Inspection on 24/05/07 for Clumber Court Care Centre (Care Home)

This inspection was carried out on 24th May 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Clumber Court Care Centre (Care... 11/05/06

Clumber Court Care Centre (Care... 08/11/05

Clumber Court Care Centre (Care... 16/03/05

Clumber Court Care Centre (Care... 28/07/04

Clumber Court Care Centre (Care... 11/03/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Cheaney Court Care Home

Thistle Hill Hall

Chater Lodge

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

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

CARE HOMES FOR OLDER PEOPLE Clumber Court Care Centre (Care Home) Bolham Lane Retford Nottinghamshire DN22 6SU Lead Inspector Karmon Hawley Unannounced Inspection 24th May 2007 10:00 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 Clumber Court Care Centre (Care Home) DS0000024636.V337631.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. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clumber Court Care Centre (Care Home) Address Bolham Lane Retford Nottinghamshire DN22 6SU 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) 01777 700823 01777 705143 clumber.court@ashbourne-homes.co.uk Ashbourne Homes Limited Post Vacant Care Home 64 Category(ies) of Dementia (8), Dementia - over 65 years of age registration, with number (64), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (64) Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2006 Brief Description of the Service: Clumber Court Care Home was established in 1993 and is now owned by Southern Cross. Clumber Court is situated around a mile from the lively market town of Retford and enjoys a pleasant, picturesque and quiet location alongside the river Idle. Due to limited transport links the home has access to a car and accommodates relatives who may have difficulty with transport. Clumber Court is built on two levels and caters for the care of older people and offers specialist residential and nursing care for up to 64 older people with dementia type illness. There are sufficient seating areas throughout the building and a pleasant secure garden for service users to enjoy. Accommodation is provided in single rooms and service users are enabled to bring in personal possessions in order to personalise them. The current weekly rates for social service placements range from £334 to £370 and for private placements £385 to £430. These fees do not include hairdressing and chiropody. These rates and information about the home is offered to prospective service users and relevant others on initial enquiry. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken by an inspector reviewing all the previous inspection records available, looking at information provided by the manager about Clumber Court and by undertaking a visit to the service with the inspector using a method called “case tracking.” “Case tracking” involves identifying individual service users who currently live at the home and tracking the experience of the care and support they have received during the time they have lived there. The inspector also checked that information provided by the manager matched individual experiences of service users living at the home by talking with them and observing the care received. Seven service users and two relatives were spoken with, all of them expressed that care was at a good standard and staff were very kind and attentive. General house records and staff records were also looked at to ensure these were maintained and provided positive outcomes for service users. Two members of staff were spoken with and were able to discuss service users needs and support required. What the service does well: What has improved since the last inspection? Service users reviews are now service user focussed thus ensuring continuity of care. Risk assessments have continued to develop working towards ensuring service users are protected. Ongoing redecoration is taking place to ensure service users live in a wellmaintained and comfortable environment. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 6 The main entrance has undergone structural changes offering a more secure entrance. Structural changes have also taken place upstairs offering a quiet room for service users to sit in. The corridors on the ground floor have been given themes, which offer enjoyment and stimulation for service users. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 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 Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are assured that their needs will be assessed and met prior to admission. The service does not offer intermediate care. EVIDENCE: The acting manager or unit manager’s visit prospective service users within the community to carry out a preadmission assessment. There are two types of assessments in use, one which is a specialised dementia care assessment. Preadmission assessments were available within case files seen. Prospective service users and relevant others may also visit the home and spend time there prior to making a decision to move into the home. The acting manager said that the statement of purpose is currently being updated but prospective service users are given an information pack and booklet about the home. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a risk that service users needs will not be fully met due to incomplete plans of care. Service users are treated with respect and their right to privacy is upheld. EVIDENCE: Service users undergo various assessments such as the activities of daily living, manual handling, pressure area care and nutritional needs. Plans of care were relevant to needs; however within one file despite a wealth of information being obtained in the preadmission assessment for dementia care needs this had not been used within the plan of care. Plans of care were not personalised with regards to service users likes, dislikes and preferences. There was limited information about service users social history and individual needs within two plans of care. Risk assessments were in place for highlighted risks in two plans of care, however information was limited about the action to take in the event of the risk actually occurring. There were no risk assessments in place for diabetes mellitus or falls within one plan of care despite these risks being highlighted. This was discussed with the acting manager and one member of Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 10 staff who stated that the member of staff who had undertaken care plan training had left employment and this training is now to be offered to additional staff. Service users spoken with said that staff were attentive to needs and they felt that their needs were met. Another also said that staff were kind and caring and helped them when they needed assistance. Staff spoken with were able to discuss service users needs and the support required. They had an understanding of caring for service users with dementia care needs and how they ensured that needs were met. There was evidence within service users files to show that the doctor, district nurse, dentist and other specialist services are accessed as required. Relevant equipment such as specialist mattresses and cushions were seen during the tour of the home. One service user spoken with stated that they can see the doctor at any time. Medication policies and procedures were observed. Relevant records such as medication received into the building and medication returned or destroyed were available. Medication administration records were clear and corresponded with the prescription. Two members of staff signed all hand written entries. Fridge and room temperatures were recorded on a daily basis. Room temperatures often exceeded the recommended 25° C, which ensures the safe storage of medicines. Whilst observing the medication records the room was very hot and humid despite several air condition units being in place. This was discussed with the acting manager who stated that she had put in a request for additional air conditioning units. Service users spoken with said that staff treated them with respect at all times and ensured that privacy was maintained. Staff were seen to treat service users with respect and knock on doors prior to entering a room. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. 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. Service users find the lifestyle in the home matches their expectations and satisfies their needs. Service users are helped to exercise choice and control over their lives. EVIDENCE: The activity coordinator is currently off sick; therefore a care assistant is delivering activities two days a week. Activities such as trips out, arts and crafts and reminiscence sessions are on offer. In addition to this outside entertainers visit the home and musical movement is offered once a week. Relatives spoken with said that they often attended special events when they were planned. Two service users spoken with said that they enjoyed the activities that were on offer, whereas two said that although they were on offer they did not wish to join in. One service user was seen going out bird watching with a member of staff. Two other service users were seen to be enjoying sitting in the inside garden area listening to music. The routine of the home is flexible and service users may choose how they spend the day, throughout the visit service users were seen to walk feely around the home and occupy themselves where able. A local priest visits the home on a regular basis to offer Holy Communion should a service user require it. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 12 There are no restrictions on visiting and visitors may be received in private should they wish. Two service users spoken with said that they often receive visitors and they are always made welcome. The two visitors spoken with confirmed that staff were polite and welcoming at all times. A good relationship was evident between staff and relatives and staff were seen to give them time to discuss any issues. Staff have received training in customer care and adult protection. The acting manager said that equality and diversity issues had been covered in both these training sessions. She stated that relationships and an individual’s sexual orientation had been given additional attention during the recent adult protection training; therefore staff had explored these issues and she felt confident that all needs would be met. Staff spoken with also discussed issues with regards to this and felt that service users individual needs are met. They stated that they ensure they get to know each residents likes, dislikes, personal needs and preferences to ensure care is indivualised. Service users spoken with all said they felt that staff treated them as individuals and that their needs were met. During the tour of the home service users rooms were seen to be personalised. A wholesome and appealing diet is on offer. Choices are available and during the lunchtime meal it was seen that three main courses were on offer. Staff were observed to assist service users with meals in a dignified manner. There is currently work in progress to ensure that each service user will be offered a nutritionally balanced meal. Service users spoken with said meals were at a very good standard and were plentiful. Staff spoken with confirmed this and stated that specialist diets such as diabetic diets were also catered for. Relevant records such as cleaning rotas and temperature control records were seen. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. 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. Service users and relevant others are assured that their complaints are listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: Relevant policies and procedures are in place for dealing with complaints should they be received. There have been four complaints received since the previous inspection concerning personal hygiene, medication and communication issues. These were all investigated and resolved. Staff spoken with were able to discuss how they would deal with a complaint should it be received. Service users and relatives spoken with expressed that they were very pleased with life within the home and care received and did not express any concerns. Relevant policies and procedures are in place for the protection of vulnerable adults. Staff spoken with were able to discuss these and the action they would take should they suspect that abuse was occurring. Both members of staff also confirmed that they had undertaken training in adult protection. All staff employed have current Criminal Record Bureau checks in place (a police check to see if an individual has a police caution or conviction.) Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. 