Inspection on 27/02/06 for Clinton House Care Home

This inspection was carried out on 27th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Clinton House Care Home 08/07/08

Clinton House Care Home 03/07/07

Clinton House Care Home 15/11/06

Clinton House Care Home 11/07/06

Clinton House Care Home 06/12/05

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Clinton House Care Home 75 Truro Road St Austell Cornwall PL25 5JQ Lead Inspector Elaine Bruce Announced Inspection 27th February 2006 09:00 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 Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Clinton House Care Home Address 75 Truro Road St Austell Cornwall PL25 5JQ 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) 01726 63663 01726 69003 Morleigh Ltd Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39), Physical disability (39), Terminally ill (39) of places Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th December 2005 Brief Description of the Service: Clinton House is a period residence with an extension added in the early eighties. The home is situated close to St Austell town centre and provides nursing care for up to 39 older people. There is a garden with a lawn to the front of the home and adequate car parking space. A patio area is situated outside the lounge/dining room on the ground floor. Accommodation is provided on two floors, accessed by a shaft and stair lift. Assisted bathing facilities are provided and all rooms have call bells. There is good wheelchair access within the home and to the patio. There are two spacious lounges with two separate dining areas. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection at Clinton House was an announced inspection undertaken by two inspectors. One of the directors of the Company was present during the course of the inspection as was the acting manager. The inspection took place over 8 hours. One of the inspectors spoke with all the staff on duty as well as a visitor to the home. Service users were also spoken to during the course of the inspection. Care plans and staff files were inspected as was the medication system. What the service does well: What has improved since the last inspection? The impact of a change of ownership for Clinton House has not yet stabilised. The nurses and the staff are still getting used to the changes and it was concluded that this will take some time as there have been (and are due to be) more changes to the management team. It was recommended at the end of the inspection that a staff meeting takes place as soon as is possible following the inspection to inform the staff fully of what is happening at the home. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 6 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. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5 The nurse in charge assesses all service users prior to admission to the home to ensure that the home will be able to meet their care needs. A contract of care is provided to each service user/family which details the terms and conditions of their placement. The home’s statement of purpose and service user guide documentation provide prospective service users with details of what the home provides helping an informed decision about admission to the home. EVIDENCE: The home has in place a service user guide document and a statement of purpose. Information is provided to prospective service users in these documents allowing decisions to be made on the suitability of the home for an individual. Visits to the home prior to admission are encouraged. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 9 Prior to admission an assessment of care needs takes place by the nurse in charge to establish that the care needs of the service user can be met. Information is included in the service user guide on the admission assessment procedure and visits to the home. A care plan is then developed from the pre admission assessment document. It is recommended that this document is consistently signed and dated. Respite care can be provided by the home as well as a longer stay. On admission to the home each service user is provided with a contract of care that details the terms and conditions of their placement. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9 The service user’s health and personal care needs are being met by the staff and multidisciplinary staff as required. Medication was found to not be administered according to the medication policy and procedure. EVIDENCE: The service users health and personal care needs are set out in an individual plan of care. The care plans are reviewed monthly to reflect the changing needs of the service users. Risk assessments are in place as is a “pen picture which includes important information on the past experiences and happy events of the service user. The nurses at the home have responsibility for care planning documentation to include the daily records. It was noted that the daily records made good reference to dietary needs but recording on social care needs was inconsistent. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 11 All the service users are registered with a general practitioner. Each service user is assessed by a registered nurse to identify the risks and treatment of pressure sores. The home or health service provides pressure relieving equipment for those at risk of developing pressure sores. The service users have access to specialist medical and nursing services according to their individual needs. The home has as recommended in the inspection report of the 6th December 2005 updated their medication policy and procedure and all the nurses (except one) have signed to say that they have read and understood the contents of the policy and procedure. The medication system is administered from a monitored dosage system that was found to be being used incorrectly on the day of the inspection. It was also noted there were a number of gaps in the medication administration records. The medication system administration was discussed with the nurse in charge. Following this discussion it is recommended that all the nurses receive updated medication training as soon as is possible. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Visitors to the home are welcomed and encouraged. Management are fully aware that there is more work to be done to ensure that the social care needs of the service users are being fully met. The meals provided at the home are traditional and change over a four week period with an alternative choice to the main meal always available. EVIDENCE: The daily records of the service users evidence in some cases that the social care needs of the service users are being met, but not in other cases. Management are fully aware that they could be doing this better and have plans in hand to address this important area. Information in care planning includes a reference to the interests of the service user and also includes them in making decisions on their daily routines for example the rising and sleeping times that they prefer. A number of staff members (according to management) run a “comfort fund” on behalf of the service users and this money would appear to be being used for some social activities on behalf of the service users. It is recommended Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 13 that information/records are held on the premises in relation to this fund for audit purposes. It was noted during the course of the day the large number of visitors to the home. They were also noted to be welcomed into the home by a staff member and asked to sign into the visitors’ book on arrival at the home. A significant number of staff changes in the kitchen at Clinton House have recently taken place. The cook has responsibility for a large number of meals to include the home and a number of meals in the community. The menu is mainly traditional and changes over a four week period. The menu includes for example two roast dinners in the week and fish and chips on a Friday. An alternative choice to the main meal is always available. On the day before a care staff member asks each service user what they would like to eat for the following day. Special diets are catered for as are liquidised meals for example. Local suppliers are used to provide the meat and vegetables. It is recommended that the kitchen staff receive updated basic food hygiene certificate training. The requirements of the recent district council environmental health officer inspection have been addressed. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18 The home has a satisfactory complaints policy and procedure provided to the service users in the service user guide. Adult protection policies and procedures are due to be reviewed and updated along with training to staff in this area. EVIDENCE: Should a service user wish to make a complaint information on this process is available in the service user guide. In addition the complaints policy and procedure is displayed in the home. More information is required to be included in the service user guide around advocacy and the rights of the service users. The home has in place an adult protection policy and procedure that is due to be reviewed and updated (along with all the policies and procedures generally). The policy and procedure on whistle blowing is also due to be updated. There are plans for staff to receive more adult protection training. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 Clinton House is well maintained externally and internally with evidence of on going regular improvements taking place. EVIDENCE: Clinton House is well maintained internally and externally. The home employs one full time and one part time maintenance staff member. Gardens to the front of the home are provided with seating and there is a pleasant patio area to the side of the home. Parking is available in the grounds of the home. On arrival at the home improvements have recently been made to the spacious reception area. Bedrooms are individual and homely and are being painted and decorated as they become available. Communal areas are spacious and include a large main lounge with a dining room off, another spacious lounge and then a further more homely smaller lounge. Off this small lounge is the nurses station office and a hairdressing room. A shaft lift and stair lift is available to the first floor bedrooms in the home. Hoists and assisted bathing provision is also available. Grab rails and ramps are also in place. Bedrooms Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 16 are provided with call bells. Pressure relieving equipment is in place as required. The premises were noted to be very clean on the day of the inspection. There are designated housekeeping staff employed by the home. There are ample hand washing facilities for the staff and a good provision of protective clothing is provided to the staff for infection control purposes. Laundry facilities are satisfactory. All maintenance records for the home were found to be in place and up to date to include for example the gas safety record, fire officer inspection and insurance certificate. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Staffing levels are appropriate to meet the care needs of the service users. More staff training is planned and needed to ensure that staff continue to have the skills to meet the care needs of all the service users. EVIDENCE: The staffing levels at Clinton House are appropriate to meet the care needs of the service users. The nurse in charge has responsibility for the staffing rota. The rota consists of seven care staff for the busy morning period and five care staff for the afternoon. At night there is a nurse on duty with three carers. There is always a nurse on duty at the home. All care staff are encouraged to undertake NVQ training in care and this has recently been welcomed with a number of new staff registering to undertake this training. Statutory training to include fire drill and moving and handling training is up to date but there is a requirement for more staff to attend first aid training to ensure that the home is covered at all times. Five staff have undertaken infection control training and more are due to do this. All procedures in regard to the recruitment of staff are being followed correctly to include criminal records bureau checks being in place for all the staff employed. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 The change of ownership at Clinton House has been difficult for management and staff and the new owners. It is anticipated that once registration of a manager takes place and employment of a nurse in charge, the home will be able to move forward. EVIDENCE: The acting manager has resigned from her post at another home that is owned by the Company. The acting manager has obtained her registered managers award qualification. The CSCI is awaiting the completion of her application with a view to undertaking the registration of her management position at the home. It has been a very difficult time at the home following significant management changes at the same time as the change of ownership. It is anticipated that a new nurse in charge will be commencing at the home soon. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 19 Following discussions with the acting manager and one of the directors of the Company it was recommended that a staff meeting takes place following the inspection. The aim of this meeting is to include the staff in the running of the home in this important difficult time. It is recommended that the service users are involved in a quality monitoring review of the home to include for example having the opportunity to complete a questionnaire following the change of ownership. All accounting and financial procedures in regard to the running of the home have recently been checked by the CSCI following the change of ownership. It is though recommended that an exact record of the fees that each service user pays is added to the information that is held at the home. Evidence is in place that staff members are receiving regular staff supervision as required by legislation. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 20 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 2 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 2 3 3 3 x x Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 21 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 9 Regulation 13(2) Timescale for action The registered person shall make 31/03/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP3 OP9 OP12 OP15 OP17 Good Practice Recommendations To consistently sign and date the pre admission assessment document. To provide medication training to the nurses as soon as is possible. To hold on the premises records of the “comfort fund” for audit purposes. To update the basic food hygiene certificate training to all the kitchen staff. To include information in the service user guide on DS0000064606.V275138.R01.S.doc Version 5.1 Page 22 Clinton House Care Home advocacy and the rights of the service users. 6. 7. 8. 9. OP30 OP32 OP33 OP34 To provide first aid training to staff to ensure that the home has cover at all times. To involve staff in the running of the home by holding a staff meeting as soon as is possible after the inspection. To involve the service users in a quality monitoring review following the change of ownership. To record the exact amount that each service user is paying for their care at the home. Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Clinton House Care Home DS0000064606.V275138.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!