Inspection on 05/06/07 for St Claires Care Home

This inspection was carried out on 5th June 2007.

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

St Claires Care Home 22/06/06

St Claires Care Home 08/11/05

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

CARE HOMES FOR OLDER PEOPLE St Claires Care Home 18-24 Claremont Road Folkestone Kent CT20 1DQ Lead Inspector Lisbeth Scoones Key Unannounced Inspection 5 June 2007 09:40 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 Claires Care Home DS0000064519.V336891.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 Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Claires Care Home Address 18-24 Claremont Road Folkestone Kent CT20 1DQ 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) Rosemere Care Home Ltd Post Vacant Care Home 39 Category(ies) of Dementia - over 65 years of age (39) registration, with number of places St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2006 Brief Description of the Service: St Claire’s provides residential care to up to 39 older people with dementia. The Home is a detached premises and is situated in a residential area near to the town centre of Folkestone, within easy walking distance of facilities such as shops, health centres, railway and bus stations and churches. There are three floors incorporating four day rooms and 37 single bedrooms, 6 of which have en suite facilities and one double bedroom. Residents and visitors have access to all parts of home via two shaft lifts. There is a small garden at the front of the premises, which is accessible to all service users. Designated car parking is limited but there is off street parking. A copy of the inspection report is on display in the entrance hall. The current weekly fees for residents funded by Social Services is £376.38, for privately funded residents £450. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit took place on Tuesday 5th June 2007. It comprised discussions with the manager, the proprietors, six members of care and other staff. A tour of the premises was made, a lunchtime session observed and a range of documentation viewed. All residents were spoken with although, due to the category of residents cared for, not all residents were able to express their personal experience of receiving care at the home. Ten comment cards, to be completed by residents’ relatives, were left in the home. Following the visit, a care manager and community psychiatric nurse were contacted for their views. Few responses were received at the time of the writing of this report. Those received were positive. Prior to the visit, the manager completed an Annual Quality Assurance Audit (AQAA). Information therein informed the inspection process. The home manager, Mary Coyne, has managed the home for over a year and is in the process of applying to become the registered manager. What the service does well: The proprietors and the manager demonstrated a good awareness of ways in which the service may be further improved. The proprietors have continued to improve the quality of residents’ environment in respect of decorating and refurbishment. The atmosphere in the home is relaxed and welcoming with good interaction between staff and residents. Staff give support to residents in a respectful manner, with emphasis on maintaining dignity. Care plans are comprehensive, informed by risk assessments and reviewed. Medication records are well maintained. Residents are encouraged to personalise their own bedroom and to be involved in choice of colour scheme when redecoration is required. Visitors are made to feel welcome and can visit at anytime. The management keep relatives informed of any information pertaining to the wellbeing of the resident. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 6 There has been little staff change over. Residents benefit from being looked after by staff who they know well. Staff are provided with comprehensive training including Dementia care. The staff team are well supported by management. The proprietors take an active role in the daily life of the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Claires Care Home DS0000064519.V336891.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 Claires Care Home DS0000064519.V336891.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): 1, 2, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive information is available to inform residents and their relatives of the facilities available. Every resident is given a signed contract. A pre-admission assessment ensures that the home can meet the needs of the residents. EVIDENCE: A Statement of Purpose and Service User Guide have been produced which details the facilities available. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 9 Due to the category of resident cared for, relatives and Social Services will generally be very much involved with the prospective resident in the preassessment process before a decision is made to move into the home. Every resident or their relative/advocate is given a copy of the home’s terms and conditions of residence. Following a previously made recommendation, the contract now includes the weekly fee. From discussions with the manager, it is evident that the pre-admission process is an important part of ensuring that the home can meet the needs of the resident. The team leader said that the assessment is the first stage of the development of a care plan. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 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. 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. Residents’ care plans provide staff with the information they need to care for the residents. Regularly reviewed risk assessments inform the care plans. Residents are protected by the home’s medication procedures. Residents are treated with dignity and respect. EVIDENCE: Since the previous inspection, care plans have improved and are now supported by regularly reviewed risk assessments. A sample of these was examined and evidenced that comprehensive information is available. This includes records of visits by GP’s, district and psychiatric nurses and other professionals. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 11 It was recommended, wherever possible, that residents or their relatives sign the care plan. There was evidence that residents’ health needs are met and regular contact made with GP surgeries. A CPN has a surgery at the home 2 or 3 times a month. A key worker system has been introduced. Key workers are involved with individual care planning and review. Staff have been provided with medication training. Two team leaders are responsible for all medication issues. This includes the close monitoring of entries on the medication charts. These were examined and in order. Medication was seen to be stored securely. Staff’s vigilance in ensuring residents’ compliance with medication was discussed with the manager. It was recommended that an up to date BNF be obtained. On touring the home and meeting with residents, it was observed that staff interacted with the residents in a respectful, friendly and unhurried manner. Cordless phones have been purchased to enable the residents to talk to relatives in the privacy of their own room. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a stimulating and friendly environment. Residents’ individual needs are recognised and respected. Relatives and friends are welcomed. Residents benefit from a varied menu and a choice of where to have their meals. EVIDENCE: It was evident that staff know the residents well. One team leader has been identified as the co-ordinator of indoor and out door activities. Activities taken part in are recorded. It was recommended that such records be audited regularly to ensure that all residents are included. At the time of the visit, a resident was encouraged to sing. The resident and others listening enjoyed this and joined in. Some residents were taken for a walk in the garden and the nearby park. Birthdays are celebrated and entertainment provided by local performers. Concerts in the Leas Cliff Hall may be enjoyed as well as monthly St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 13 visits made to the Salvation Army hall. It is the manager’s intention to further develop the therapeutic activities. Some care plans contained “personal profiles” thus providing staff with information of residents’ interests and previous life style. The manager was encouraged to obtain such information for all the residents. Staff demonstrated a caring and patient approach, encouraging and assisting individual residents. It is the home’s policy to welcome visitors at any time. Residents are offered a choice of menu ensuring a wholesome and varied diet. Nutritional assessments are undertaken as part of care planning and weights monitored. Residents may choose to have meals in their own room if this is assessed as ‘safe’ for the individual resident. A lunchtime meal was observed and evidenced that residents are provided with a choice of meals. It was however recommended that a member of staff be present to ensure that any expressed need is acted upon. It was further recommended, for dignity purposes, that resident are provided with serviettes. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with opportunities to air their views and make a complaint. Residents are protected from abuse. EVIDENCE: The Service User Guide contains the complaints procedure. A new complaint record has been introduced. The manager said that no complaints have been received. She said she ensures on a daily basis that any concerns residents and relatives may have are dealt with quickly. As evidenced on the training matrix and in conversation with staff, adult protection training is provided. One of the proprietors is the adult protection trainer. Post training questionnaires would ensure that staff have a good understanding of the issues and that the training would be implemented. Role play has also been introduced. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in an improving environment which is comfortable and is kept to a good standard of cleanliness. Planned upgrading work is in progress to enhance the quality of the environment for residents. EVIDENCE: Since the previous inspection, improvements to the environment have been made. The programme of decorating and furniture replacement is under way in respect of corridor areas and residents’ bedroom furniture and flooring. Those bedrooms visited looked comfortable and well furnished. The doubleglazing replacement of the windows in the bays in residents’ lounges is next on the agenda. It is the proprietors’ intention to purchase better-looking radiator St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 16 covers to replace the existing ones. Two maintenance staff members are employed, specifically for undertaking decorating/maintenance and gardening. The proprietors are committed to improving the physical environment for the residents. The home was clean and apart from one area, odour free. The home provides single room accommodation. The only shared room is currently used as a single. Four rooms have an en-suite facility, and two rooms have an en-suite shower. It was noted that residents mainly used the communal areas of the home. Independent residents accessed their own room freely. It was noted that stair gates and ‘keypads’ have been fitted to top and bottom of stairways. Since the previous inspection, the use of these has been reviewed. Due to the nature of residents’ illness, it was deemed the only option to provide a safe environment for the residents. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 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. 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. Residents’ needs are met by adequate numbers of well- trained staff. Residents are protected by the home’s recruitment policy and practices. EVIDENCE: Since the last inspection, staffing has stabilised with a low turnover. The proprietors’ decision to recruit from further a-field has proved successful. Staff employed have various qualifications and the appropriate skill mix. Care staff are supported by cleaners, catering staff, laundry and maintenance. An administrator works with the manager during two days a week. NVQ training is encouraged. Four staff have completed NVQ Level 2 and three level 3. Two staff are undertaking NVQ level 4. The manager said she has nearly competed the course. A sample of staff files was viewed and evidenced sound recruitment procedures. Documentation involved in recruiting staff from overseas was included in the sample. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 18 In conversation with staff and evidenced on the training matrix, the manager provides staff with dementia care and challenging behaviour training. Accessing diabetic care and continence management training was discussed with the manager. The home is in the process of appointing a senior lecturer to coordinate all the training and study days for the care home. Both new and more established staff have demonstrated a commitment to ongoing training and development; new staff undertake an in-depth induction training programme, with mandatory training included in the early stages of employment, with regular updating for other staff as necessary. In respect of such training, see also standard 38. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 19 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, 32, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures that residents benefit from the ethos, leadership and management approach. Residents and relatives are encouraged to have a say in how the home is run. Residents’ financial affairs are safeguarded. Staff are regularly supervised and supported. Residents’ and staff health, safety and welfare are promoted and protected. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 20 EVIDENCE: Since the previous inspection, the acting manager has become the manager. She has nearly completed NVQ 4 and is in the process of applying to become registered with the CSCI. She demonstrated a commitment to manage the home and provide strong leadership. She has a clear open door policy. The manager has worked at the home for a number of years having gained promotion to her current position. Staff said they feel supported by the manager and the team leaders. The manager in turn said she feels supported by the proprietors. As part of the home’s Quality Assurance system, every four months, a questionnaire is sent out with the invitation to the relatives meetings. The manager confirmed that responses to the questionnaire are collated and findings recorded. Decisions would be made on any necessary action to be taken. Relatives’ meetings are held every three months. GP’s and the community psychiatric nurse would be invited to attend. A recent meeting, attended by the GP, had been a great success and relatives were able to ask questions. The home does not currently keep personal finances on behalf of residents. The manager and team leaders undertake regular one to one supervision with staff. Staff spoken with confirmed the practice, which they found helpful. The manager and both proprietors are moving and handling trainers. A Standaid hoist has recently been purchased. One proprietor is the trainer for the majority of other mandatory training. Staff have regular Fire Safety awareness training. On the day of the visit, a number of staff attended Food Hygiene Training. Evidence was seen of the recording of accidents and incidents within the written records kept for individual residents. These are regularly audited. Comprehensive risk assessments are carried out. St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 21 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 3 3 x x N/A 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 2 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 3 4 x 3 4 x 3 St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 22 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 2 Refer to Standard OP9 OP19 Good Practice Recommendations That a current BNF be obtained That the home continues with the refurbishment and redecoration of the premises according to a planned programme That the manager applies to the CSCI to be registered 3 OP31 St Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Claires Care Home DS0000064519.V336891.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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