Inspection on 20/08/08 for Clifton Meadows

This inspection was carried out on 20th August 2008.

CSCI found this care home to be providing an Adequate 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 Meadows 04/01/08

Clifton Meadows 16/04/07

Clifton Meadows 09/03/06

Clifton Meadows 02/08/05

Clifton Meadows 17/03/05

Clifton Meadows 03/09/04

Clifton Meadows 26/01/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/02/2009.

CARE HOMES FOR OLDER PEOPLE Clifton Meadows Badsley Moor Lane Rotherham South Yorkshire S65 2BA Lead Inspector Ramchand Samachetty Key Unannounced Inspection 20th August 2008 09:30 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 Meadows DS0000003101.V371731.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 Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clifton Meadows Address Badsley Moor Lane Rotherham South Yorkshire S65 2BA 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) 01709 838639 01709 838913 jan.scott@anchor.org.uk keri.sherwood@anchor.org.uk Anchor Trust Vacant Care Home 65 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (40) of places Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2008 Brief Description of the Service: Clifton Meadows is registered to care for 65 older people, 40 of whom being in the category of old age and 25 older people with dementia. It is owned and managed by Anchor trust, which is a national voluntary organisation providing a range of services for older people. The Home is situated in the residential area of Clifton, within easy reach of Rotherham town centre and other leisure facilities, including Clifton Park and Herringthorpe playing fields. The Home consists of 2 two-storey buildings, adjacent to each other. It also shares its premises with some units of sheltered accommodation, which are provided by its parent organisation, Anchor Trust. One of the buildings (Wentworth Lounge) has been specifically redesigned to provide a service for people with dementia. All residents bedrooms are single and have en-suite facilities. Bedrooms and some communal facilities are grouped in smaller units to facilitate group living. Each building is equipped with a kitchen, a laundry, dining areas, lounges and a range of hygiene facilities. Meals are prepared in only one of the buildings and it is transported to the other building in a heated trolley. There is a passenger lift in each building to facilitate access between the floors. There are some garden areas and car parking spaces around the Home. The home has produced a statement of purpose and a service user guide. The current scale of charges, at 20th. August 2008, range from £353.00 to £455.00 per week. Further information can be obtained from the home. Clifton Meadows DS0000003101.V371731.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 inspection is 1 star. This means that the people who use this service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations- but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This key unannounced inspection was carried out on 20 August 2008, starting at 09.30 hours and finished at 18.00 hours. It was carried out by an inspector and an ‘Expert by Experience’ (a lay person), who attended the home for a period of about three hours. There were 65 people in residence at the time of this inspection, 25 of whom lived in the unit for people with dementia. The deputy manager and a project manager were present during the inspection. They were later joined by the Area Manager, Ms Carole Townend. The inspection included a tour of the premises, examination of care documents and other records, which included medication, complaints and staff files. We spoke to fourteen people living at the home, four relatives and two volunteers. We spoke to five members of staff besides the managers. The care of three people who use the service was examined and some aspects of care provision were observed. Feedback on our findings, including those of the ‘Expert by Experience’ was given to senior members of staff and to the managers present. We would like to thank all the people living at the home and their relatives, visitors and staff who helped with this inspection. What the service does well: There is a good and committed staff team, which is working well together to ensure the continuing wellbeing of people living at the home. People who use the service and their relatives were complimentary about care staff, who they found to be ‘good and friendly’. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 6 People who live at the home continue to find the accommodation and facilities to be, on the whole, good and comfortable. Relatives praised the excellent quality of the laundry. Staff continue to work in co-operation with the relatives and friends of people who live at the home to promote their social inclusion and wellbeing. People who live at the home say that the meals served continue to be generally of good quality. Some people described them as being ‘wholesome and appetising’. The home is well supported by ‘Anchor Homes’, its parent group, in matters of staff recruitment, training and quality monitoring. What has improved since the last inspection? What they could do better: Although care planning has been improved, there is a need to ensure that all identified risks that people face in their daily activities are appropriately managed. Care needs assessment should clearly include social and recreational needs, which in turn should be addressed in care plans. Staff also need to show how they have conducted the reviews of care plans and what outcomes were achieved. The management of medicines must be further improved. This is in relation to the total amount of medicines kept in the home for each person, in order to monitor their use more effectively. The outcomes of medicine audits and any action taken should also be recorded. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 7 The provider must make sure that all the required room furniture and fittings are in place before admitting a person at the home. This will ensure that their rights are respected and their wellbeing promoted. Staff should ensure that the security of the buildings is safeguarded at all times in order to protect the people who live in them from potential harm. Although people living at the home find their meals to be generally good, there is a need to ensure that the food choices of people, who do not always have the ability to choose, are established and adhered to. This will ensure that their rights are promoted. Although the provider has increased the number of care staff working on the unit for people with dementia, there is further need to review the care staffing of both units against the dependency needs and the lay out of the buildings. This will help make sure that the needs of people using the service can be met in a satisfactory manner. We have also advised that consideration be given in future care staff recruitment, to employ more males in an effort to reflect gender balance in the provision of care. 