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. Service users live in a safe, well-maintained environment, which is clean, pleasant and hygienic. EVIDENCE: Many improvements have taken place since the previous inspection. There have been structural changes in the main entrance to provide a more secure area. A sensory garden is in the process of being developed. A service user has participated in purchasing items, potting plants and arranging accessories. Redecoration is taking place upstairs on the Rufford unit and structural changes have taken place to make an additional room, which has been made into a cottage theme for service users to spend quiet time in. Downstairs the main corridors have been placed into themes such as memory lane. There are various items available to encourage reminiscence such as old theme shops and photographs and practical skills such as a washing up area. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 15 The home was clean pleasant and hygienic and relevant equipment such as hand washing facilities were available throughout the home. One service user spoken with said that they felt that staff worked hard and the home was always clean and tidy. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 16 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. The number and skill mix of staff meet service users needs. Service users are in safe hands at all times. EVIDENCE: The duty rota showed that there is one registered nurse on duty on each unit throughout the day and one registered nurse on duty throughout the night covering both units. There are also five or six care assistants on duty; the acting manager said that skill mix is taken into consideration when planning the duty rota and there are unit managers and senior care assistants within these numbers. Staff spoken with stated that there was sufficient staff to meet service users needs. Service users spoken with confirmed that staff were available when they needed assistance. Two relatives spoken with felt that additional staff would be beneficial during busy times. This was discussed with the acting manager who will explore this issue further. Eight members of staff have attained the National Vocational Qualification (a nationally recognised work and performance based qualification) level two and six have attained level three. Two members of staff are working towards gaining level two. Both members of staff spoken with confirmed that had achieved these qualifications. The induction programme remains in depth and there was evidence in staff personnel files to show that this takes place. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 17 Four staff files were seen, all contained the required documentation such as proof of identify, references and professional registration numbers. The staff training matrix seen shows that staff continue to complete compulsory training. Staff spoken with said that they felt very supported by the company with regards to training and that training was at a good standard. One service user spoken with said they felt that staff were well trained and knew how to look after them. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home, which is run in their best interest. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The acting manager has now been in post for three months. She has previous managerial experience in caring for service users with mental health needs. She is in the process of applying to be registered with the Commission for Social Care Inspection to become the registered manager. Throughout the visit she was able to discuss the plans she has for continued development of the home in regards to a whole persons needs approach. Staff spoken with said that the acting manager was very approachable and supportive. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 19 The acting manager carries out various audits such as medication, the environment, kitchen, care planning and accidents on a monthly basis. Any areas of concern are then addressed via an action plan. Questionnaires have been handed out to relatives and service users, the acting manager is awaiting replies so she may act upon any comments. Although service users and relatives meetings are held the acting manager said that no one has attended these. Staff meetings are held on a regular basis; staff spoken with confirmed this. Service users personal allowances were checked. Each service user has an individual accounting sheet and receipts are kept for all transactions. Service users money is placed into a non-profit central banking account. The accounting system has now been computerised. Records were seen and these corresponded with the amount in the bank and the amount of cash kept in the home. The balance of these reflects the amounts stated in total for the service users individual accounts. Staff spoken with said that service users may access this money at any time. The acting manager said that advocates are not currently in use, however these would be accessed if required. Relevant maintaince certificates such as the mains electrics, lift and gas were seen. Water temperatures are tested on a monthly basis. Fire alarm systems are tested on a weekly basis and emergency lights on a monthly basis. Staff had undertaken several fire drills; staff spoken with were able to confirm this. Accident records contained required information and the accident audit showed that all accidents had been looked at, the time of day and cause, therefore ensuring that prevention of further accidents. The acting manager said that ten members of staff will be attending a falls prevention course in the near future. Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 X 3 X 3 X X 3 Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 (1) 13(4,c) Requirement Systems must be in place to ensure that all information gained in the preadmission assessment is utilised in the plan of care to ensure service users needs are fully met: Service users individual risks are managed ensuring they are protected; Service users wishes and feeling are ascertained and taken into account when planning care and details of support required for all highlighted need is recorded to ensure service users needs are fully met. Timescale for action 30/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 22 Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Clumber Court Care Centre (Care Home) DS0000024636.V337631.R01.S.doc Version 5.2 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!