Inspection on 13/09/06 for Clyde House

This inspection was carried out on 13th September 2006.

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 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 House 13/08/08

Clyde House 22/11/05

Clyde House 21/06/05

Clyde House 07/10/04

Clyde House 21/06/04

Similar services:

Springfield House

The Shelley

Thorndene

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Clyde House Sedlescombe Road North St Leonards On Sea East Sussex TN37 7JN Lead Inspector Liz Daniels Unannounced Inspection 13th September 2006 10:45 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 House DS0000013974.V308128.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. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clyde House Address Sedlescombe Road North St Leonards On Sea East Sussex TN37 7JN 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) 01424-751002 clydehouse@new-meronden.co.uk www.newcenturycare.co.uk New Century Care Limited Mrs Linda Davidson Care Home 48 Category(ies) of Dementia (48), Old age, not falling within any registration, with number other category (48), Physical disability (48) of places Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The maximum number of service users to be accommodated is fortyeight (48). Service users must be older people aged sixty-five (65) years or over on admission, or fifty (50) years or over on admission if they have a physical disability. The maximum number of service users with nursing needs to be accommodated at Clyde House is thirty (30) excluding the Tay Unit. A maximum number of eighteen (18) service users with a dementia type illness, aged fifty-five (55) years or above on admission to be accommodated on the Tay Unit. One named service user with nursing needs to be accommodated on the Tay Unit. 22nd November 2005 Date of last inspection Brief Description of the Service: Clyde House is a large building situated in a residential area of Hastings, close to local amenities and public transport. It is owned by New Century Care Limited (NCC Ltd) and is part of a group of homes situated in East Sussex. The home is set out over three floors and is registered to provide care for a maximum of 48 residents. The lower ground floor, known as the garden floor, has access to the garden and the middle floor, on the ground floor from the main entrance, has the main lounge and dining room. Thirty residents requiring nursing care can be accommodated on these two floors, whilst the top floor, known as the Tay Unit), is registered to accommodate eighteen residents with a dementia type illness. A shaft lift enables easy access to all parts of the building and all areas are accessible for those with limited mobility. There are hoists and bath hoists as well as grab rails and disability aids in the bathrooms and toilets. A large garden to the rear and communal areas on all floors provide relaxation areas for residents and their visitors. There is a parking area to the front of the building for up to approximately ten cars. The home welcomes prospective residents or their representatives to view the premises, discuss their needs with the Registered Manager and spend time with the staff and residents. Weekly fees range from £450 - £650 as at 29/8/06, for full nursing care. The fees do not include hairdressing, chiropody, manicures and any sundries, such as newspapers or personal shopping: these are charged as extras. Information about the service is available on the organisation’s website (New Century Care Limited) and from the home’s Manager. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 5 Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced. It included a visit to the home by an Inspector, which began at 10.45am and lasted for just under eight hours. The Manager facilitated the visit and the Area Manager also attended for part of the time. It also provided the opportunity to talk with them, two members of staff and one of the catering staff before spending time with several of the residents. No visitors were available to meet with the Inspector during the visit. The Inspector also toured the premises and examined records that included resident’s files, medication records, staff files, training records, the accident log and the complaints log. Evidence contributing to this inspection has also been gathered from previous inspections, surveys circulated to residents and their relatives (four of which had been returned to the Inspector) and from data provided by the Registered Manager of Clyde House. All of the key standards, together with those where concerns had been raised at the last inspection, were inspected. What the service does well: What has improved since the last inspection? Clyde House has now been nicely refurbished and as was found at the last inspection this has been sensitively managed to reduce the inconvenience for the residents. The three requirements that were made at the last inspection have been met whereby the information about the home has now been updated, the procedure in place for the management of Adult Abuse reflects Social Services as the lead agency and the programme for fitting magnetic door guards to fire doors that need to be open, has been completed. As a result the residents have the information they need and their welfare is protected. A monthly newsletter is becoming very popular and ensures all residents and their relatives are informed about events in the home and the activities that are planned. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 7 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 House DS0000013974.V308128.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 Clyde House DS0000013974.V308128.