Inspection on 24/01/06 for St Clements Nursing Home

This inspection was carried out on 24th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

St Clements Nursing Home 09/03/09

St Clements Nursing Home 07/03/07

St Clements Nursing Home 26/07/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE St Clements Nursing Home 170 St Clements Hill Norwich Norfolk NR3 4DG Lead Inspector Mrs Marilyn Fellingham Announced Inspection 24th January 2006 09:30 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 Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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 Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Clements Nursing Home Address 170 St Clements Hill Norwich Norfolk NR3 4DG 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) 01603 427487 Providence Health Care Limited Mr Govinden Vythelingum Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One person under the age of 65 who will be named in the Commissions records. Date of last inspection Brief Description of the Service: St Clements was built in 1947 and sits within close proximity to Norwich city centre. An extension was built to increase the accommodation in 1989. The well tended garden extends out the back of the property in approximately half an acre. The home has accommodation for 24 older people with access to the ground floor and first floor by a passenger lift. The home is suitably adapted to cater for people with varying disabilities in either double or single bedrooms. There is a lounge with an added conservatory, which is used as a dining facility when required. A library, hairdresser and chiropodist visit the home on a regular basis. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over five hours. A tour of the premises took place and staff and care records were inspected. Opportunity was taken to communicate with all members of staff on duty, several of the service users and relatives. A number of comment cards were received from service users, relatives and other agencies; these did not give rise for great concern. What the service does well: What has improved since the last inspection? New pedal bins have been purchased which will help minimise the overall risk of infection. Refurbishment is on going and more rooms have been re decorated. Hospital type beds have been purchased. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 6 More qualified nurses and carers have been appointed. Improvement has been made in ensuring that there are detailed records kept of all training and induction. 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. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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 Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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): 3,4,5. Prospective service users are assessed well before admission and not admitted unless the home can meet their needs. The procedure for admission allows prospective service users with the opportunity to visit the home where possible. EVIDENCE: Admission documentation for two new service users was examined and it confirmed that the procedure for admission to the home adequately guides the manager and his staff who are responsible for the assessment process. It provides informative material such as risk of falls, nutritional assessment, skin integrity, mobility needs, so that decisions can be made for admission purposes. The two relatively new recent admissions, were spoken to, by the Inspector, they confirmed that they felt their needs were being met. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 9 These two recent admissions also confirmed that they and their relatives had been given the opportunity to visit the home prior to admission. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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): 7,8,9,10,11. The management of care plans is handled extremely well, the service users health, personal and social needs appear to be met. The individual plans of care are clear and decisive about the care needed to meet the assessed needs of the service users. The handling and administration of medication is managed well. Dignity and respect are observed in all areas and in the care of the dying. EVIDENCE: The inspector examined six care plans including the two belonging to the recent admissions. These were found to be excellent with much evidence of continual review and evaluation of care. Risk assessments were in place for skin integrity, moving and handling and nutrition; the care plans highlighted care that was needed if it was perceived that a service user was at risk. Risk assessments were also in place for use of wheelchairs especially when being used for outside visits and use of bed rails. Care plans also had evidence of changes in the planned care as the individual’s St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 11 care needs changed. There was evidence that special diets were catered for and supplements given if required. The care plans gave detailed instruction where catheter care was required, turning charts were in place for residents who were considered to be at risk with vulnerable skin integrity. Overall the care plans indicated that the service user’s health care needs were being met. A random check was made to ascertain if the handling of medication was satisfactory. The Inspector found that the MAR charts and the relative medication all tallied with remaining medication in stock. The MAR charts were clear and complete with evidence of random auditing. Those service users and relatives spoken with felt that they were well treated with both respect and dignity and that their privacy was upheld. The home is about to commence the Liverpool Pathway of care that is specially designed to meet the needs of those people who are dying. Policies and procedures were seen for the care of the dying, as were letters from relatives expressing their gratitude for the care that their relatives had received. The Inspector gained the impression that the care of the dying was handled well. