Inspection on 08/07/08 for Clinton House Care Home

This inspection was carried out on 8th July 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

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 27/02/06

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 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Clinton House Care Home 75 Truro Road St Austell Cornwall PL25 5JQ Lead Inspector Mike Dennis Unannounced 09:00 24 June 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 Clinton House Care Home DS0000064606.V364491.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. Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 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 clinton.house@btconnect.com Morleigh Ltd Miss Patricia Jennifer Nancarrow 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.V364491.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users to include one named person out of category. To include three out of category service users by reason of age and disability. Service users to include one named person under 65 years of age for one weeks respite from 4th September 2006. 3rd July 2007 Date of last inspection 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.V364491.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 unannounced inspection at Clinton House was a key inspection that took place over 7 hours. The inspection took place on the 24th. June 2008. One of the directors of the Company was present during part of the inspection. The senior nurse on duty was also consulted. The key inspection focused on the premises, meals, medication, records relating to care, staffing and management to include policies and procedures. Case tracking of five people took place and some of these people were spoken to during the course of the day. Very positive comments were received in relation to the care that they are receiving at the home. For example: “I get regular visitors and I like my privacy, which the staff respect” “I would not change anything”, “I get a choice of meals and have a lovely room, I would not like to be anywhere else”. It is noted that the physical care needs of a number of the people at Clinton House are high. The management at Clinton House have complied with the requirements made at previous inspections and continue to make progress. The weekly range of fees for the home is from: £308.09 to £577.50. The home is able to offer day care and respite care as well as longer stays. What the service does well: The registered manager has specific roles and responsibilities that are separate to the nurse in charge of care. This division of tasks is working well at the home with each person being competent and skilled. The directors of the Company are both very involved in the running of the home and are therefore very “hands on” and fully aware of the strengths and weaknesses’ of the home. Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 6 People told us that they were most satisfied with the service being provided at the home What has improved since the last inspection? What they could do better: There are no Statutory requirements issued as a result of this inspection. There are three recommendations: It is recommended that where hand written entries are made to the Medication Administration Records (MAR), these are witnessed by two signatures. To consider additional recording by care staff by the keeping of a day record to illustrate the overall lifestyle of residents. Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 7 The frequency of staff supervision to be increased to comply with the standard of all staff receiving supervision at least 6 times per year. 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. Clinton House Care Home DS0000064606.V364491.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 Clinton House Care Home DS0000064606.V364491.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, 3 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s statement of purpose and service user guide documentation provide prospective people with details of what the home provides helping an informed decision about admission to the home. The nurse in charge assesses all people prior to admission to the home to ensure that the home will be able to meet their care needs. People may visit the home prior to admission. EVIDENCE: Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 10 The home has in place good detailed information in the service user guide document and statement of purpose on the terms and conditions of placements at Clinton House. The information provided in these documents allows decisions to be made (by prospective people) on the suitability of the home for them. Visits to the home to have a look around, see the accommodation and meet the staff are encouraged prior to admission. The home offers day care and respite care as well as longer stays. Information is included in the service user guide on the admission assessment procedure and visits to the home. Prior to admission an assessment of care needs takes place by the nurse in charge to establish that the care needs of the people can be met. When the assessment has been undertaken through care management arrangements the home has received a summary of the assessment and a copy of the plan. A care plan is then developed from the pre admission assessment document. Clinton House Care Home DS0000064606.V364491.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. This judgement has been made using available evidence including a visit to this service. Care planning documentation has been considerably improved. The care plans evidence that the care needs of the residents are being met at all times. Medication is being administered correctly to residents. Staff are fully aware of the principles of respect, dignity and privacy in their delivery of care to the residents. EVIDENCE: The residents’ health and personal care needs are set out in an individual plan of care that is based on the activities of daily living. The care plans are Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 12 reviewed and upgraded with new documentation and information at regular intervals. The care plans clearly identify the care needs of the people and how these are being met. Regular reviews of the care plans are also taking place. The care plans are fully accessible to the staff to include the carers and the nurses. All the residents are registered with a general practitioner. Each person is assessed by a registered nurse to identify the risks and treatment of any pressure sores. The home or health service provides pressure relieving equipment for those at risk of developing pressure sores. Each nurse at the home has been given specific specialised responsibilities to include for example pressure care, nutrition, continence assessments. Medication administration records were found to be completed correctly on the day of the inspection including the records for controlled medication. The storage of the medication is satisfactory. It is recommended that where hand written entries are made to the Medication Administration Records (MAR), these are witnessed by two signatures. The home has a medication policy and procedure in place that has been read by all the nursing staff. Reference books are available in the home for medication information. Staff who administer medication have received accredited medication training. People who have the capacity are encouraged to keep and take their own medication. Secure storage arrangements are provided for this purpose. Documentation is in place to guide staff on privacy and dignity in respect to the delivery of care. Induction training covers the principles of privacy and dignity. The home operates a key worker system to allow a “special” relationship with the residents to be built up through one to one time being spent together. Information on privacy and dignity is presented to the residents in the service user guide. The overall record keeping at the home is of a good standard. This standard could be further enhanced by care staff completing daily record sheets to give an overview of each residents lifestyle within the home. Clinton House Care Home DS0000064606.V364491.