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Inspection on 29/07/05 for Clyde Court Nursing Home

Also see our care home review for Clyde Court Nursing Home for more information

This inspection was carried out on 29th July 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home was found to be delivering good quality care, by staff described by one service user as "very good and caring, we could not do better". The home had good assessments and care plans for residents and used these to deliver the care. There were good relationships between staff, residents and visitors, as one resident said "they are my friends". Residents received individual care based on good assessments, care planning and good knowledge of residents by staff. Residents said that they felt safe in the home. Food was of a high standard, as one resident said, "we could not do better, you do not loose weight here". The home, by good employment practices, ensures that the staff who work in the home are suitable to do so. Good maintenance, servicing and the continued development of the Health and Safety Committee maintain the health and safety of residents, visitors and staff.

What has improved since the last inspection?

Devices have been fitted to some of the bedroom doors to enable residents to have their room door open at night but also ensure it closes in the event of a fire. The medication practices have been reviewed and are generally very safe Some bedrooms have been decorated.

What the care home could do better:

Ensure that all medications including eye drops have a label put on the container by the pharmacy.

CARE HOMES FOR OLDER PEOPLE Clyde Court Nursing Home 22/24 Lapwing Lane Didsbury Manchester M20 2NS Lead Inspector Les Hardy Unannounced 29 July 2005 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 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 F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Clyde Court Nursing Home Address 22/24 Lapwing Lane Didsbury Manchester M20 2NS 0161 434 1824 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care home with nursing (N) 33 Category(ies) of Old age, not falling within any other category registration, with number (OP) (33) of places Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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. 2 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.. 3 A copy of the Residential Forum Guidance ` Care Staffing in Care Homes for Older People` must be available in the home. 4 Staffing levels for service users who require personal care only must comply with the minimum requirements of the Residential Forum guidance. 5 The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Date of last inspection 18 November 2005 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 the maximum of 33 service users. This number includes up to 24 who may require nursing care and 9 who require personal care. The home was first registered in 1992 and consists of a two- 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 is wheelchair accessible. A new passenger lift and a wall mounted hoist has been installed recently. There is provision for 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, pubs and public transport. Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection, which was unannounced, was carried out on a Friday, started at 7.15 pm and lasted for 6.5 hours. During the inspection, 12 residents, 2 visitors and 9 staff were spoken with. All 4 requirements from the previous report had been actioned by the home and met. The 2 recommendations from the previous report have also been actioned. During this inspection only a selection of key National Minimum Standards were assessed therefore to gain the full picture of how the home meets the needs of residents, this report should be read with the previous and any future reports. What the service does well: The home was found to be delivering good quality care, by staff described by one service user as “very good and caring, we could not do better”. The home had good assessments and care plans for residents and used these to deliver the care. There were good relationships between staff, residents and visitors, as one resident said “they are my friends”. Residents received individual care based on good assessments, care planning and good knowledge of residents by staff. Residents said that they felt safe in the home. Food was of a high standard, as one resident said, “we could not do better, you do not loose weight here”. The home, by good employment practices, ensures that the staff who work in the home are suitable to do so. Good maintenance, servicing and the continued development of the Health and Safety Committee maintain the health and safety of residents, visitors and staff. Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? 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 F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 5. Appropriate assessments undertaken prior to admission meant that the home ensured that they were able to meet the needs of the residents when admitted. Relatives had a positive involvement in the home. EVIDENCE: All residents were assessed both by the referrers and a senior member of staff from the home prior to admission. The home undertook full assessments of a high standard that gave a very full picture of the service user. This ensured that the home could not only establish if they could give the prospective resident the care they needed, they were also able to plan the care needed along with any required aids..The full assessments obtained were used to write the care plan required by standard 7 (see next section). Residents admitted for Care with Nursing were also assessed for Funded Nursing Care by NHS staff trained to do so. One visitor spoke of the openness and honesty of the home when they came for a visit whilst choosing a home. This helped them to make the decision that this home could meet their relative’s needs. Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, and 9. The homes knowledgeable staff, together with care plans and risk assessments and safe methods of medication handling ensured good safe care for the residents, but they must ensure that the Pharmacy labels eye drops correctly. EVIDENCE: Residents had care plans, which detailed their needs and had been written using the assessments mentioned in the National Minimum Standard and in the previous section. These gave full details of the care required and informed staff of how this should be delivered. The risk assessments gave details of what action was needed to meet concerns raised by risk assessments, such as in the case of moving and handling risk assessments these gave full details of how the residents should be moved, including any aids Care plans and assessments were reviewed monthly. Each resident had a summery care plan that could be used to give staff unfamiliar with the resident an overview of needs for which a plan was available. Staff had an appropriate knowledge base to ensure that the care plans were put onto practice. A district nurse who regularly visited care only residents in the home was confident that the homes staff carried out care she planned. The home ordered new prescriptions for residents, signed these as their agent and photo copied them before sending them to the pharmacist for dispensing. Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 10 When the medicines were received these were checked against the prescription and if correct the receipt recorded on the Medicine Administration Record (MAR) Chart. Administration was recorded on the MAR as was the sending of unwanted drugs for destruction. The home must ensure that eye drops when dispensed by the pharmacist have a label on the drop container as well as the outer pack, as required by the Royal Pharmaceutical Society of Great Britain. This will enable identification of the drugs to the resident even if the outer pack gets damaged, mislaid or the container placed in a different outer pack therefore avoiding potential risk to the resident. Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,. 13,.14,and 15. The home had a friendly atmosphere were residents were able to dictate their day. The quality of the food was high. EVIDENCE: Residents were enabled to have control over their own lives as much as their physical health allowed. Residents reported that they were able to get up and go to bed at times they wished and if they needed staff help, as one said, “all I have to do is ask”. Residents, staff and visitors had good relationships, as one visitor said, “the staff are warm and friendly.” This sentiment was echoed by residents who as one said of the staff “they are my friends.” Most of the residents spent a lot of the day in one or other of the lounges. Smoking is permitted in one of the lounges. Some activities were organised, such as trips out to the local pub or further afield, such as a shopping centre or the seaside. Regular visits from local entertainers and film shows on a large screen were very regular events. Other activities such as board games were arranged on an individual basis. On resident said they would like more activities, but were unclear about what type and said that they were not up to taking part anyway. Some residents also went out with their visitors regularly. Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 12 Regular meetings were held between residents and staff and residents felt they were listened to. The home encouraged visitors who said that they felt welcomed. Breakfast and lunch were served during the inspection. Breakfast was served either in residents rooms or as they came to the dining room. The cook made breakfast on an individual basis for each resident who were asked what they wanted. Tea was served in individual pots. Meals were of a high standard. Lunch was either deep fried fish and chips or fish pie and mashed potato both served with mushy peas. Residents who did not like fish were offered alternatives; in one case this was boiled ham. Residents were enthusiastic about the food with comments such as “it could not be improved,” “much better than home.” and “you can have as many helpings as you want”. They were particularly complementary about the range of puddings, at least five, available each day. Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were at this inspection. EVIDENCE: Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed at this inspection. EVIDENCE: Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. The home provided competent trained staff to ensure that the needs of residents were meet. Appropriate recruitment policies ensured that residents were protected from unsuitable staff. EVIDENCE: The home was deploying staff to at least the minimum required by the current staffing notice dated 10 November 2004. 66 of the care staff had at least the level 2 NVQ award. Residents said that they felt safe with staff and one member of staff who had recently gained the award stated that her practice had changed for the better since undertaking the award. Registered nurses were seen to be aware of residents care needs and had the skills to met these. All staff at the home had appropriate checks including 2 references and Criminal Records Bureau (CRB) before commencing employment. All staff at the home undertook mandatory training in Fire Prevention and Moving and Handling. Trained nurses had undertaken up dating courses to enhance their skills and the care they provided. The home provided a placement for student nurses from the University of Manchester, which as well as enabling them to get an insight into care of this client group, could encourage some to return to this field of nursing on qualifying ensuring that residents continue to be looked after by competent Registered Nurses in the future. Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 and 38. The home ensures that they meet their obligations regarding health and safety. EVIDENCE: The home did not hold money for any of the residents. Those who received an allowance received this directly weekly for which records were kept. Any extras such as hairdressing were invoiced either to the resident or a relative. The home had a Health and Safety Committee that included residents, which discussed matters relating to health and safety at the home, which concluded with a report being written by an administrator. The home ensured that all equipment services and maintenance was up to date. The Handyman undertook weekly fire checks and fire drills were carried out 6 monthly. A recent Environmental Health Officers inspection had been satisfactory. Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 17 Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION x x x x x x x x 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 Standard No 16 17 18 Score x x x x x x x 3 x x 3 Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 19 yes 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. 1. Standard 9 Regulation 13 Requirement The home must ensure that all medication containers including eye drops have a label on the actual container. Timescale for action 01/10/05 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 Good Practice Recommendations No recommendations were made at this inspection. Clyde Court Nursing Home F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 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 F55 F05 s21540 Clyde Court V240502 D290705 Stage 4.doc Version 1.40 Page 21 - 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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