Inspection on 19/06/09 for The Close

This inspection was carried out on 19th June 2009.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Close 23/07/08

The Close 24/07/07

The Close 25/07/06

The Close 29/09/05

The Close 26/04/05

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 17/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Close 53 Lynn Road Snettisham Kings Lynn Norfolk PE31 7PT     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Buttery     Date: 1 9 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Close 53 Lynn Road Snettisham Kings Lynn Norfolk PE31 7PT 01485540041 01485540041 rsiva91@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Norfolk Care Ltd care home 23 Number of places (if applicable): Under 65 Over 65 0 23 dementia old age, not falling within any other category Additional conditions: 1 0 The maximum number of service users who can be accomodated is: 23 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either whose primary care need on admission to the home are within the following category: Old age, not falling into any other categories - Code OP Dementia - Code DE Date of last inspection Brief description of the care home The Close is a care home providing personal care and accommodation for twenty-three older people. The home is privately owned by Norfolk Care Ltd. The home is located in the village of Snettisham. The coastal town of Hunstanton is approximately five miles away and King?s Lynn approximately ten miles. Care Homes for Older People Page 4 of 26 Brief description of the care home The Close is a large detached property and provides accommodation on the ground and first floors for up to twenty-three elderly people. Seventeen of the bedrooms are single and three are double. Nine of the bedrooms have en-suite facilities. Access to the first floor is gained by one of two staircases, one with a stair lift, or a passenger lift. There is a pleasant, well-maintained garden with lawns, trees and shrubs, which has a path all around the home, enabling residents to walk safely outside. The current fee range is #363.00 - #450.00. There are additional charges payable for hairdressing, private chiropody, newspapers and personal toiletries. People are advised verbally about the charge payable at the time of the initial. A copy of the latest inspection reprtt is available in the hall of the home, and further copies available on request. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection, and during our visit, we discussed the care and support needs of the people living in the home with the new manager of the home and with the proprietor. We looked at a number of individual resident and staff files as well as other records held in the home. During the inspection, we looked around the home, and spoke to some of the residents and staff, whose views are reflected in the report. Care Homes for Older People Page 6 of 26 Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed information is obtained before any new resident moves into the home to ensure that the identified needs can be met by the home, in a way suited to the individual. Evidence: As part of our inspection visit, we discussed the admission procedures of the home with the new manager and the proprietor of the home. These procedures include a detailed pre admission assessment, normally completed during a visit to the prospective new resident either in their home, or in hospital. The assessment shows the identified needs of the person seeking a move to the home, and from this information, the service can confirm that they are able to meet the needs of the person, whether any aids or adaptations are necessary, and the Care Homes for Older People Page 10 of 26 Evidence: timescales they are working to. Providing they are happy that the persons needs can be met, arrangements would then be made for the new resident to move into the home, and initial care plans would be written During our visit, we looked at the records for four people living in the home, including two recent admissions. These records showed details of the assessments that had been undertaken. Since our last visit, the information that the service provides to prospective new residents, including the statement of Purpose and service User guide have been revised, ensuring that people have information about the home to look at when making any decisions. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Further work in needed to ensure that individual plans show sufficient detail, to ensure that the persons needs will be met in an appropriate manner. Evidence: As already indicated, initial care plans are prepared in readiness for new admissions, and based on information gathered during the assessment. Although some work has been done, the care plans still need a thorough review, to ensure that they provide sufficient detail on the people living in the home, their individual needs and how these needs will be met. The individual plans also need to show how the resident has contributed, and if this is not possible, demonstrate the involvement of family members, and should also show what the anticipated outcome of each of the individual plans is. It was also evident that the new manager has started to introduce the required Care Homes for Older People Page 12 of 26 Evidence: changes, including a six monthly review with family involvement, and continuing with these changes will ensure the care plans are brought to an acceptable standard. Since our last visit, a new quality assurance procedure has been introduced, and this is helping ensure that the views of the individuals living in the home are known, and planning can therefore ensure that these needs are met in the future. In addition, regular residents and family meetings are held which further enhances the homes ability to ensure they know the likes, preferences and dislikes of the resident living in the home. The service has a good working relationship with their local GP practice, and support from district nurses, dietitians and other health professionals, and external dentists, opticians and chiropodists visit the service on a regular basis. Medication is obtained through Boots, using their monitored dosage system, and staff who are responsible for administering medication are suitable trained. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are able to take part in a variety of activities, suited to their individual needs, and have a good choice of home cooked food available. Evidence: During our visit, we looked at the various activities that are available to people living in the home, ans spoke with some of the residents. Since our last inspection, the service has introduced a new activity calendar and is encouraging people living in the home to take part in gentle exercises sessions, games and walks into the local village.. In addition, a number of games are played including Bingo and dominoes, and regular singing sessions and musical entertainment is provided. The service has also acknowledged that some people do not want to participate in group activities, and ensures that time is available for staff to spend time on a one to one basis with any residents, looking at magazines or newspapers or just talking. Care Homes for Older People Page 14 of 26 Evidence: These new initiatives do need to better documented within individual plans, so that on future inspections, we can see how individual social needs are being met, and further work is needed to ensure that the service has details on individual likes and dislikes. Positive comments were made by residents about the food they are given, one lady said it was much better than she had in a previous home, another said it was really tasty, and a choice of main meals is always available. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place to ensure that any concerns, complaints or allegations are dealt with, and individual residents are aware of how to make concerns known. Evidence: Procedures are in place to ensure that any concerns or complaints received by the home are investigated, and within set times. The proprietor told us on the day of our visit that they had not received any complaints since our last inspection, one concern around food had been raised, but this was discussed with the family and quickly resolved. Safeguarding procedures are in place to ensure that any allegations of abuse are dealt with in accordance with local authority guidelines. One incident was recorded in the last year, which was dealt with through the relevant procedures, and found to be unwarranted. The provider confirmed that all staff receive safeguarding training within their initial induction training, and further updated training will be provided to all staff in the coming year. However, when looking at staffing records, the record of training provided in the past year was poor, and this will be discussed further later in the report. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is set in a large property which provides clan a=nd safe accommodation for the people living there. Evidence: The service operates from a large older style building in the centre of the village of Snettisham. The premise have been extended and updated, and plans are now being discussed for a further extension to the home. The home is close to a number of local attractions and amenities, and the nearby seaside town of Hunstanton. On the day of our visit, the home was clean, and free from unpleasant odours, and while looking around the home, and talking to some of the residents, offers suitable facilities, with aids and adaptations as required to meet individual need. We also saw that many of the residents have been able to bring personal possessions with them, including some furniture, ornaments and photographs. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment procedures are in place but not being fully implemented, which may leave people living in the home at risk. Evidence: During our inspection visit last year, we identified shortfalls in the records held, and records that could not be found. The records that were examined during this visit clearly showed that some work had been done, but still failed to fully meet the required standards, for example one record examined showed only one written reference, another did not have an up to date reference from the last employer. In addition, although we were told of a variety of training courses that had been arranged, there was little documentary evidence available. It was therefore agreed that the proprietor and new manager would do a detailed audit of the recruitment files, ensuring that all required information is in place, and submit a training plan to the commission with details of the training to be arranged in the coming 12 months. Care Homes for Older People Page 19 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place, and being reviewed to ensure the health and safety of people living in the home. Evidence: Following our inspection visit last year, the providers informed us that they would be changing the management structure within the home, and have now recruited a new manager, with a good nursing and administrative background. Although there are still a number of areas that need to be improved, it was clear from our visit that significant steps have already been made, and that the further required improvements should take place in the coming months. Since her appointment, the new manager has spent a good deal of time working alongside the proprietor, and identifying where changes are required. They meet formally on a regular basis, and in addition the new manager is able to discuss ideas Care Homes for Older People Page 20 of 26 Evidence: and issues with the manager of another home owned by the providers which is close by. Health and safety policies are currently being rewritten, and further training will be provided, and as already indicated, care plans and recruitment records will be audited and reviewed to ensure that information in up to date and relevant. The new manager has not yet submitted an application to register with the commission, and this should be done as soon as possible. Care Homes for Older People Page 21 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15(1) Individual plans must show the involvement of the individual they relate to and how the individual can expect all their health and social care needs to be met, and show that the plans are kept under review. Evidence must be available to show how activities and events meet the expressed likes of people in the home 31/10/2008 2 12 15(1) 31/10/2008 3 27 19(1) All documentation detailed in 30/09/2008 schedule 2 of the regulations must be obtained before staff start working in the home to ensure residents are not at risk. A manager must be 30/11/2008 appointed to run the home, and an application for registration submitted to the CSCI to ensure the home is run for the benefit of the residents living there. A system to gain the views of 30/11/2008 people living in the home and ensuring the quality of the service is reviewed must be introduced to ensure that Page 22 of 26 4 31 8(1) 5 33 24(1) Care Homes for Older People people living in the home are given chance to express their views. 6 36 18(2) All staff must be appropriately supervised to ensure that any issues or concerns are dealt with. 31/10/2008 Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 7 15 Individual plans must show the involvement of the individual they relate to, include more detailed information about the person, and show evidence of review to ensure that identified needs are met in a way suited to the individual person 31/08/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 31 8 An application for the 30/09/2009 registration of the new home manager must be submitted to the commission To ensure that consistent management is provided on a full time basis, and that people living in the home can be confident their views are taken into account Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. Care Homes for Older People Page 24 of 26 No. Refer to Standard Good Practice Recommendations 1 12 Individual plans should show the social activities and events that people enjoy, and how these are provided for them Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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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