Inspection on 22/11/05 for Clyde House

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 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 22nd November 2005 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.V261341.R01.S.doc Version 5.0 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.V261341.R01.S.doc Version 5.0 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 01424-756029 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.V261341.R01.S.doc Version 5.0 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 Thirty (30) service users will be older people with nursing needs. 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 21st June 2005 2. 3. Date of last inspection 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 illness. Thirty residents can be accommodated 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 DS0000013974.V261341.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of seven hours, beginning at 10.45am. Two Inspectors undertook the Inspection enabling time to be spent both in the new Tay Wing and in the rest of Clyde House. The Inspectors met with the Registered Manager, an Area Manager for New Century Care and three other members of staff. A full tour was undertaken and there was the opportunity to speak with one resident privately in his room and to spend time with many of the 14 residents who were relaxing in the lounge in the Tay Wing. A range of documentation and key records were then inspected. This report should be read in conjunction with the report from the first inspection this year, on 21st June 2005. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose needs updating to reflect the different services offered by the Tay Wing and the rest of Clyde House. It should also give details of the Manager and the staff complement for each area. The activities Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 6 that the residents are involved in are recorded in their daily record sheet, but their emotional well-being is not included. The Recommendation from the last inspection has therefore been partially met. Documentation should also reflect individual resident’s understanding and their ability to have personal autonomy and make choices. When a complaint has been investigated a record of feedback to the complainant and assurance that the complainant is happy with the outcome should be kept. The policy for Adult Protection must identify Social Services as the lead agency for any investigation and all staff should have training in Adult Protection. The programme to install magnetic door guards and therefore avoid doors being propped open, must be completed. 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.V261341.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 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 the following standard(s): 1,4 and 5 The Statement of Purpose needs updating to reflect the different services offered by the Tay Wing and the rest of Clyde House. It should also give details of the Manager and the staff complement for each area. Good processes for admission are in place, to ensure the suitability of the Home for a resident. EVIDENCE: The top floor of Clyde House is now known as the Tay Wing and is dedicated to the care of residents with dementia type illness. The Manager expressed to the Inspectors that she is keen the Home remains integrated and that the Tay Wing does not become too separated from the rest of Clyde House. However, although there is a comprehensive Statement of Purpose, it does not clearly identify the differences between the services available in the Tay Wing and those in the rest of the Home. A resident is usually identified as being suitable for the Tay Wing, by Social Services or Health. Once the Home is approached, either the Manager or the senior nurse for the Tay Wing carries out the Home’s assessment in hospital or in the resident’s own home. Emergency and unplanned admissions are avoided where possible but once the decision has been made for a resident to be admitted they move in, initially on a trial basis. Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 9 All the staff that work within the Tay Wing have had training in mental health, but if specific care is required within the Home, specialist training is put in place in order to meet that individual’s needs. As an Organisation, staff with particular skills support and provide supervision for staff in other Homes, providing a network of expertise. Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 10 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 and 10 The Care Plans reflect the health, personal and social care needs of the residents and by being regularly reviewed, remain contemporary. Health care needs appear to be met well. The activities that the residents are involved in are recorded in their daily record sheet, but their emotional well-being is not included. The Recommendation from the last inspection has therefore been partially met. Resident’s privacy is upheld. EVIDENCE: Clyde House provides 24 hour nursing care if required and each resident has a Care Plan and Risk Assessments, which reflect their current personal and health care. Four Care Plans were viewed on the day of Inspection. Two did not contain the resident’s photo although the Manager confirmed that they were being developed and should therefore be available soon. The Care Plans are generated from the information gathered in the initial assessment. A risk assessment for falls, a nutritional assessment, a dependency assessment and an assessment of tissue viability were evident. All are reviewed and evaluated monthly. Any broken areas of skin are recorded in the care plan but reviews and evidence that they had resolved was not clearly documented. Pressure mattresses are used when required and the monthly weighing of residents at risk of weight loss is prescribed and undertaken. The residents have access to Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 11 the external health professionals they need and staff accompany them to health appointments if necessary. An assessment of ‘choice of lifestyle’ is also recorded, which includes their hobbies and interests. Activities the residents have been involved in are recorded in the daily record sheet although the emotional well-being of individual residents was not recorded on a regular basis. Staff are committed to promoting privacy and respect for residents. Personal care, any private discussion, medical examinations or treatment are provided in the resident’s room. Screens are provided for those residents sharing a double room. Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 12 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): 13 and 14 Documentation should reflect each resident’s understanding and their ability to have personal autonomy and make choices. Good practise is in place for the management of personal monies and residents are enabled to personalise their rooms. EVIDENCE: During the Inspection, most of the residents in the Tay Wing were spending time together in the lounge. In the rest of the Home, a few residents sat in one of the lounges but the majority were in their own room. During the afternoon, the Activity Co-ordinator organised a game of Bingo and five residents took part. Documentation did not reflect the choices that individual residents are making about, for example, how they wish to spend their time. Visitors are welcome at any time at Clyde House and can meet their relative or friend in private in their room, in one of the lounges or in the sun lounge. Regular outings are organised and two residents attend a club each week. Arrangements are made for residents to attend a church service on Sunday if they wish and two ministers visit the Home. Many of the residents choose to handle their own financial affairs, or solicitors are appointed to act on their behalf. The Home does not act as the appointee for any individual and details of advocacy services are available in the resident’s guide. Sundries can be provided by the Home and the bill settled on a monthly basis with the resident Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 13 or their relative. Residents bring their own possessions into the Home enabling their rooms to be personalised. Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 14 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 Good procedures for the Management of Complaints are in place but a record of feedback to the complainant and assurance that the complainant is happy with the outcome should be kept. The policy for the Protection of Vulnerable Adults must reflect Social Services as the lead Agency who will initiate any investigation into Adult Abuse. All staff should have training in Adult Protection. EVIDENCE: The Home has had two complaints since the last inspection. Both have been investigated internally and a satisfactory outcome achieved. However no complaints have been forwarded to the Commission. The Home has a complaints procedure for residents, which contains the contact address for the Commission and is publicised in the main entrance. There is also a policy for staff, which does not include the contact address or telephone number for the Commission. There is a set time span of 28 days for the complaint to be managed. Copies of written complaints are kept and the action taken is recorded. Where possible any investigation is fed back to the complainant either verbally or in writing, although a record of this and assurance that the complainant is happy with the outcome, is not kept. A suggestions box is kept by the main entrance of the Home to enable residents and their visitors to share any ideas they may have for change. There is a policy in place for Adult Protection and the Prevention of Abuse, containing much useful information. However it does not clearly identify Social Services as the lead agency for any investigation or the need to inform the Commission. Four staff have had training in Adult Abuse and a further training session is booked for next January. Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 15 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, 22 and 25 The accommodation at Clyde House is homely, comfortable and well maintained, with good facilities for wheelchair users and spacious communal areas and grounds. The current re-decoration and re-furbishing programme is to a high standard and has been well planned to cause minimal disruption to the residents. The programme to install magnetic door guards and therefore avoid doors being propped open, must be completed. EVIDENCE: Clyde House is a large building that has been converted and adapted to accommodate up to 48 older people. It is divided into two areas enabling care to be provided for those requiring nursing care and also those who are assessed as having a dementia type illness. The Tay Wing has been refurbished and opened earlier this year. The remainder of the Home is currently being re-decorated and re-furnished, but care is being taken to ensure minimal disruption to the residents. All carpets and curtains are being replaced and new pictures have been arranged for all the communal areas. New furniture is being provided in the bedrooms and residents have had some choice in the colour schemes within their room, to ensure no one has a colour Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 16 they do not care for. There is a shaft lift to each floor and a stair lift to reach one area of the Home that is up three steps. All areas of the Home are accessible for wheelchair users and there is a range of equipment and aids to meet individual needs and assist those with reduced mobility. Adjustable beds are provided for those residents needing nursing care and there are hoists and bath chairs available. The garden is well maintained and is overlooked by the sunroom, which provides communal space for the residents and their visitors. There are call bells in each room and magnetic door guards on the majority of bedroom doors, enabling residents to choose to have their doors open, although on the day of Inspection some doors were propped open. The Manager reported that a programme is underway to install magnetic door guards throughout the Home. The door releases are checked alongside the weekly fire alarm tests. Fire Drills are now arranged at different times and have recently included the night staff, meeting the Requirement from the last Inspection. There is emergency lighting throughout and all the radiators are guarded. The water temperature was checked in one bathroom and was found to be 42C. Records of monthly water temperature checks throughout the Home were viewed. Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 17 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): None of these standards were assessed at this Inspection. EVIDENCE: Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Good financial arrangements for residents’ monies are in place. EVIDENCE: Policies and Procedures are in place to safeguard and protect the financial interests of the residents. Some of the residents handle their own financial affairs, or solicitors are appointed to act on their behalf. The Home does not act as the appointee for the financial affairs of any of the residents. The invoices for funds are managed through the Head Office for the Organisation. The fees and any sundry items or services are separated out on the invoice. The Home also buys sundries and pays for services not included in the fees, from a ‘float’. Residents or their relatives can then settle payment on a monthly basis or the bill is forwarded to Head Office for inclusion with the invoice. One member of staff has direct responsibility for purchasing the sundries and arranging payment; the Manager oversees this periodically. Separate records for each resident are kept. Discussion was held about the storage of records of monies spent and the storage of the ‘float’ of money. It was agreed that arrangements Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 19 would be made for more secure storage than is currently in place. The Inspector was unable to examine the Company records on the day of Inspection. Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 2 15 x COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X 3 X X 3 X STAFFING Standard No Score 27 X 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 21 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 OP1 Regulation 4 (1)(a)(b) Sched. 1 Timescale for action The Statement of Purpose should 31/01/06 reflect the different services offered by the Tay Unit and the rest of Clyde House. It should also give details of the Manager and the staff complement for each area. The policy for Adult Protection 31/01/06 must identify Social Services as the lead agency for any investigation and all staff should have training in Adult Protection. The programme to install 31/12/05 magnetic door guards and therefore avoid doors being propped open, must be completed. Requirement 2. OP18 12 (1)(a) 13 (6) 3. OP19 13 (4) Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 22 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 OP7 Good Practice Recommendations Daily records in relation to individual residents should show to how their emotional and social needs are being met. This was a Recommendation from the last Inspection. Documentation should reflect individual resident’s understanding and their ability to have personal autonomy and make choices. A record of feedback to the complainant and assurance that the complainant is happy with the outcome should be kept. 2. 3. OP14 OP16 Clyde House DS0000013974.V261341.R01.S.doc Version 5.0 Page 23 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.V261341.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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