Inspection on 21/06/05 for Clyde House

This inspection was carried out on 21st June 2005.

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 13/09/06

Clyde House 22/11/05

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 Caroline Johnson Unannounced 21 June 2005 10:00 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 House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Clyde House Address Sedlescombe Road North St Leonards-on-sea East Sussex TN37 7JN 01424 751002 01424 756029 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) New Century Care Limited (NCC Ltd) Mrs Linda Davidson Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (OP) 48 of places Physical disability (PD) 48 Dementia (DE) 48 Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for forty eight (48) service users, aged sixty five (65) years and over on admission or fifty (50) years on admission if they have a physical disability. 2. Thirty (30) service users will be older people with nursing needs. 3. Eighteen (18) service users, in the Tay Unit, will be service users with dementia type illness aged fifty five (55) years or above on admission. Date of last inspection 7 October 2004 Brief Description of the Service: Clyde House is registered to provide nursing care for a maximum of 48 residents. The top floor is registered to accommodate eighteen residents with a dementia type illesss. Thirty residents can be acommodated on the remaining two floors. Clyde House is a large building situated in a residential area of Hastings close to local amenities and public transport. A shaft lift enables easy access to all parts of the building. There is a large garden to the rear and communal areas on all floors. The home is owned by New Century Care Limited (NCC Ltd) and is part of a group of homes situated in East Sussex. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the year running from April 1 2005 to March 31 2006. The inspection lasted from 09.30am until 4.30pm. During the inspection there was an opportunity to meet with three residents in private and to observe a bingo activity where approximately eight residents participated. Three members of staff were interviewed individually. A number of records were examined and plans for the care to be provided for three residents and the pre admission documentation held in respect of one recently admitted resident were seen on this occasion. A full tour of the building was not undertaken. However, the Tay Unit, communal areas, several bedrooms and some of the bathrooms were seen. The registered manager was on duty throughout the inspection and the Operational Director was also present. The Tay Unit has been registered since the last inspection of the home to provide care for eighteen residents with a dementia type illness. It had only been open approximately seven weeks and already there were seven residents accommodated. What the service does well: What has improved since the last inspection? The home has worked particularly hard to address the requirements and recommendations made at the last inspection of the home and they are to be commended for the progress made. The quality of care planning was very good, and all areas of the plans were reviewed and updated regularly. Major refurbishment of the building was underway at the time of inspection. Refurbishment of the Tay Unit had been completed and the work carried out was of a very good standard. In addition to repainting, wallpapering and recarpeting all areas, new chairs, pictures and curtains are also to be provided. Some of the home’s procedures have also improved. An example included the changing of the times for staff breaks to ensure that there are more staff around to assist with residents’ mealtimes. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 6 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 H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 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 House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 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) 1,2,3,6 Prospective residents are given detailed information about the home and the facilities provided. The home ensures that a detailed assessment of prospective residents’ abilities and needs is carried out prior to agreement being reached on whether accommodation can be provided. EVIDENCE: There is a detailed statement of purpose and brochure in place providing information about the home, the staff team, the facilities, sample menus and details of the activities on offer. A copy of the terms and conditions of residence is given to prospective residents prior to admission. Detailed records were seen in respect of one resident recently admitted to the home. A staff member spoken with stated that she had recently visited the local hospital to assess the nursing needs of a prospective resident for the Tay Unit. She advised that a staff nurse from the Tay Unit would also carry out a psychiatric assessment prior to the home making a decision about accommodation. In future joint assessments will be carried out to try to speed up the process. The home does not cater for intermediate care. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 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) 7,8,9 Care plans include detailed information about the needs of each resident accommodated. They are reviewed and updated at regular intervals. The home needs to place more emphasis on recording how they are meeting the social and emotional needs of the residents accommodated. EVIDENCE: Care plans were seen in respect of three of the residents accommodated. The plans had all been reviewed recently and provided detailed information for staff to follow to ensure that residents’ needs would be met appropriately. Risk assessments and Waterlow scores had also been reviewed at regular intervals. Risk assessments had been carried out in relation to the use of cot sides and these had been discussed with individual residents and/or their relatives/representatives. Residents’ weights are being monitored monthly. The chef meets with residents when they are admitted to the home and a nutritional assessment is carried out. The assessment is reviewed and updated regularly. