Manager has information about the Falls Prevention team based at the local hospital and contact with this agency must be made to validate current care practice in relation to falls prevention. The records confirm involvement and referral of a range of external healthcare professionals to meet people’s assessed needs. One person said they felt well cared for by the staff and safe at the home. One person confirmed that staff acted in a manner that preserved his right to privacy. This person receives help from younger female staff with bathing and stated that staff’s consideration for his feelings has helped him to accept this degree of intimate support. One person feels happy with the accommodation but unhappy about the manner in which staff address her at times. The Registered Manager was informed about this persons concerns and the need to promote a culture whereby staff clearly understand and adopt the values of privacy and dignity within their everyday practice and develop positive professional and personal relationships with all residents was highlighted. Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14. The Statement of Purpose does not inform people of the arrangements that are in place for their social, cultural, recreational and occupational preferences to be met. This means that people do not have a clear idea about what is on offer and what commitment they can expect from the home. EVIDENCE: The residents spoken with stated they choose how to spend their time and whether to participate in the activities run by the home. One person said they would like to go out more often and that friends and relatives are relied upon to provide these opportunities. One person said the home ‘sometimes provided suitable activities’. The information in the Statement of Purpose is not specific about the actual arrangements that are available for residents to decide about and engage in social and recreational activities. Two people said that relatives are welcome to visit at any time and can participate in all aspects of the home life if they wish. Feedback from one relative confirmed they can meet their relative in private and are kept informed about important matters affecting them. One person felt that he was able to directly influence his care and enjoyed positive relationships with the staff. One person felt that relationships with staff were strained at times. Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 12 A record is required of each persons personal belongings brought into the home. Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 13 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 standard(s) These standards were not assessed at this inspection. EVIDENCE: Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 14 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 standard(s) These standards were not assessed at this inspection. EVIDENCE: Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed at this inspection. EVIDENCE: Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Standard 38 was partly assessed. The Registered Manager maintains good records in relation to maintenance and accidents. EVIDENCE: The fire record book identified a fault with the closure device on the door leading to the dining room and with a number of emergency lights. These need to be rectified. The individual files contain information about accidents that have occurred. The Registered manager audits the number of accidents which is good practice. It would be advantageous for the Registered Manager to use this information to develop a falls strategy which will identify ways to reduce the number of falls in the home and promote effective treatment and rehabilitation for those who have fallen. (See National Service Framework for Older People – Standard 6). Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 1 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 x
COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x 2 Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4, 5 Requirement The Statement of Purpose must explain the arrangements in place to meet all of the points identified in Schedule 1 of the Care Homes Regulations 2001. (This requirement is outstanding from the inspection of 14/12/04) The Registered Manager must not admit people who fall outsideof the registration category of the home. Prospective residents must receive written confirmation that the home can meet their assessed needs. Personal care care plans must describe how the individuals needs and wishes are to be met by staff. (This requirement is outstanding from the inspection of 14/12/04). The Registered Manager must demonstrate how staff are assisted to maintain good personal and professional relationships with residents. The Registered Manager must talk with residents about their social interests and ensure they are aware of the arrangements available for them to participate
C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Timescale for action 30/09/05 2. 3 14 22/07/05 3. 3 14 22/07/05 4. 7, 8,10 15 31/09/05 5. 10, 12 31/08/05 6. 12 16 30/09/05 Clifton Manor Residential Care Home Version 1.30 Page 19 in recreational activities. 7. 8. 14 38 17 23 Maintain a record of furniture 31/08/05 brought into the home by residents. The registered persons must 31/07/05 arrange for the fire door leading to the dining room to be repaired and for the faulty emergency lights to be repaired. The care plan that describes the 22/07/05 footwear that residents are to wear to reduce the risk of falling must be followed by the staff. 9. 7,38 12 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 Good Practice Recommendations Clifton Manor Residential Care Home C53 C03 S2299 Clifton Manor V234313 210605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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