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Good information about the service provided at Clyde House has been produced, and a thorough assessment of prospective residents takes place to ensure a resident’s individual needs can be met. EVIDENCE: At the last inspection, the Statement of Purpose did not fully describe the different services offered by the Tay Unit and the rest of Clyde House. Details of the management structure as well as the staff complement for each area also needed to be included. However, it is now being re-printed, having been updated to reflect all the services provided, and a revised organisational plan identifies the management structure for each area of the home. Similarly the Resident’s Guide has been amended and the Manager confirmed that a copy of the revised information would be given to each resident. It is also practice that a Residents Guide is sent out to enquirers and given to any prospective residents who look around the home. Copies are on display in the main entrance of the home with a copy of the Commission for Social Care Inspection (CSCI) report, the home’s monthly newsletter, and the analysis of the most Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 10 recent service user survey. Information about local church services and advocacy services is also available there. Past inspections have found it is usual practice that, following an enquiry, prospective residents or their relatives are invited to visit Clyde House if at all possible, to spend time with the Manager and staff, view available rooms and discuss the home’s suitability. If it is then appropriate to pursue an admission, the Manager or her deputy undertakes an assessment in the person’s own home or if they are in hospital, they visit them there. A comprehensive proforma is completed. The Manager confirmed that she also asks for information from the prospective resident’s Care Manager, or from nursing and medical staff if the person is in hospital. Their written assessment if available then helps underpin the home’s pre-admission assessment. If the home is suitable and once funding has been agreed (if it is needed), they are then admitted for a trial period. The resident is then provided with a contract that identifies the room they occupy, the fees payable and the services provided. One resident who met with the Inspector could recall her husband coming to view the home whilst she was in hospital and remembered a member of staff visiting her there. Three of the four surveys returned prior to the inspection stated that they had received a contract and also that they had received enough information prior to moving in to enable them to make an informed choice about the home. The care files for three residents were viewed during the inspection. All had been assessed prior to admission and the information gathered had been used to underpin their plan of care. Information and assessments from health and Social Services were also found ‘on file’. Each of the three residents had also had physical and social assessments, as well as various Risk Assessments. Clyde House does not provide ‘Intermediate Care’ although residents are admitted for planned respite care. Emergency respite care is also provided very occasionally. Clyde House DS0000013974.V308128.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 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. Care plans that are updated promote individualised health and personal care for the residents and the practises in place encourage residents to be cared for with respect and dignity. The recording of medication administration must improve to ensure residents are protected. EVIDENCE: Three resident’s files were reviewed. All had individualised care plans and risk assessments that had been reviewed monthly and there was evidence that they had been updated. Each day, the staff also complete a daily record for each resident, documenting care provided and any significant events. Any changes in care are also passed on verbally in the handover between each shift. The Manager confirmed that the staff explain to each resident on admission that they will have a care plan, discussing the care that is required with them and their relatives. They or their relative then sign that they are aware of the Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 12 content of their plan. Any care given is explained and any new care introduced is discussed with them and/or their relative. The condition of residents’ skin is assessed and monitored, any pressure areas are recorded and if a sore develops the treatment and outcome is documented. The Manager confirmed that in general, staff within the home manage any wounds but advice is also sought from a nurse specialising in tissue viability either within the organisation or externally. A protocol for staff is in place to support this practice, meeting the National Institute for Clinical Excellence (NICE) guidelines for pressure area care: these recommend that any person who develops a Stage 2 pressure sore is referred to a nurse specialist, enabling the resident to have expert advice and an individualised plan of treatment. There are various types of pressure relieving mattresses and cushions to support the management of pressure areas at Clyde House. Resident’s dependency is also assessed and the risk of falling is identified. The home has electric hoists and hoist-assisted baths for those with reduced mobility. Grab rails are fitted in the toilets and raised seats are available; there are also adjustable beds. Residents have a continence assessment as part of their admission and continence advice is sought if needed. Nutritional screening is also undertaken and resident’s weights are monitored. The chiropodist visits the home and arrangements are made for residents to see a dentist or optician as needed. Where possible residents remain registered with their own GP or they register with a GP of their choice. No current residents wish to self-medicate. A resident’s medication is discussed at their pre-admission assessment and if the resident asked to self medicate the Manager assesses whether it is appropriate, recording it as a Risk Assessment. If they are assessed as safe, the resident and where possible their next of kin, will sign a consent form with the Registered Manager, which is then kept in the resident’s file. The medications for the remainder of the residents are stored in a clinical room, with some stock in a wall cupboard, but most for the garden room and middle floor in one trolley and those for the Tay Unit in a separate trolley. The Medication Administration Records (MAR charts) were reviewed at this visit. Five of the charts had not been signed to confirm the residents had had their 6am medication. Similarly doses prescribed for 7am and 10am for one resident had not been signed for. The Manager confirmed that this particular resident preferred to take his medication with food later in the day. During the inspection the times of administration on the MAR chart were amended to reflect the actual times