Inspection on 21/05/07 for St Clair House Care Home

This inspection was carried out on 21st May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

St Clair House Care Home 01/04/08

St Clair House Care Home 20/02/06

St Clair House Care Home 15/08/05

St Clair House Care Home 11/01/05

St Clair House Care Home 15/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE St Clair House Care Home 32 Basset Road Camborne Cornwall TR14 8SL Lead Inspector Ian Wright Unannounced Inspection 9:15am 21 and 22nd May 2007 st 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 St Clair House Care Home DS0000041642.V339527.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. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Clair House Care Home Address 32 Basset Road Camborne Cornwall TR14 8SL 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) 01209 713273 01209 610699 stclaircare@yahoo.co.uk stclaircare@yahoo.co.uk St Clair Care Limited Mr David William Maund Mr David William Maund Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th February 2006 Brief Description of the Service: St Clair provides care and support for up to eighteen elderly people. The registered provider is St Clair Care Limited. Mr David Maund, the owner of the home, is also the registered manager. The home is a two storey Georgian building which has been extended at the rear. The home is situated close to the town of Camborne where a range of amenities and facilities are available. The home generally has satisfactory access for people who experience disabilities with bedrooms situated on both floors and a passenger lift is also provided. The ground floor provides two homely communal sitting rooms at the front and rear, and an attractive dinning room. The building is maintained to a good standard. There are very attractive and well-maintained gardens are at the rear of the home. A copy of the full inspection report is available from the manager, and it is suggested a copy is requested from them or CSCI if required. The range of fees at the time of the inspection is £430 to £595 per week. There are additional charges e.g. for hairdressing, chiropody, and newspapers etc. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place in eleven and half hours over two days. All of the key standards were inspected. The methodology used for this inspection was: • To case track four service users. This included, where possible, meeting and discussing with the service users their experiences, and inspecting their records. • Discussing with three staff their experiences working in the home. • Discussion with other service users and their representatives. • Observing care practices. • Discussing care practices with management. • Inspecting records and the care environment. Other evidence gathered since the previous inspection, such as notifications received from the home (e.g. regarding any incidents which occurred), was used to help form the judgements made in the report. What the service does well: What has improved since the last inspection? The policy regarding adult protection has been updated to reflect current government guidance. There have however been no concerns regarding staff practices in this area. Medication, management and care records are all maintained to a good standard. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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 St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are issued with a copy of terms and conditions of residency or a contract, so they are aware of their rights and responsibilities. The pre admission assessment procedure is satisfactory, and enables the registered persons to ascertain they can meet the needs of service users, before admission is arranged. EVIDENCE: A copy of the home’s statement of terms and conditions of residency / contract was inspected. An individualised copy of this document was contained on service user files. The registered provider assesses service users before they are admitted. The registered provider said service users or their relatives could visit the home before formal admission is arranged. Some service users remembered an assessment was completed before admission was arranged. Copies of assessments were available for inspection in service user files. A copy of a social services assessment was also on file where these were completed. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All service users have a care plan, and there is evidence that these are reviewed. This helps to ensure service users’ care needs are suitably met. Healthcare support seems appropriate so service users can be assured they will receive suitable support from medical practitioners. The operation of the medication system is to a good standard so service users can be assured their medication is looked after and administered appropriately. Issues regarding the diverse backgrounds of service users appear suitably addressed. Service users have said they feel they are treated with respect and dignity. EVIDENCE: There is a copy of a care plan in each service user file. Staff said care plans were accessible to them. Care plans are reviewed regularly. Some service users the inspector spoke to were aware they had a care plan. All service users said care is delivered to a good standard, and staff did their best to meet their needs. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 Page 10 Service users said they were satisfied with the healthcare support they received. This includes visits from GP’s, district nurses, chiropodists, dentists and opticians. The registered provider has a satisfactory medication policy. Medication is administered via the monitored dosage system. The medication system was inspected and is managed to a good standard. Medication records kept are also managed to a good standard. Records show staff that administer medication have received formal training in this area. Service users said they felt staff worked with them in a manner, which respected their privacy and dignity. Service users were positive about their care. Service users said personal care was provided to a good standard. Service users said care was delivered in the way they wanted. The registered provider has a satisfactory policy regarding anti discrimination. There are currently no service users from ethnic minorities, although the manager said the home would be more than happy to accommodate service users from other cultures. The local population is predominantly Cornish, and from ‘White-UK’ background. Issues regarding sexuality, gender and disability seem to be suitably addressed. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Routines and activities are generally to a good standard so service users can live a lifestyle that meets their needs. Appropriate arrangements appear to be in place regarding the management of service user monies. Visiting arrangements are flexible. Meals are provided to a good standard, so service users receive an appetising, wholesome and nutritious diet. EVIDENCE: Most service users said they could get up and go to bed when they wished and routines are flexible to suit their needs. However some said getting up and breakfast arrangements could be more flexible. Some service users said they felt obliged to get up at 07:30 for breakfast, which is always served at 9 am in the dining room. Management said service users could get up when they liked, and a snack was always provided, before breakfast, if service users got up early. Service users should be able to get up and / or have their breakfast at a time of their choosing and a recommendation is made regarding this. All service users said they could go to bed when they wished. The registered persons provide regular trips out in a minibus for service users. This provides an excellent opportunity for service users to remain part of the wider community. This service is commended as excellent practice. Other St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 Page 12 activities arranged by staff include bingo and other games. There is a weekly keep fit session. Some service users, the inspector spoke to, did not want to participate in some activities, but felt their right was respected. These service users said they were quite happy to organise their own time, for example spending time in the lounge with others or in their own bedrooms. Some service users receive library books. Religious ministers also visit the home. Some service users said they enjoyed sitting in the pleasant garden when the weather is good. Service users said they could receive visitors when they wished. The inspector spoke to several relatives and friends of service users who were all satisfied with the care given at the home. Service users all said they were encouraged to make choices and did not feel there were excessive or inappropriate restrictions placed upon them. A minority however did express some concerns regarding morning arrangements as outlined above. No monies are looked after on behalf of service users, but if staff at the home purchase items on behalf of service users, these items are invoiced and service users reimburse the home on a monthly basis. Other monies were either maintained by the individual, individual solicitors or a service users relative. Some bedroom doors are lockable, but staff said service users could have a bedroom door lock if they wanted this facility. Service users said they felt their personal belongings were safe and secure in the home. Some service users said they had a lockable cash tin. Service users said they could bring in their own furnishings and personal belongings if they wished. Service users have their meals in the dining room. The inspector shared lunch with service users on the first day of the inspection. The food provided was to a very good standard. Service users said if they did not like a particular dish an alternative was always provided. A choice of a hot and cold evening tea is offered. Suitable records of menus and records of meals provided are maintained. Special diets (e.g. pureed meals) are provided if required. Support provided to service users at meal times was to a good standard. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. The registered provider has suitable procedures regarding complaints and adult protection. Subsequently service users can be assured there are appropriate procedures to deal with any concerns or bad practice. EVIDENCE: The registered provider has suitable procedures regarding complaints and adult protection. Staff and service users showed some awareness of the procedures, and were able to say whom they would approach if they had a complaint or were concerned about abuse. The Commission for Social Care Inspection has not received any complaints regarding this service. Some staff have received training regarding prevention of abuse and adult protection, delivered by the county council. It would be beneficial if more staff could attend this training if opportunities become available. Staff and service users all said they had not witnessed any bad or abusive practices. All staff have Criminal Record Bureau (CRB) check, and a Protection of Vulnerable Adults check (where applicable). St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. St Clair House provides a pleasant, homely, clean and well-maintained environment for service users to live and feel at home in. EVIDENCE: The building was inspected. The building appears to be well maintained, clean, pleasantly decorated and homely. There is a very pleasant garden, which service users can use. There are two pleasant lounges and a dining room. The rear lounge overlooks an extremely pleasant garden. There are large patio doors, which enable the service users to look outside even if they cannot walk in the garden. Many of the service users said they enjoyed walking in the garden, and there are tables and chairs outside for people to use. Bedrooms are individualised and comfortable. A shaft lift is provided to assist service users to go upstairs. Decorations are to a high standard. Bathroom and St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 Page 15 shower facilities are to a suitable standard. Suitable kitchen and laundry facilities are provided. Cleaning staff are employed, and the home was clean and hygienic at the time of inspection. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are satisfactory so service users can be assured that a suitable number of staff are available. Recruitment records are satisfactory so service users can be assured suitable checks take place when staff are recruited. Staff training is to a good standard so service users can be assured staff have suitable skills and knowledge to cater for their needs. The registered provider has a satisfactory approach to ensuring staff have a national vocational qualification in care. Equal opportunities issues regarding recruitment and work practices seem satisfactory. EVIDENCE: Suitable staffing is provided. Rotas show usually four staff are on duty in the morning and two staff in the afternoon and evening. There is one ‘sleep in’ member of staff and one waking night member of staff. Auxiliary staff such as a cook and cleaning staff are employed. Staff turnover is very low and the team appear to work well together. The registered provider has a good approach to providing National Vocational Qualifications (NVQ) for care staff. The pre inspection questionnaire states 100 of care staff have at least an NVQ2 in care. Staff recruitment records are to a good standard. The registered persons have ensured current staff complete an application form. A Criminal Records Bureau check and Protection of Vulnerable Adults check (where applicable) are St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 Page 17 obtained. Two references have been obtained for staff. Staff induction arrangements are to a good standard. For example a copy of a completed induction checklist is contained on staff files. Staff training records were inspected. Staff training generally meets the standard, although there are some minor gaps in training required by regulation. For example some staff require training in food hygiene and infection control. Manual handling training is completed in house. This is satisfactory as long as the manual handling trainer receives the required updates from an approved professional. Staff have also received other training for example some staff have been on courses regarding dementia awareness, incontinence and health and safety. The registered provider’s approach to equal opportunities and anti discrimination is to a satisfactory standard. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered persons are suitably experienced, skilled and qualified to manage the home. The registered persons has an excellent approach to quality assurance so service users can be assured there is a system to check the care they receive is of good quality. There are suitable arrangements for managing service user monies. The management of health and safety issues is to a good standard, so service users can be assured they live in a safe environment. EVIDENCE: The registered persons have suitable experience, skill and knowledge to manage the home. Mr Maund- owns the home and manages it on a day-today basis. Mrs Maund, is also involved in the day-to-day management of the home. They are assisted by Laura Crowley- the Assistant Manager who is also involved in the day-to-day management of the home. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 Page 19 The registered persons have a suitable quality assurance policy. Quality assurance practices include completing an annual survey of service users, an annual development plan and residents’ meetings. The results of the survey are very positive. It would be an improvement if the key issues were recorded regarding residents’ meetings. However it is clear service quality is taken very seriously at the home, and all service users spoke highly of the service provided. No cash is maintained on behalf of service users, and if any items are purchased on behalf of service users, the service user is invoiced on a monthly basis and reimburses the home. The registered provider has a health and safety policy. Records kept of checks required by regulation are good. For example there are suitable records for the testing of fire equipment and moving and handling equipment. Health and safety risk assessments are satisfactory and there are suitable checks to assist with the prevention of Legionella. There are suitable records regarding the central heating system being serviced. The electrical hardwire circuit and portable electrical items have been tested. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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 X 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 3 St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 OP10 OP12 Good Practice Recommendations Management should monitor that service users do get a choice when service users get up and go to bed, and when they can have their breakfast. St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Devon Office Unit D1 Linhay Business park Ashburton Devon TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 St Clair House Care Home DS0000041642.V339527.R01.S.doc Version 5.2 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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