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 10 Daily records are kept in relation to each resident. Generally records include information about residents’ physical needs and references to each resident’s social /emotional needs are limited. One care plan refers to a resident’s needs in relation to epilepsy. There is no description of the seizures typically experienced by this resident. Records seen in respect of medication administered to residents were in order. Medication is stored appropriately and records are kept of all medication returned to the home’s pharmacy. The home’s pharmacist provides training annually for the staff team. At the last inspection it was recommended that a review of the administration of medication be completed. The manager advised that the home’s procedure was discussed with all qualified staff during a staff meeting. Staff are monitored regularly to ensure that they are following the home’s procedure appropriately. The home’s policy in relation to care of the dying has been amended as was required at the last inspection of the home. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 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) 12,15 The numbers and frequency of activities provided is appropriate to meet the needs of those accommodated. Menus are varied and the home is good at seeking the views of residents to ensure that they continue to meet their individual dietary needs. EVIDENCE: Activities are planned one month in advance. An activity co-ordinator is employed to work 2.00 –4.30 four afternoons each week. Residents and staff spoken with stated that there are sufficient numbers of activities in the home. There is a selection of books available in the sun lounge for residents’ use. A hairdresser spends two days a week in the home. Music therapy is provided regularly. Outings are arranged to places of interest and generally there is an outing weekly. A recent outing was arranged to the tearooms at Fairlight. A couple of residents attend a club one day a week. During the inspection there was a game of bingo and approximately eight residents participated. Arrangements are made to meet the individual wishes of residents in relation to their religious observances and it was noted that two ministers and a nun visit the home regularly. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 12 There is a four-week rotating menu in place, which is reviewed three-four times a year. A choice of meal is provided daily and staff advise residents of the choice to be served one day in advance. Should someone request something different to the set menu then this can also be arranged. A resident spoken with during the inspection had chosen something different to the set menu. She advised that the food served `is always excellent’. Since the last inspection the times for staff breaks have changed which ensures that there are always enough staff around to help at meal times. In addition the manager assists at mealtimes. A monthly audit is carried out to ensure that residents remain happy with the quality and quantities of food served. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 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) The home encourages those in their care and/or their relatives on their behalf to speak up if they are unhappy about any aspect of the care provided. EVIDENCE: The manager advised that there had been no complaints since the last inspection of the home. There is a suggestion box in the foyer of the home for residents and/or their relatives or representatives to share their views and to make suggestions for changes. Staff spoken with stated that they had received training in adult protection and prevention of abuse. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 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) 19,20,21,23,24,26,26 The owners ensure that the residents in their care have a homely and comfortable environment to live in. The Tay Unit has recently been refurbished to a very good standard. Major refurbishment of the rest of the building is also underway and once completed will ensure that every one has very pleasant and comfortable surroundings. EVIDENCE: At the time of inspection there was major refurbishment underway which included all areas of the home. New glass had been fitted in the sun lounge. All communal areas, bathrooms and bedrooms were to be either repainted or new wallpaper applied and new carpet is to be fitted throughout the building. Chairs, curtains and pictures are also to be replaced. The Tay Unit had already been refurbished and a resident spoken with was very pleased with the decor. The manager advised that new curtains and some new items of furniture have yet to be provided in the lounge/dining room in the Tay Unit. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 15 All areas of the home seen were clean and there were no unpleasant odours. At the last inspection a requirement was made to review and update infection control procedures in relation to the use of gloves and aprons. The manager advised that this had been done and the overuse of gloves and aprons had been raised with individual staff during supervision. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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) 27,28,29,30 Staff are provided with regular opportunities to update their skills and knowledge. Recruitment procedures are thorough and by the time new staff complete their induction/foundation training they have a very good understanding of the needs of the residents accommodated. EVIDENCE: All staff spoken with during the inspection were clear about the extent of their individual roles and responsibilities and those of others. Staffing levels were discussed with the manager, with care staff and with of the residents. Residents stated that they never have to wait too long either by day or night when they call for assistance. There is a stable staff team and the home has not needed to use agency staff for some time. All staff have received training in dementia and so are able to work in all areas of the home. Staff are allocated to work on a particular floor each day and become familiar with the needs of all residents accommodated. A branch of the company has been registered to provide NVQ training. The company has employed a staff member to visit each of the homes within the area to provide training for all care staff to achieve NVQ level two. In addition this member of staff also oversees induction and foundation training for new staff. All new care staff are expected to study for NVQ level two. More than 50 of the staff team have already achieved level two, and three staff have completed level three. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 17 A detailed list is kept of the training provided to staff. In addition to the core training that all staff are expected to attend, training is also provided on wound care and tissue viability, continence, food supplements and medication. In addition managers’ meetings are held monthly and these are seen as professional training sessions where professionals are invited to talk about a variety of topics relevant to the care industry. Through supervision subjects such as peg feeding, dressings and moving and handling are discussed on an individual basis with staff. All staff have an annual appraisal of their performance. Staff recruitment records were seen in relation to two staff employed to work in the home. The home’s recruitment procedures had been followed and all necessary checks had been carried out. CRB checks have been carried out in relation to all staff employed to work in the home. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31,32,33,36,37,38 The home is well managed and staff see the management of the home as supportive and approachable. The home has worked hard on addressing the requirements and recommendations of the last inspection and they are to be commended on the progress made. The quality assurance system in place ensures that regular monitoring is carried out on a wide variety of areas so that the home can continually review and if necessary update the quality of the care provided to residents. The home needs to ensure that night staff are given regular opportunities to take part in fire drills. In addition they should ensure that all staff are clear about the action that should be taken if the fire alarm sounds when they are providing personal care to residents. EVIDENCE: The manager is a Registered General Nurse and she has also completed the Registered Manager’s Award. She is supported in her role by a deputy manager who has almost completed the Registered Manager’s Award. Staff described the manager as `very approachable and supportive’. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 19 Since the last inspection of the home a fire safety officer has visited to look at the procedures in place in relation to fire safety. Where assessed as appropriate magnetic door guards have either been fitted or were due to be fitted by the end of the month. Detailed records are kept in relation to the testing of fire equipment in the home and all equipment is serviced regularly. Fire drills are held regularly. Records showed that drills are held during the day and there have been no drills held recently at nighttime. Staff spoken with were generally clear about what should happen should the alarms sound. However, further clarity is required in relation to the action that should be taken by staff should the alarms sound when a resident having a bath. A policy has been developed and introduced in relation to the use of wheelchair belts. In all rooms seen call bells were easily accessible and residents spoken with also stated that they are always easily accessible. If a resident is unable or refuses to use a call bell then a risk assessment is carried out. The home places strong emphasis on quality assurance and a number of audits are carried out to monitor the quality of the care and support provided. These include resident and relatives’ questionnaires, which are sent out annually. Questionnaires can be anonymous and are sent to the head office. The manager then receives general feedback and all residents receive information about any action taken to address issues raised. Some of the other audits carried out by the home periodically include audits of maintenance, catering, medication, falls, infection control, kitchen and philosophy of care. Records seen in respect of accidents were sufficiently detailed. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 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 Standard No 16 17 18 Score 3 x x 3 3 3 x x 3 3 3 Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 21 NO 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 38 Regulation 23(4)(e) Requirement Night staff must be given regular opportunities to participate in fire drills. Timescale for action 31 August 2005 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. 2. 3. Refer to Standard 7 8 38 Good Practice Recommendations Daily records in relation to individual residents should show to how their emotional and social needs are being met. In relation to one residents care plan, records should include a description of the type of seizures that are typically experienced by this resident. The home should check with all staff that they are clear about the action to be taken by them should the fire alarm sound when they are providing personal care to residents. Clyde House H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 H59-H10 S13974 Clyde House V231644 210605 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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