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 Meadows DS0000003101.V371731.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 Meadows DS0000003101.V371731.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): 1 and 3. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The home was providing sufficient information about its services and facilities to enable people to choose it. Assessments of needs were appropriately carried out before people were admitted to the home, in order to make sure that their care needs could be met. EVIDENCE: The acting manager stated that the home’s statement of purpose and service user guide had been reviewed and improved. They were available to people who live at the home and other interested parties. We spoke to two people who had recently been admitted to the home and they said that they had received sufficient information from the home in order to help them choose it. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 10 The care files of people recently admitted to the home were checked. They showed that their needs were fully assessed before their admission to the home and this ensured that their care needs could be met. The home does not provide an intermediate care service. Clifton Meadows DS0000003101.V371731.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. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Individual care plans of people living at the home had been improved to ensure that they were receiving appropriate care and support. However, reviews of care plans and risk assessments were not consistently and appropriately undertaken and these could affect the health and safety of people who use the service. EVIDENCE: People who use the service and their relatives told us that they were ‘happy with the care that was being provided. One person who was using the service said ‘ I am pretty well looked after; the carers work hard to please every body’. One relative added that she was satisfied that her mother ‘is well cared for and well respected by all staff’. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 12 People using the service and who were able to express their views, commented that personal care was always provided to them in a way that protected their privacy and dignity. We noted that people were well dressed and in good attire throughout the day. The care plans of three people using the service were checked. They were based on their assessed personal and health care needs. We noted that individual care plans and the supporting documents used, have been improved. The manager commented that individual care plans were now more ‘personcentred’. Care plans were developed to reflect the needs and preferences of individuals. Staff spoke of the involvement of people who live at the home and their relatives in developing and reviewing their individual care plans. One relative told us that she had been encouraged to take part in developing the care plan for her loved one. Care plans included actions to be taken to meet needs and these were clearly laid out. The care and support provided were being appropriately recorded. However, we noted that in one instance, the risks faced by an individual were not appropriately assessed and therefore no action plan to manage them was put in place. This could affect the way in which this person’ s needs are addressed. In another instance, action was not followed up to make sure that an item of care need had been completed. The reviews of care plans were being undertaken and were only evident by staff writing that they had done one. There was no information on how they had reviewed the care plan and what the outcomes were. People who live at the home and their relatives told us that staff were always prompt in getting medical and other health care assistance. People at the home had visits from their GPs, opticians and chiropodists. The district nursing service was supporting staff with meeting the health care needs of a few people. However, we noted that the communication between the district nursing team and staff at the home was rather poor, and this had led to difficulties in the administration of an item of medicine to one person. The deputy manager explained that action had been taken to rectify this issue and both staff teams and the person concerned were satisfied with the outcome. We checked the way medicines were managed at the home. The storage of medicines was satisfactory. Medicines administration records were well kept and were provided with individual photographs to confirm their identity. Although medicines received at the home were recorded, we found that the total amount of a small number of medicines in stock was not clear, as the carry forward figure was not recorded. This could make it difficult for staff to keep track of the quantity of medicines being used. The deputy manager confirmed that a senior member of staff was undertaking a regular audit of medicines at the home. We advised that the outcome of such audits and subsequent remedial actions be documented so that staff could be assisted in improving their care practice within this area. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 13 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. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. The planning and provision of social and recreational activities for people who experience dementia has improved. However, individual social care needs were not always assessed and included in care plans and could therefore remain unmet. There were still some shortfalls in the meals service for people with dementia and these could affect their continuing health and welfare. EVIDENCE: On the day of this inspection, we met the activities coordinator, who was working at ‘Wentworth Lounge’, (the unit for people with dementia). She was helping a number of people with their nail care and also getting them ready for hairdressing by the regular private hairdresser who had called in. A small number of relatives were also in attendance. Staff commented that it was a ‘pampering’ day for the people in their care. We noted that staff had made it a social occasion for people and the atmosphere was relaxed and pleasant. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 14 People who live in the ‘Solway lounge’ (the unit for older people) told us that there were always ‘several activities’ in which they could get involved. They spoke of both small group and individual activities. These included regular coffee mornings, gardening, reading and watching television, going out on trips, shopping and family visits. People who were more able tended to participate more in a wider range of activities. However, staff were starting to plan more personal activities on a one to one basis, so that every person could benefit from social stimulation and social inclusion. This approach was evident with people who had dementia. However, there was still a need to ensure that all social care needs were appropriately assessed and included in individual care plans, for action. Some people who use the service told us that the daily routines were flexible and they could decide how to organise and use their time. They could undertake their own past times or go out as they choose and still get involved with group activities at the home. We spoke to a few relatives and they said that they were always welcomed at the home. They felt that staff were providing ‘good care’ to their loved ones. In discussion, the manager explained that she had reviewed the holding of large events, such as pantomimes and theatrical shows, which, had been organised with the help of the ‘Friends of Clifton Meadows’ group. These activities were not being organised until management was sure that the home was able to meet all the necessary health and safety measures. Some people who live at the home stated that they were sad that these events had been discontinued. People using the service and who could express their views, told us that the meals served at the home were ‘generally good’. Although, there was a weekly menu of the meals on offer, (Solway Lounge) some people commented that they did not know what to expect, as they could only choose their food on the day. We spent some time observing the meals service at both units. At the Solway lounge, the kitchenettes, which were also used as dining areas, were well laid out. Dining tables were provided with clean linen, appropriate cutlery and cruets. Lunch consisted of chicken in white sauce, chilli con carne served with roast potatoes, broccoli and butter beans. Deserts consisted of rice pudding, artic roll and ice cream. The protein part of the meals was plated and vegetables were served in tureens. This gave people an opportunity to serve themselves with their preferred portion. There was a choice of fruit drinks or water. There was one care worker in each kitchenette, serving the food and assisting people as necessary, with their meals. A few people commented that the food was ‘cold’ and that it reached their dining room later than usual. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 15 At the unit for people with dementia (Wentworth lounge), people had their lunch mainly in two dining rooms. The food was brought to the building in special food trolleys. We observed two care workers in each dining room. One was plating the food and the other assisting people with eating or attending to people who were in their own rooms. We noted that people, who needed assistance had to wait until a care worker was free. We also noted that people in this unit were not offered an appropriate choice of drinks. Staff gave all of them orange fruit drinks without first establishing their choice. It was difficult to find out how staff had worked with the people in this unit to ascertain and promote their choice of food. In discussion, the manager told us that staff were working hard to improve the meals service. She explained that food choices for the afternoon meals had been improved by the addition of items like pies, pasties, quiches, sandwiches and soups. Some people told us that they were now happier about the teatime meals. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 16 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. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Concerns and allegations were responded to promptly and in accordance with the home’s policy and the local adult safeguarding procedures. This practice ensured the safety and wellbeing of people who use the service. EVIDENCE: A complaints procedure was available to people who use the service and their relatives. A copy of the procedure was included in the service user guide to inform people living at the home of how they could raise their concerns if they felt something was not right for them. Complaints records showed that the home had received four complaints in the last twelve months. Three of them had been investigated and concluded within 28 days. The complainants had been informed of the outcomes with which they were satisfied. One was currently being investigated. There was an adult safeguarding policy to guide staff on the prevention of harm and abuse to people who use the service, and on procedures to be observed in reporting any allegations of such practice within the home. Staff were aware of this policy and had received training on its implementation. The deputy manager had appropriately referred a case to the local safeguarding team and had worked with them to resolve it satisfactorily. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 17 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 and 26. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. People living at the home were satisfied with the overall standard of their accommodation. However, furniture was not always adequately provided for the comfort of people at the home. The security of the unit for people with dementia was not appropriately and consistently maintained and this could compromise the safety of people living there. EVIDENCE: We undertook a tour of the premises (Wentworth and Solway), in the company of a senior member of staff. Both buildings had appropriate wheelchair access at their entrances. A loop system was available in both units to help people who use hearing aids. All bedrooms were provided with individual letterboxes and doorbells in order to promote personalised and private accommodation. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 18 The external doors to unit for people with dementia were provided with security keypads to ensure that people do not wander out of the building unnoticed. However, on the morning of the inspection, we witnessed a resident from the adjoining ‘sheltered flats’ getting into the building by opening the outside door with a key and activating the inner door code. She told us that she had come into the home to do her laundry. This practice suggested that the home was still sharing its facilities with nearby tenants and their access to the building meant that the security of people living in the unit could be compromised. In the Wentworth Unit, we checked the communal areas and a few bedrooms with the permission of their occupants. The place was well maintained and well decorated and clean. There was a ‘sensory room’, which was used for relaxation by people living in the unit and staff commented that it was well liked by every one. We noted that in one bedroom, there was only a bed and a chair. The television and other items, like books and bottled drinks, were kept on the floor. The person had moved in a few days ago and he did not have much to bring in. In discussion, the deputy manager said that furniture had been ordered for him. We noted that most people had brought in, some of their own furniture and items of memorabilia and these helped to make their rooms pleasant and homely. A ‘sensory’ garden has been developed for the benefit of people who have dementia. Staff commented that the garden had been well used over the summer period. The deputy manager told us that the telephone system has been upgraded and that calls could now be redirected internally in order to facilitate communications. People who live at the ‘Solway’ unit said that they were happy with the facilities available to them. They were satisfied with their accommodation, which they described as being pleasant and comfortable. They also spoke positively about the gardening facility that they continued to use and benefit from. In discussion, people who live in the unit also said that they were particularly pleased with the laundry service. We found both buildings clean and tidy. We noted that a rigorous procedure for hand washing was in place as part of the home’s infection control policy. People said that there had been some improvement in the storage of equipment and other items and this has started to reduce clutter and in particular, made their en-suite facilities more easily accessible. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 19 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. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Staff recruitment, induction and training were satisfactory. However, the number of care staff deployed was still insufficient to meet needs of people using the service. EVIDENCE: The home operates two units, one for people with dementia, which can accommodate up to 25 people (Wentworth) and one for older people, which can accommodate up to 40 (Solway). Each of the units has a dedicated staff team, with a team leader on the day shifts. Both teams are responsible to the manager and deputy manager who oversee the whole service. On the day of our visit, there were 25 people in the Wentworth building and 39 people in Solway. There were four care workers and a team leader at the Wentworth unit. There was also a part-time ‘activities co-ordinator’ who worked for four hours each weekday. At the ‘Solway’ unit, there were four care workers and a team leader. We observed some of the day’s routines at both units. We noted that a hairdresser was in attendance at the Wentworth unit and that the activities coClifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 20 ordinator spent most of her time getting people ready for their hairdressing, whilst providing some nail care to two people. In discussion with staff, we noted that most of the care workers’ time was spent with providing direct care and that the activities co-ordinator was limited in the time she could spend with people on a one to one basis, to meet their needs for social stimulation. At lunchtime, there were two care workers on each floor at Wentworth unit. Meals were served to people in the dining areas and in their own rooms. We noted that one care worker was busy helping people to take their place in the dining room and the other was plating and serving the meals to people at the dining tables and to those in their rooms. This practice meant that a number of people, who needed assistance with feeding, had to wait for some time before eating their meals. The meals were also not at their optimum temperature. The team leader was busy administering medicines and otherwise answering office queries. The number of care staff deployed on the day and at certain times, such as meal times, was not sufficient to meet the needs of people using the service. At the Solway unit, there were four care workers and a team leader on duty for the day. One care worker was assigned to each wing of 10 people. People who live in this unit and their relatives continued to say that they did not think there were always enough care workers to meet their needs. We noted that social activities in this unit were mostly organised by volunteers of the ‘Friends of Clifton Meadows’ group and the people who live in the unit and who were able to do so. The staff duty rota indicated that there were three care workers scheduled to work at night at Solway and two at Wentworth. One of the care workers at Solway would be a senior carer and would oversee both units at night. In discussion with the managers, they told us that, in response to the requirement we made at our last inspection, the service had increased its staffing level at Wentworth, by one care worker during daytime and would continue to review the deployment of care staff, to meet the dependency needs of people, more effectively. We checked the recruitment and selection procedures, which were in use at the home. These were corporate ones and were based on an equal opportunities policy. We looked at the records of two care workers who had been recently recruited. All the pre-employment checks, including references had been sought and obtained before staff started working at the home. This practice ensured the safety and welfare of people using the service. Appropriate induction had also been provided to all new care workers. Although the home’s recruitment policy included the practice of equal opportunities, we noted the continuing gender imbalance in the care team. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 21 We spoke to four members of staff. They stated that they were receiving ongoing training on a number of topics. These included moving and handling, adult safeguarding, person-centred care planning and dementia care. The manager told us that the home was receiving additional support from Anchor’s corporate specialist dementia team. The latter was offering a five-day course on dementia care for all new care staff. The manager commented that training on equality and diversity was addressed through a course on ‘Rights and Responsibilities’, which is provided to all staff. We spoke to four members of staff and they showed a good understanding of the needs of people in their care and their competence in addressing those needs. Information from the ‘Annual Quality Assurance Assessment’ that was sent to us before our visit, indicated that only 34 of the permanent care staff had achieved a level 2 in the ‘National Vocational Qualification (NVQ)- direct care. We noted that seven other care workers were currently following this course. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 22 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 and 38. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to the service. Appropriate temporary management arrangements were in place to make sure that the home was well run in the absence of a registered manager. Health and safety procedures and practices ensured the welfare of people living and working at the home. EVIDENCE: The registered manager has left the service since our last inspection. The provider has appointed a deputy manager and has made arrangements for a project manager to oversee the daily running of the home. The provider has confirmed that recruitment to the vacant manager post will be carried out in due course. In discussion, we noted that management tasks were being Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 23 appropriately carried out. The home management was supported by an administrator and by the availability of the provider’s corporate services, like finance, staff training and staff recruitment. People who live at the home and their relatives stated that the new managers were ‘improving the running’ of the home. They confirmed that they had attended a ‘Residents’ meeting at which they were informed of the changes taking place at the home. Some people said that they felt there was ‘too much change’ and that they did not always know ‘who was doing what’. They were therefore unsure of what other changes would take place. We noted that the management team were using the internal quality monitoring methods to check and improve the quality of the service being provided. These included audits of finances, medicines administration, care documentation and the implementation of health and safety measures. There were also regular staff meetings and satisfaction surveys of people living at the home and their relatives. We looked at a few monthly reports of the provider’s visits to the home. They showed that appropriate action was being taken to address matters highlighted during these visits. The deputy manager confirmed that a programme of staff supervision has been drawn up and was being implemented. We spoke to a few care workers and they said that they were satisfied with the supervision and guidance that they were receiving. Arrangements were in place to support people living at the home with the management of their money, which was left for safekeeping by relatives. Separate accounts were kept for each person. Financial transactions carried out on their behalf were appropriately supported with receipts. We noted kept that people could access their money whenever they required it. In discussion, staff said that they were aware of the home’s health and safety procedures. They were receiving on-going training on various aspects of health and safety. These included fire safety, moving and handling, safe use of equipment and hazardous substances. The deputy manager confirmed that appropriate risk assessments were in place with regards to the environment and to working practices in order to ensure the health and safety of people who live and work at the home. Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 24 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 3 X 3 X X N/A 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 2 13 3 14 2 15 2 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 2 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 3 X 3 Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 25 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 15 Requirement Care plans must be improved to reflect how the identified risks faced by individuals will be managed. Staff must record the method used in their review of care plans and the outcomes of such reviews. Timescale for action 28/11/08 2. OP9 13 The quantity of medicines received and stored at the home 28/11/08 must appropriately recorded in order that they can be effectively monitored. Appropriate furniture and fittings must be provided to people who live at the home, in order to ensure their wellbeing and comfort. The provider must further review and improve the level and deployment of care staff at both units, in order to ensure that all identified needs of people living at the home are appropriately met. 28/11/08 3. OP19 23 4. OP27 18 28/11/08 Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 26 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 The outcomes of audits carried out with regards to medicines management and remedial action if any, should be recorded and monitored in order to encourage good practice. The social care needs of people using the service should be consistently and fully assessed and included in their care plans. Staff should make sure that meals served to people at the home are always within the required temperature. Staff should make sure that they establish the food and drink choices of every one in their care before serving them in order to uphold their right to choose and their dignity. The provider should make sure that the security of the building used by people with dementia is protected and promoted at all times. The provider should take into account the need to reflect an appropriate gender balance in the composition of the care team, in line with good practice. 2. 3. 4. OP12 OP15 OP15 5. 6. OP19 OP27 Clifton Meadows DS0000003101.V371731.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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