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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): 12,13,14,15. Social activities need to be managed better and the home needs to offer a range of activities to satisfy the service users social and recreational needs. Contact is maintained with family and friends and visitors are made welcome. Service users are encouraged to make choices in relation to daily living. Management of meals is good. EVIDENCE: The management of activities is extremely haphazard; an activity co-ordinator had been appointed but unfortunately has left the home. The manager is hoping to appoint a new activity co-ordinator and develop an activity programme for the service users that will meet their social and recreational needs. A mobile library does visit the home and some reminiscence therapy sessions have been carried out. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 13 Those service users that the Inspector was able to speak with confirmed that they felt that they were given adequate opportunities to make choices in relation to their daily living including decisions about what they would like to eat. They also stated that they are able to decide where they would like to eat their meals and where they wished to see their visitors. Meals continue to be handled well, the Inspector witnessed a number of service users being assisted with their food and it was being carried out in an empathetic way. The menus indicated that the diet was wholesome and well balanced and the residents said that they felt the meals were good and that there was always a good choice; relatives also confirmed this. Comments made by the service users consisted of phrases like “very good cook” very good choice of food” and “if you can’t find anything on the menu cook will do something for you”. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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): 17,18. The home appears to be making every effort to ensure that its residents are well protected especially from any forms of abuse. EVIDENCE: The home has a robust system in place for dealing with abuse; the policies and procedures for this were inspected. Members of staff have attended a training session on abuse and those spoken to were very aware of the Whistle Blowing procedure and stated that they would have no hesitation in alerting the manager to any suspicion of abuse taking place. The home appears to ensure that the service users rights are protected and the manager is negotiating for an advocacy representative for one of the service users to make sure that her rights are upheld. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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): 19,23,25,26. Service users live in a well-maintained and safe environment that also appeared to be clean and tidy. The home suits the needs of the service users. EVIDENCE: A tour of the home took place and it appeared clean and tidy with no visible hazards; risk assessments for the environment are now in place and records for these were seen. The home has purchased some ‘hospital type beds’ to accommodate the needs of some service users. Storage of equipment is still a problem for the home but the providers are aware of this and plans are in place to deal with this situation. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 16 Most of the rooms have now been re decorated and there is a refurbishment is on going. New pedal bins have been purchased to maintain and assist with infection control. The resident’s rooms were personalised with items from their homes and those spoken to said that they were happy in their surroundings. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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): 27,28,29,30. The deployment of staff is sufficient to meet the needs of the service users. Staff have a good understanding of service users support needs Staff skill mix is adequate. Service users are protected by the home’s recruitment procedures and practices. EVIDENCE: Duty rosters were examined and they indicated that the home is adequately staffed and also indicated that there was mostly an extra carer on in the mornings above what is needed to meet the needs of the service users. Those service users spoken to by the Inspector said that they felt their needs were being met and the staff were very kind and caring and appeared to know what they needed to do for them to make them comfortable. Training plans were inspected and they confirmed that the staff were competent to do their jobs and the Inspector also noted that there were many training sessions planned for the future. The manager inferred to the Inspector that he felt that NVQ training was a priority for the home during the coming year. In house training is given for manual handling and covered in the induction period along with all mandatory training for all new staff; staff members confirmed this. Those staff on duty that the Inspector spoke with stated that St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 18 the manager was very good and supported them well in relation to ensuring that their training was adequate and gave them the skills that they needed to carry out their jobs with confidence and competency. Service users are in safe hands and recruitment records were seen for three new members of staff, all required checks had been made along with two references. It was recommended that the home retain copies of birth certificates and other proof of identification in the home. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35,38. The home is run in the best interests of the service users. The health welfare and safety of the residents are protected. EVIDENCE: An impressive auditing system has been put in place where quality is monitored and records of action taken, so that areas of improvement can be made where required. Service user’s allowance monies are in safe hands; records of all transactions were seen and found to be satisfactory. Risk assessments are in place for the overall environment, the Inspector saw these; these included the risk of fire. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 20 St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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 X X 3 3 3 X 3 X X X 3 x 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 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 X X 3 X 3 X X 3 St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 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. Refer to Standard OP29 Good Practice Recommendations It is recommended that the home retains copies of birth certificates and other confirmation of identity. St Clements Nursing Home DS0000063411.V275072.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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. 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