Inspection on 16/05/06 for Clyde Court Nursing Home

This inspection was carried out on 16th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Clyde Court Nursing Home 21/01/06

Clyde Court Nursing Home 29/07/05

Clyde Court Nursing Home 18/11/04

Clyde Court Nursing Home 08/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Clyde Court Nursing Home 22/24 Lapwing Lane Didsbury Manchester M20 2NS Lead Inspector Leslie Hardy Key Unannounced Inspection 16th May 2006 13:00 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 Clyde Court Nursing Home DS0000021540.V292945.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. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Clyde Court Nursing Home Address 22/24 Lapwing Lane Didsbury Manchester M20 2NS 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) 0161 434 1824 0161 448 8501 Mrs Elizabeth Heather Martin Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The maximum number of service users requiring nursing care shall be 24. The maximum number of service users requiring personal care only shall be 9. Minimum staffing levels for service users requiring nursing care as specified in the Notice dated 10 November 2004 issued under Section 13 of the Care Standards Act 2000 shall be maintained.. A copy of the Residential Forum Guidance ` Care Staffing in Care Homes for Older People` must be available in the home. Staffing levels for service users who require personal care only must comply with the minimum requirements of the Residential Forum guidance. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 21st January 2006 Date of last inspection Brief Description of the Service: Clyde Court Care Home is a large detached property built originally in 1895. The home has been adapted to accommodate a maximum of 33 residents. This number includes up to 24 who require nursing care and 9 who require personal care only. The home was first registered in 1992 and consists of a three-storey building, with a newer ground floor extension. There are twenty-two single rooms and five double rooms available. There is a passenger lift. The home only allows smoking in residents own bedrooms if they are able to safe do this unsupervised, otherwise smoking is allowed on the external patio area. The home is wheelchair accessible. There is a lift available to the three main floors but in the three cases were individual bedrooms are up a further small number of stairs, hoists are provided. There is provision for car parking at the front of the building. At the rear of the house there is a large patio leading from the dining area, from which, access via a ramp to the lower patio area and garden area can be obtained. There is easy access to local shops, cafes, pubs and public transport. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 5 The current fees for the home are £450 to £550 a week. Hairdressing, private chiropody and newspapers are extra. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The report brings together information on the home gathered since the last inspection in February 2006, including a questionnaire completed by the home, which was used to inform an unannounced inspection that took place at the home on Tuesday 16 May 2006. This inspection started at 1.00 pm and lasted for 7 hours. During the inspection, 12 residents, 5 visitors, 1 advocate and 9 staff were spoken with. A tour of the building was also carried out. A number of questionnaires together with reply paid envelopes for return directly to the inspector were given to residents and these were returned. The three requirements and one recommendation made in the last report had all been implemented. What the service does well: What has improved since the last inspection? Following training on adult abuse recognition and reporting, staff now knew not only how to recognise this, but also how to report concerns. This coupled with Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 7 action reminding nurses as to the home policy on how medications must be given, and monitoring of this, should ensure better protection for residents. The home have implemented the latest versions of risk assessments for pressure sores and nutrition to ensure that residents are as protected as possible. 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. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 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 Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Good assessment of residents coupled with encouraged pre admission visits ensures that the home can not only provide for the residents needs, the resident is assured that their needs are known and will be met. EVIDENCE: Residents are only admitted to the home following assessments undertaken by the referring agency and if the admission is for nursing care, a NHS funded nursing care assessor. This together with the home’s own pre admission assessment undertaken by a senior nurse from the home, ensure that residents are only admitted to the home if the home’s staff have the skills to meet these needs, and the home has any specialist equipment that would be required by the resident. Residents have an opportunity to visit the home prior to admission if they are able to do so, and their relatives are encouraged to also visit prior to the admission. This also, as relatives said, ensured that the home are able to enquire of particular individual needs of the residents so Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 10 that they can be recorded and addressed. Also it helps the resident or relative make an informed decision about whether they felt the home is right for them. As a relative said, it was the fact that the home could meet the residents needs that made the ability of residents to settle into the home that much easier. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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 the service. Good care is given to residents that meet their assessed needs and any changes that occur during admission. Residents are treated as individuals. The procedures in place for handling medication ensure that the risk of errors is minimised. EVIDENCE: All residents had care plans, which had been initially written using all the pre admission assessments that had been undertaken, together with risk assessments undertaken following admission. Risk assessments were not only reviewed regularly, the tools in use were the most recent including a new version of the Waterlow pressure ulcer risk assessment and a new Manchester tool for nutrition assessment. In-house training on the use of these had taken place. Changes in risk together with changes in the residents’ needs were reflected in the care plans, which were reviewed monthly, with new plans also being written to reflect changing needs. Two residents had pressure ulcers; these had been acquired during a hospital admission. The home were Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 12 appropriately treating these with the help of specialist nurses from the local NHS Primary Care Trust. Other specialist nurses were seen to be involved by the home in residents’ care as required. This ensured that staff received the best advice available to ensure a good level of care for residents. Care plans were known by staff and used at shift handovers, not only to ensure that residents received care that meet their needs, but also as a basis to discuss how residents were responding to having their needs met. One relative reported that her father had not able to walk on admission to the home but was now independent using a Zimmer frame. She puts this down to the staff in the home and how they had identified and responded to his needs. The home had good procedures in place for the ordering, receipt, administration and disposal of medication. Since the last inspection, all trained nurses had been reminded in writing of the home medication procedures. The adherence to these policies meant that it was found at this inspection that residents were protected as much as possible from medication errors. Residents and visitors confirmed that residents were respected by staff and their dignity maintained. Staff knocked on their bedroom doors before entering, all personal and intimate care was given behind closed doors. Residents looked smart and cared for in their own clothes. Staff and residents were always talking to each other and as one visitor said whose mother had recently moved into the home, Staff at this home interact with my mother, and if you look around you see that residents are smiling and staff are always talking to residents, and treating them as individuals. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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 the service. The ability to choose how they spend their day, with some choice of activity available is a positive feature of the home, and helped residents feel it was their home. Visitors are made to feel welcome. Mealtimes are made a positive experience for residents with a good choice of well cooked and presented food available. EVIDENCE: Residents confirmed that they have control over when they get up and retire at night. As one resident said, I always stay up till midnight. The home had a number of lounges and residents were seen to have their favourite were they spent a lot of the day. Some residents preferred to spend the majority of the day in their bedroom and staff supported them in this, encouraging them to take at least one meal a day with the other residents. The home does offer some leisure activities including going out with staff to the local shops, or trips further a field. A film show, once a week, was a big attraction. This coincided with the day of the inspection, and was shown on a large screen. Residents choose which films they wish to see, and sit cinema Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 14 style. Ice creams are served during the performance. Residents said they were appreciative of these shows. The home has three small lounges which each have a TV set, also a larger main lounge which does not have a TV, and music is not played very often, apart from meal times. This enables residents to talk and engage in activities such as reading or just to be quite. Staff also engaged in one to one, or small groups, activities such as cards and scrabble with residents. Religious services were also held regularly in the home. The home encouraged visiting at any reasonable time, and a number of visitors were seen in the home during the inspection. As one visitor said, all my family members are made welcome and also offered a drink at every visit. Residents felt very much at home. As one resident said who had recently been in hospital, when I returned I was hugged by staff who welcomed me back and I felt, yes I am home. Residents were full of praise for the food served in the home. There were always a number of choices available at lunch and dinner, including 2 hot choices available at the evening meal served during the inspection. The was also a large choice of sandwiches available and staff encouraged residents to choose. The cook spent time talking to residents and getting their views and needs. Meal times were very social occasions were all residents encouraged and enabled if possible to eat in the dining room, at tables set with table clothes, cloth napkins, cutlery, condiments and a flower setting, which assisted in making meal times a highlight of the day. Staff encouraged residents with their meals, both verbally and assisting if required. Discussion with staff about the needs and requirements of a newly admitted resident who had a African Caribbean background showed that the home were aware of her particular needs including diet and were developing an acceptable menu for the resident. The home also was able to provide diets for residents with clinical conditions such as diabetes and also for personal choice such as vegetarian Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. By encouraging residents and visitors to feel able to raise concerns and having them dealt with ensured that these did not progress to formal complaints. Staff had a good knowledge of what was adult abuse and how to report it. EVIDENCE: The home had a complaints register which showed that no complaints had been received since the last inspection. Residents and relatives were clear that they had been told how to and knew how to complain, but because they said they could and did raise any concerns with staff as soon as they arose and were confident they would be dealt with to their satisfaction, so the need to complain formally was not required. All but three staff at the home had recently undertaken up dating in the recognition and reporting of adult abuse. Staff were found to be confident in this area, not only aware of what could constitute adult abuse, but knew the local reporting arrangements so they could report it themselves if required. The home had information available regarding an advocacy service, and an advocate visited the home during the inspection. He said that the residents he visited would say that they were very happy in the home, and that from his Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 16 experience, any concerns he raised on behalf of residents was promptly dealt with to the residents satisfaction. At the local election that took place 12 days before the inspection, it was reported by the manager that all the residents had a postal vote, and over half of them voted. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home provided a homely atmosphere and was well maintained. Good infection control mechanisms were in place. The home must ensure that bad odours are noticed and dealt with speedily. EVIDENCE: The home is clean, and well maintained and furnished and as one relative said, looks homely rather than clinical. The homes handyperson said that he was able to keep on top of day-to-day matters and had an account at a builder’s merchant, which enabled ready access to any supplies he needed. Bedrooms were found not only to be well maintained but the majority contained a large number of personal effects and furniture owned by the resident. Each room was very much the residents own. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 18 The home had a good range of aids adaptations and equipment that enabled them to meet the resident’s needs. The home had an appropriate infection control regime in place and had recently requested a visit from an infection control nurse from the local NHS Primary Care Trust who had talked about caring for residents with MRSA and looked around the home. The manager reported that the nurse was happy with the control of infection arrangements in place. The home was found to be kept clean and also odour free apart from outside one bathroom and toilet, which smelt for a long period of the inspection. Following discussion the cause was found and action taken to prevent a reoccurrence. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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 the service. The home was appropriately staffed by knowledgeable competent personnel, who kept their knowledge up to date. Good recruitment practices were in place, which should ensure that inappropriate staff do not put residents at risk. EVIDENCE: The home was found to be staffed at least to the levels set out in the staffing notice currently in force. Residents confirmed that they felt that staff were able to meet all their needs appropriately. Staff responded calmly, professionally and competently to a serious deterioration in a resident’s health during the inspection. As well as an appropriate complement of registered nurses at the home, they also had on the day of the inspection out of 14 carers, 3 carers with NVQ level 3 in care, 6 carers with NVQ level 2 in care, and another 2 staff who are currently undergoing training. Having this good level of staff who had undergone appropriate training together with an appropriate induction programme for new staff helps ensure that residents receive appropriate care. All care staff had access to ongoing up dating training. A review of four staff files showed that the home had good systems in place for the appointment and ongoing employment of staff, which included getting Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 20 written references and doing Criminal Records Bureau checks. The processes in place should ensure that the home do not employ staff that could put residents at risk. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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 the service. The home was well managed with good systems in place for residents to make their views known on life in the home. Regular maintenance of equipment and installations in the home should ensure resident safety. EVIDENCE: Residents, visitors and staff all had a high opinion of the manager, who had recently also obtained The Registered Manager Award. The home was well run with resident very clear that they not only could but were encouraged to express their views and feelings about living at the home. They felt that they could do this not only during regularly contact with the manager but at regular meetings that were held between residents and the home’s management. These meetings were also used to feed back the results of regular quality Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 22 assurance audits undertaken about the home, which were not only undertaken yearly by an external body as part of the ISO 9001 accreditation, but also by regular internal audits where short questionnaires were sent to residents to complete. The home did not control the finances of any residents. All extra such as hairdressing are charged for in the form of a monthly invoice. The home regularly reviews it policies and procedures. Regular servicing and maintenance agreements are in place to ensure that all equipment and fittings in the home are safe to use. The home have a safety committee made up of residents staff and management that review any untoward occurrences in the home and recommend and monitor action. Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 4 3 X X X X 3 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 X 3 X 3 X X 3 Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 24 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 OP26 Regulation 16(2)(K) Requirement The home must ensure that clinical waste bins are emptied appropriately to ensure no bad odours occur in any part of the home.. Timescale for action 01/08/06 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 Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Clyde Court Nursing Home DS0000021540.V292945.R01.S.doc Version 5.1 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. 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. 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