the medication is offered. The resident’s name, with their photo, accompanies their MAR chart: however eight resident’s photos were not included. The trained nurses at the home administer medications; they have all had in-house training. Carers assist in the administration of medication although they are not involved in the administration of Controlled Drugs (CDs). A clinical disposal company Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 13 undertakes the disposal of medications. Medication that is identified as ready for disposal is put into a box and every two weeks the contents of the box are checked by two staff, recorded and signed for in a book and placed into the disposal bin. This practice was discussed with the Manager and it was agreed the medications should be stored in a locked cupboard until checked by the two staff and put into the disposal bin. A pharmacist audits medications in the home every six months. Staff who met with the Inspector confirmed that the ethos of the Home is to support residents in caring for themselves as far as they are able but also to provide privacy and show respect when residents are undergoing examinations or personal care. During the inspection, staff were observed to be attentive and courteous to the residents. One resident who met with the Inspector commented that ‘I’m being well looked after’ and another confirmed that ‘the staff are very nice’. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 14 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 good selection of pastimes and activities that are available helps to ensure that the lifestyle experienced by residents matches their expectations and preferences. Autonomy and choice are upheld, enabling residents to have a voice and they also benefit from varied and nutritious meals. EVIDENCE: A large lounge and conservatory on the ground floor at Clyde House enables residents to sit together and watch television, read or meet with their visitors. Videos, books and games are available and there is also a stereo and organ to provide music. The home has budgies in the lounge and the conservatory although resident’s pets are not encouraged unless in exceptional circumstances. A separate lounge in the Tay Unit provides similar facilities for those residents, or they can mix with the residents in the communal areas downstairs if appropriate. One of the staff works part time as a carer and part time as the Activity Co-ordinator. She organises an activities programme that includes some group events but also room visits and celebrations of individual’s birthdays. They are publicised through a monthly newsletter circulated to all residents and relatives; it is also available in the main entrance for other visitors. Of the service user surveys returned to the Inspector prior to the visit, one said there are ‘always’ activities for them to take part in, one Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 15 said ‘usually’ and two said ‘sometimes’. One resident commented that they joined in on the day trips out. Friends and relatives can visit anytime that the resident wishes and staff rearrange meals for any resident who wishes to go out. Residents can meet with their visitors in one of the communal spaces, if they prefer not to meet with them in their own room. Where possible residents are encouraged to maintain links with the local community. Hobbies, likes and dislikes are recorded in resident’s care plans and staff support them to continue with their interests. One resident who spoke with the Inspector said how pleased he was that he had a ground floor room with a door that opens onto the garden, enabling him to watch the wildlife as he used to do when working as a gardener. Another resident continues to attend church on a Sunday and go out to lunch. Arrangements are made if residents wish to receive Communion and the home currently celebrates the Christian festivals. There are currently no residents from an alternative cultural background but some of the staff at Clyde House are employed from overseas. Although there have not been celebrations for other festivals the Manager confirmed that the staff and residents share stories about their own homes and different cultural backgrounds. The Manager is therefore confident that the home could meet the needs of residents with varying social and cultural needs. It is not known how many of the residents manage their own financial affairs and how many have a relative or solicitor who acts on their behalf. The home does not act as the appointee for any resident. All of the accounts for residents are managed through the organisation’s head office. Residents are encouraged to bring in personal possessions with them. Whilst walking around the home the Inspector met with several of the residents informally in their bedrooms. Those who spoke with the Inspector said they liked their rooms and had chosen some of their own furniture and belongings to bring with them to make them feel more homely. Staff were seen to be respecting residents’ privacy by knocking before entering. Leaflets explaining about advocacy services are available in the main entrance of the home and the Manager confirmed that staff always endeavour to ensure residents have a voice and that they ensure there is always someone available to speak on their behalf. Previous inspections have found the food provided at Clyde House is varied and enjoyed by the residents. Meals can be eaten in the dining room or alternatively some residents prefer to eat in their own rooms. The home has recently purchased new hot trolleys to ensure that the food is kept hot whilst being taken to each of the three floors. The menu seen by the Inspector was nutritious and varied. Two choices of meal are available for lunch, with one usually a vegetarian alternative. There is a cooked tea, or soup and sandwiches, followed by a dessert. A new menu is being devised that will also publicise the ‘sweet trolley’ (alternative desserts such as yoghurt, ice-cream, Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 16 crème caramel or chocolate pudding) that is always available. One resident who met with the Inspector described the food as ‘very good – too good as I need to lose weight!’ whilst in the surveys returned, one person responded that they ‘always’ like the food, two said ‘usually’ and one said ‘sometimes’. The Inspector was able to see lunch being served and enjoyed by residents in the dining room: it looked appetising and was nicely served and presented. The kitchen and storage area was viewed. Fresh fruit and vegetables were evident and food was appropriately stored in the fridges and freezers. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 17 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has a satisfactory complaints procedure and residents are confident that their views are listened to and acted upon. Safe measures are in place to ensure residents are protected from abuse. EVIDENCE: Previous inspections have found that there is a complaints procedure in place, which is publicised in the Residents Guide, and that residents or their relatives have felt confident to raise any concerns. Residents seen during this site visit unanimously expressed confidence in the Manager and confirmed that they can raise anything with her. They also said they know she listens and feel reassured that she will follow through their concerns. Of the four surveys received by the Inspector, three identified that they ‘always’ know who to speak to if not happy, and one that they ‘usually’ do. One commented, “Linda (the manager) is lovely and always helpful”. Of the four, three also said they ‘always’ know how to make a complaint and one said ‘sometimes’. This was followed up with the comment “but if you make a complaint it is not always dealt with”. The Commission has not received any complaints about the service since the last inspection. The home has received six complaints within the last year of which one was substantiated. Details of complaints, their investigation and the outcome reached are documented in the home’s complaints log. The Manager confirmed that the outcome is discussed with the complainant to ensure they agree. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 18 Adult Protection policies and procedures continue to be in place and have been updated to reflect Social Services as the lead agency to lead an investigation in the event of an allegation of Adult Abuse. Criminal Record Bureau (CRB) Disclosures are applied for as part of the recruitment process. A Protection of Vulnerable Adults First (POVA First) check is also applied for and once received an individual is employed, although they do not provide care unsupervised until their CRB disclosure has been received. All staff receive basic training in Adult Abuse as part of their induction training. All staff that met with the Inspector could explain the action to take if they had any concerns about a resident’s welfare. One allegation about a resident’s welfare whilst at Clyde House had come to the Commission (CSCI) since the last inspection. This was investigated under Adult Protection procedures and not substantiated. However some recommendations were made which have been implemented and the home investigated the allegations appropriately, demonstrating that robust procedures are in place. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 19 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 and 26 Quality in this outcome area is good. This judgement has been made using evidence including a visit to the service. Clyde House provides a spacious, comfortable and pleasing environment that is clean and satisfactorily maintained whereby it provides a safe home for residents and meets their individual needs. EVIDENCE: Clyde House is situated in a residential part of St Leonards on Sea but is convenient to local shops and bus services. It is a large detached property that provides accommodation over three floors, all of which can be accessed by stairs or a lift. There is a good size garden to the rear that can be reached via some resident’s rooms, a door on the lower ground floor (known as the garden floor), or by steps from the conservatory on the ground floor. On the ground floor there is a dining room and a lounge, both of which lead into the large conservatory overlooking the garden. The refurbishment, which was underway at the last inspection, has been completed. The home is now comfortably furnished and provides a light, spacious environment. Radiator guards are in place throughout the Home and windows are restricted. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 20 The fire alarm is serviced annually, last in November 2005 and tested weekly. Records show that alarms on the garden floor and middle floor are activated on a rotational basis to ensure they sound and the fire doors close. Random fire drills also occur, during daytime, evenings and nights whereby both groups of staff are involved. Records demonstrate that there has been three fire drills involving night staff this year to date and three involving the day staff. All attendances are recorded and the Manager monitors that all staff attend the required number of drills each year. All the fire extinguishers are checked each month and there is also a fire risk assessment for the home that is reviewed annually and was last revised in June 2006. The laundry facilities were not inspected on this occasion. Past inspections have found that there are good measures in place to prevent the spread of infection and that the home is cleaned and well maintained. At this inspection it was clean and free from odours except in one area. The Manager explained the reason for this and it was apparent during the inspection that staff were diligent in ensuring that the area was deodorised as much as possible to make it pleasanter for others. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 21 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 evidence including a visit to the service. Residents are protected by the recruitment procedures in place and staff are qualified, or have received training, whereby residents are in safe hands at all times. EVIDENCE: Two registered nurses are on duty at Clyde House during the day and one at night. Seven carers support them during the morning, five in the afternoon and evening and three at night. Staff are designated to work in either the Tay Unit or the rest of the home. The Manager works some shifts as the nurse in charge and some shifts as an extra, enabling her to provide staff support and to complete administrative work. These numbers appear adequate for the number of residents that the home is registered for. Agency staff are very rarely used as the organisation has its own ‘bank’ of staff to provide temporary cover. Neither agency nor bank staff have been employed within the last two months. Catering and cleaning staff, maintenance and gardening staff are also employed. Of the twenty-four care staff, fifteen have or are currently studying for the National Vocational Qualification (NVQ) level 2. It is the organisation’s policy that any new care staff are recruited with a view to them undertaking the ‘Skills for Care’ Induction and Foundation, leading into the NVQ level 2 if they do not already have it. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 22 Four staff files were inspected during the visit. A ‘Protection of Vulnerable Adults First’ (POVA First) check is applied for, for all new recruits, enabling staff to be employed to work under supervision until the full CRB disclosure is received. All had POVA first checks that had been received prior to their start date and CRB disclosures had been received for three of the staff files seen. The remaining member of staff had been in post for four weeks and working under supervision until the CRB is received. Two references and a completed application form containing all the appropriate information were in each file. Copies of birth certificates and passports are held and each file had a copy of the contract with terms and conditions of employment. An annual training programme is in place for both the trained nurses and the care staff. The mandatory training including fire training, ‘Moving and Handling’ and ‘First Aid’ are scheduled, but there is also specialist training, specific for the needs of the residents accommodated at Clyde House. All training is held in work time whereby staff have a minimum of three paid training years per year. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 23 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 evidence including a visit to the service. Clyde House is well managed and the quality assurance processes in place ensure that the home is run in the best interests of residents and that they are kept safe. EVIDENCE: The Manager at Clyde House is a registered nurse who has attained her Registered Managers Award (RMA). She has been at the home for over eight years and has considerable experience in caring for older people. Supported by a Deputy Manager she leads a team of ancillary and care staff. An Area Manager provides extra support if required and visits the home at least once a week. Those staff and residents who met with the Inspector expressed confidence in the management team. One resident commented that ‘Matron is extremely good’ and a member of staff commented ‘anyone can raise anything Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 24 – things usually get followed up’; another also said ‘I can go to either the Manager or the deputy at any time if I have any concerns’. As part of their quality assurance, Clyde House undertakes annual service user surveys. These are analysed and presented in easy to read graph format. After being laminated the results are publicised to the residents and displayed with the other information in the main entrance. They are also discussed at staff meetings whereby an action plan for any improvements can be agreed. The Area Manager explained that the organisation has devised a survey to ascertain the views of stakeholders, which will be sent out very shortly. It will also be analysed and the results circulated. There is an Annual Development Plan for the organisation, and within that a plan for Clyde House. Previous discussions at inspections have shown that the plan is moulded and changed, depending on the views of residents and needs of the service. The Area Manager confirmed that this ethos still continues. A monthly internal audit is also undertaken and a senior manager undertakes a monthly, unannounced visit to inspect the premises and speak with residents and staff. Either the residents at the home manage their own financial affairs or relatives or solicitors act on their behalf. As stated earlier in the report, the home or organisation does not act as the appointee for the financial affairs of any of the residents. The home has a ‘float’ of money that can be used to buy sundries. Residents or relatives then pay for services not included in the fees, either as cash on a monthly basis or the bill is forwarded to Head Office to be included on the invoice. The fees and any sundry items or services are separated out on the invoice. Individual resident’s records for sundries bought were not examined on this occasion but past inspections have found them to be well maintained and the relevant receipts available. Prior to the site visit the Manager returned data to be considered as part of the inspection. The training information included within that, shows that there is a comprehensive programme of training for the year that includes the annual mandatory training in fire procedures, ‘Moving and Handling’ and ‘First Aid’. The Manager maintains a matrix to monitor that all staff have their mandatory updates. The information returned prior to the inspection demonstrates that the home is well maintained and this was borne out on the day of the inspection. Monthly water checks to check the water temperature were viewed and fire records were examined. The Accident Log for the home was viewed: slips, trips and falls have been recorded and appropriate action taken. The Manager explained that she monitors all the accidents and therefore identifies if there are any trends and the action needed to reduce that trend. Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 25 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 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 X 3 X 3 X X 3 Clyde House DS0000013974.V308128.R01.S.doc Version 5.2 Page 26 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 OP9 Regulation 13 (2) Requirement Medications that are administered must be signed for, to ensure residents are not at risk of having their medication twice. There must be a photograph of each resident at the home. Timescale for action 13/09/06 2. OP9 17 (1)(a) Schedule 3 (2) 13/09/06 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 House DS0000013974.V308128.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 House DS0000013974.V308128.R01.S.doc Version 5.2 Page 28 - 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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