Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 26/07/05 for St Clements Nursing Home

Also see our care home review for St Clements Nursing Home for more information

This inspection was carried out on 26th July 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service is extremely good at formulating care plans from comprehensive assessments; the home is also competent at reviewing and evaluating the care. The service is keen to comply with regulations. The Providers/Manager are good at supporting the staff and ensuring that they are confident in their roles.

What has improved since the last inspection?

Some improvements have been made internally and externally. Six rooms have been re decorated, guttering has been replaced, a shed to house continence pads has been provided. Daily menus are now on display and a greater variety of food is offered that is more nutritious. The garden looks tidier and the residents are able to sit in a new gazebo when the weather permits. A room has been provided for training purposes and the staff room has been re furbished.

What the care home could do better:

The home could provide a wider form of activities for the service users. The service could provide detailed records of training and induction that are up to date and accurate.

CARE HOMES FOR OLDER PEOPLE St Clements Nursing Home 170 St Clements Hill Norwich Norfolk NR3 4DG Lead Inspector Marilyn Fellingham Unannounced 26 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Clements Nursing Home Address 170 St Clements Hill Norwich Norfolk NR3 4DG 01603 427487 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Providence Health Care Limited Mr Govinden Vythelingum Care Home 25 Category(ies) of Old age (25) registration, with number of places St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: As well as up to 24 elderly people, the home can accommodate a person under the age of 65 who will be named in the Commissions records. Date of last inspection 3 February 2005 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 I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over six and a quarter hours. A tour of the premises took place and staff and care records were inspected. Opportunity was taken to communicate with several of the residents, a few relatives and staff members; this was in addition to the senior staff on duty. The home has undergone a number of changes over the past six months. has seen change in ownership and manager. It What the service does well: What has improved since the last inspection? Some improvements have been made internally and externally. Six rooms have been re decorated, guttering has been replaced, a shed to house continence pads has been provided. Daily menus are now on display and a greater variety of food is offered that is more nutritious. The garden looks tidier and the residents are able to sit in a new gazebo when the weather permits. A room has been provided for training purposes and the staff room has been re furbished. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 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. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 Service users are given sufficient information prior to admission to the home, this enables them to make an informed decision as to whether the home can meet their needs. Each service user is given a statement of terms and conditions. EVIDENCE: The Inspector spoke with a service user who had recently been admitted to the home and her relatives. They reassured the Inspector that they were all given sufficient information that allowed them to make a decision about choosing the home and if they felt that the resident’s needs could be met. They also felt that her needs had been met to date. Examination of records and discussion with residents confirmed that they are given a statement of terms and conditions on point of entry to the home. The statement contains relevant information that ensures no doubt can be made as to what is being offered in the way of facilities and care for the prospective residents. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The management of care plans is handled exceptionally well and all service users health, personal and social needs are met as far as is possible. The care planning system is clear and provides staff with enough information to meet the health care needs of the residents. EVIDENCE: A number of individual care plans were reviewed, these were simply set out with clear guide lines for care and contained evidence of regular review. The plans showed evidence of assessment for moving and handling, risk assessments for falling, skin integrity assessments and plans of care if found to be at risk. One resident indicated that she was ”nicely hoisted”. The care plans also indicated when other health care professionals had been involved with the residents care and it was noted that opticians had visited and also the continence nurse advisor. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 10 The home needs to be commended for their care planning skills. Observations made during the inspection showed that staff were well able to promote the resident’s dignity and privacy. Communication between staff and the residents was noted to be most courteous and appropriate to their individual needs. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 The management of meals is handled well. EVIDENCE: Examination of menus indicated that the residents receive a well balanced and wholesome diet; residents confirmed this with the Inspector and stated that they are always given a choice and that “nothing is too much trouble for the cook”. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 There are suitable arrangements in place for dealing with complaints. EVIDENCE: Those residents spoken with and two relatives indicate that they would address the manager or one of the carers if they had a concern or a complaint and they stated that they felt that they would be listened to. Information is readily available within the home and the procedure for making complaints is issued to every resident on admission. The home keeps a record of all complaints, this was reviewed at the inspection and showed that responses to complaints are made within the twenty day period indicated in the home’s procedure. The home has in place a very comprehensive procedure and policy for abuse that the staff indicated they were aware of, the policy is up to date. They also said they would feel very comfortable in ‘blowing the whistle’ if they suspected anyone of causing abuse or distress to a resident. Inspection of the training plan indicate that all staff are to receive training in abuse and they also are receiving sessions on abuse for their NVQ training. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,26 Residents live in a well maintained and safe environment, though risk assessments for the environment need to be in place. EVIDENCE: The home appears safe with much improvement to the overall environment. The garden was looking good with the addition of a gazebo for the residents to use. The home appeared clean and hygienic throughout, two relatives commented that they chose the home because it was the only one they looked at that did not have an offensive odour. One bathroom is frightfully cluttered with wheelchairs and equipment and constitutes a hazard and risk assessments need to be carried out in the best interests of the residents: consideration needs to be given to providing extra storage place. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2728,29,30 Staff in the home are employed in sufficient numbers to adequately meet the residents needs. The residents are protected by the home’s recruitment policy. EVIDENCE: Adequate staff were on duty consisting of both registered nurses and care staff in sufficient numbers to meet the assessed needs of the residents. The Manager/Provider is aware of dependency levels and is looking to increase the carer ratio above the minimum standard. Extra house keeping staff are already employed to assist with the busy mealtime periods so that care staff are able to devote time to the residents. Residents spoken with indicate that they are well looked after and stated that the new manager was “very hands on” and “liked to see what was going on”. A good training programme is in place and a learning resource room has been provided for all the staff: however although the staff indicate they have undergone numerous training sessions there are no records in place for this and it is recommended that records are maintained and kept up to date. During a tour of the home a training session was taking place in relation to safe manual handling of residents. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 15 A robust recruitment process is in place and CRB checks are seen to be up to date and two references are obtained before new staff can commence; this is seen in the records for recruitment. The home is moving forward with NVQ training and 50 of carers have achieved NVQ status. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,38 The home is managed by a suitable person and the residents benefit from his leadership and experience. The health safety and welfare of the residents is promoted by the management structure that is in place. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 17 EVIDENCE: The Manager/Provider has had experience of running a care home and holds a management certificate. He has already made many significant changes that staff indicate are for the best especially in relation to resident care and protection. There is an open transparent atmosphere and the staff say they are now working well as a team and feels that the manager supports them well in their roles. The residents financial interests are safeguarded and the home takes no responsibility for residents monies. Invoices for hairdressing, chiropody and any other services that the residents may require are sent directly to the residents or significant others. The home seeks to promote the health, welfare and safety of the residents, though the issue already identified in this report concerning risk assessing the environment. The Manager/Provider is very aware that there could be language problems with the introduction of foreign nurses and insists that language courses are attended and indeed facilitates these. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 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 Standard No 16 17 18 Score 3 x 3 3 3 x 3 3 3 3 3 St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 19 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 19 Regulation 13 Requirement The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards. Timescale for action 2 months 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 19 28 Good Practice Recommendations It is recommended that consideration be given to providing storage space for equipment and thus encourage best practice by reducing potential hazards. It is recommended that training records are kept and maintained. St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI St Clements Nursing Home I55 S63411 St Clements V236828 260705 Stage 4.doc Version 1.40 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!