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment of the social care needs of residents and the activities being provided at the home meets residents needs. Visitors to the home are welcomed and encouraged. During the course of the inspection the residents commented very favourably on the standard of the meals at the home. EVIDENCE: The assessment of the social care needs of the residents has improved. Information in care planning includes a reference to the interests of the people and also includes them in making decisions on their daily routines for example the rising and sleeping times that they prefer. Families and representatives of Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 14 the people are asked to complete information in the form of a pen picture on the service user. The social activities log shows the regular entertainment that is going on. A notice board in the lounge of the home displays the activities for each week. The activities on offer were seen to be varied and interesting. A senior staff member has been given responsibilities to ensure that the social care needs of the people are being met. Arrangements are in place for the people to take part in Communion should they so wish. The birthday of each service user is celebrated. 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. The nurse in charge of care was observed to offer support to visitors on the phone and in person when required. 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. All the cooks have obtained their basic food hygiene qualification. Records are in place to comply with the District Council Environmental Health Department “Better Business”. It was noted during the course of the inspection that the staff were able to assist people sensitively with the meals where they are more dependent. Each person spoken to during the course of the day expressed very positive comments on the standard of the meals. Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 15 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 This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints policy and procedure provided to the people in the service user guide. Adult protection policies and procedures have been reviewed and are deemed satisfactory , in line with the local council multy-agency procedures. EVIDENCE: Should a person wish to make a complaint, clear information on this process is available in the service user guide. In addition the complaints policy and procedure is displayed in the home. The home has received no complaints. The home has in place a good adult protection policy and procedure that has recently been updated by the manager. The policy and procedure has been distributed and read by all the staff. A number of staff have attended external adult protection training and a number of staff have watched an in house adult protection video. It is appropriate for the staff who have not received any Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 16 training to undertake this as a priority to ensure the safety and well being of the people in the home at all times. Clinton House Care Home DS0000064606.V364491.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 a maintenance person and one of the directors is also involved in the regular maintenance of the home. Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 18 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 although due to the number of visitors the car park can be very full. 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. A shaft 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. All maintenance records for equipment were found to be up to date on the day of the inspection. The premises were noted to be 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. A number of improvements have been made since the last inspection. A bathroom has been upgraded to a wet room and a second bathroom refurbished. New chairs in the dining room have been purchased. Water tanks in the roof space have been replaced. Radiators throughout the home can now be regulated individually. Additional “hospital beds have been purchased and new linen supplied. New hoists are also available. Following a fire authority inspection, some fire doors are to be replaced. Residents informed us that they were content with their living environment. Clinton House Care Home DS0000064606.V364491.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels at Clinton House are appropriate to meet the needs of the people. Recruitment procedures for new staff are satisfactory. Staff training is ongoing with a large amount of training recently undertaken and more planned. This is to the benefit of the people in the home and the staff. EVIDENCE: Staff work a variety of shifts to include twenty four hour cover with a qualified nurse always on duty. On the day of the inspection 9 carers were on duty working a shift from 0800 to 1400 and 4 (normally 5) on duty from 1400 to 2000. The nurse in charge on the floor was working from 0800 to 2000. The nurse in charge of care has responsibility for all the staffing rotas and is included in the rota over the week end hours. In addition to the nursing and Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 20 care staff, the registered manager, bookkeeper and administrator were also on duty. Other staff include 2 cooks, 5 kitchen assistants, housekeeper/domestics, laundry person and handy person. There is an acceptable use of any agency staff. Recruitment procedures were found to be satisfactory on the day of the inspection. Two written references and a criminal records bureau check are in place for all staff. All care staff are encouraged to undertake NVQ training in care. Out of a total of twenty four care staff, twelve have obtained this qualification (either an NVQ 2 or NVQ 3)with an additional six undertaking studies to obtain the qualification. All statutory training is up to date to include moving and handling, fire drill and first aid. The nursing staff attend training to ensure their skills are updated regularly. This has recently included would care and continence. All the nursing staff have a first aid qualification except for one. Induction training to new staff is to be updated in line with the skills for care guidance. All staff have received induction training in adult protection ans a program for staff to complete more advanced training in adult protection is underway. Other courses attended include:- Mental Capacity Act, No Secrets, Equality and Diversity, Swallowing and Language therapy and the Liverpool Pathway, Care of the dying. It was noted during the course of the inspection that staff morale was high and they presented as enjoying their work at the home. Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 21 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, 32,33, 34, 35, 36, 37, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management team at Clinton House are experienced and competent in delivering positive outcomes to the people in the home. People spoken to during the course of the day expressed very positive comments on the standard of care that they are receiving at the home. EVIDENCE: Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 22 The home has a full time experienced and qualified registered manager in place. She has specific duties and responsibilities which are separate to the responsibilities and duties of the nurse in charge. This management structure is working very well. In addition senior care staff are employed, again with specific responsibilities and duties. These duties include the allocation of fire warden duties. The senior care staff are undertaking NVQ 4 studies. The manager regularly attends training and has recently attended training on the Mental Capacity Act. Administration support and financial support is provided to the manager as required. The directors of the Company are very involved in the running of the home. A quality assurance/monitoring assessment review of the home has taken place with an analysis of the results undertaken by one of the Directors of the Company. These results have been made available in the service user guide. Records are in place for personal finances in relation to the service users. The manager regularly carries out an audit of their finances. Considerable work has gone into reviewing and updating all the policies and procedures at the home. Particular effort has been put into the monitoring of legionella health. Staff supervision is a little behind schedule. Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 23 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 2 3 3 Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 It is recommended that where hand written entries are made to the Medication Administration Records (MAR), these are witnessed by two signatures. To consider additional recording by care staff by the keeping of a day record to illustrate the overall lifestyle of residents. The frequency of staff supervision to be increased to comply with the standard of all staff receiving supervision at least 6 times per year. 2. 3 OP9 OP36 Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Clinton House Care Home DS0000064606.V364491.R01.S.doc Version 5.2 Page 26 - 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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