Inspection on 05/08/05 for The Clough Residential Home

This inspection was carried out on 5th August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Clough Residential Home 18/03/09

The Clough Residential Home 05/02/07

The Clough Residential Home 17/01/06

The Clough Residential Home 06/01/05

The Clough Residential Home 04/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE THE CLOUGH Chorley New Road Bolton Lancs BL1 5BB Lead Inspector Grace Tarney Announced 5 August 2005 th 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. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Clough Residential Home Address Chorley New Road Bolton Lancashire BL1 5BB 01204 492462 01204 495314 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) Aegis Residential Care Homes Limited Mrs W Williams CRH PC 32 Category(ies) of OP Old Age registration, with number of places THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 31 OP Service users to include up to 1 PD This condition is in respect of this specific service user only and the registration of the home would revert to the initial registration category once the placement has concluded. Date of last inspection 6th January 2005 Brief Description of the Service: The Clough is a detached converted property situated in a quiet residential area of Bolton, off Chorley New Road. The house is set in its own very large beautifully kept gardens. There is plenty of parking within the grounds of the home. There is easy access to Bolton town centre and the surrounding motorway network. The door at the side of the home allows a level access for wheelchair users and people who have problems climbing steps. The home provides accomodation in mainly single bedrooms, on the ground and first floor. There are 2 shared bedrooms. There is a large lounge that overlooks the garden at the front of the house plus a large dining room and attached to this a large conservatory. There is also a smaller lounge area that is known as the library. The toilets and bathrooms have aids to assist any resident with a disability or mobility problem. The home is registered to provide care for 32 residents for social/residential care. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was made aware that this inspection was to take place. Several weeks before the inspection questionnaires were sent out to doctors, social workers and district nurses, as well as to the residents of the home and their relatives. The questionnaires asked what people thought of the care and services provided by the home. A lot of questionnaires were returned and all of them were complimentary about the staff, the care and the comforts of the home. The inspector spent 6 hours at the home. During this time she looked at care and medicine records to ensure that health and care needs were met. She also looked at records about staff training. The inspector also spent time speaking to 5 residents and 3 relatives. She also spoke to a district nurse who was visiting the home, 2 care staff, the manager and the chef. The Inspector walked around some areas of the home to check that the things that needed improving from the last inspection had been done Not all the National Minimum Standards were looked at on this visit. During the next inspection, which will be unannounced, the inspector will look at the rest of the Standards that are considered to be important for resident safety and wellbeing. These are the Standards that have to be inspected at least once a year. What the service does well: What has improved since the last inspection? THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 6 The manager and the owner had made good progress in ensuring that most of the things that needed improving from the last inspection had been done. A new call bell system had been provided. This new system made sure that the call bells were in easy reach of the residents, making it easier for them to ring for help. 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 CLOUGH F56 F06 S9285 The Clough V219205 300605 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 THE CLOUGH F56 F06 S9285 The Clough V219205 300605 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) 3 The system for ensuring that all prospective residents had a detailed assessment undertaken prior to admission to the home gave an assurance both to residents, relatives and staff that a resident was only admitted if the home could meet their needs. EVIDENCE: Before any resident was admitted to the home an assessment of their needs was undertaken, either by a senior member of staff from the home or from the professional i.e. care manager requesting their admission. The assessments were detailed and gave a clear indication of the residents’ needs and their capabilities. The assessments looked at the physical, mental and social care needs of the residents as well as the involvement if any, of their relatives. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 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) 7,8,9,10 &11. The care plans reflected the support needs of the residents. Care practices ensured that the residents health care needs were met, that they were treated with respect and their dignity was upheld. The medication system in place ensured that the residents received their medicines safely. EVIDENCE: Individual care plans were in place for each resident. The care plans of 2 of the residents were looked at. All of the care plans gave clear instructions and guidance on how the care needs of the residents were to be met. Each resident had a long-term care plan in place but if they did develop any acute problems then a short-term care plan was implemented. This is good practice. They were reviewed monthly and any changes were noted and acted upon. The care staff wrote daily progress reports on the residents. These however did not give enough detail about how the resident had spent their day. They stated mainly “No problems”. Staff should look at developing the reports so that they give a clearer picture of how the residents spend their day. Risk assessments were in place and covered such areas as moving and handling, nutrition, pressure sores, the use of bed rails and falls. Residents were weighed regularly and their weights recorded. Any concerns around weight loss were acted upon. New weighing scales had been provided. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 10 A discussion with the residents and relatives identified that the residents had access to other health care services including hearing, sight tests and a visiting chiropodist. Evidence of these visits was kept in the residents’ individual files. Equipment necessary for the prevention and treatment of pressure sores was available. This was provided from either within the home or from the community nurses. The inspector spent some time talking to one of the visiting community nurses. This nurse stated that the home was “excellent” and as far as communication was concerned it was a “2 way thing”. The nurse said that the home always followed any instructions given, promptly and correctly. Continence aids were in use and the staff were aware of how to contact the continence nurse advisor for advice if deemed necessary. The medication system was safe. Designated and appropriately trained staff administered medications. The medications were securely stored and the medication administration sheets were filled in accurately. A new system is in place whereby the medications are dispensed, along with the medication administration (MAR) sheets on a weekly basis. The medication sheet is kept within the cassette and returned each week. Staff were advised that, to ensure they kept an accurate record of medications received and administered they either kept the MAR sheet or took a photocopy of it. Staff were also advised to keep the prescription of Warfarin with the MAR sheet. This extra precaution ensures that the dose of Warfarin that is given is in accordance with the requirements of the doctor prescribing it. The general practitioner who completed a questionnaire stated that the home managed the residents’ medication safely. A discussion with the residents and a relative identified that they feel they are treated with respect and their right to privacy is upheld. During the inspection, staff members spoke with residents in a respectful way. Staff spoken to gave examples of how privacy and dignity were promoted. They also gave good practice examples of how they would care for a resident who was terminally ill. The general practitioner who completed a questionnaire stated that the staff had a clear understanding of the care needs of the residents. This was confirmed by speaking to the residents. Of the 12 questionnaires completed by the residents or their relatives all stated that they were happy with the care and comforts of the home. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 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) 12 13 &15. The home enabled residents to exercise as much personal freedom and choice as possible and find enjoyment with the wide range of activities available. The dietary needs of the residents were well catered for with a balanced and varied selection of food being served. EVIDENCE: The residents spoken to said that they were very satisfied with how they were allowed to spend their day, more or less as they pleased. The home does not employ an activities organiser. Two of the care assistants are deployed to undertake them in the afternoons. Residents and staff seemed happy with this arrangement. The programme of activities was displayed on the corridor and in the reception area so that residents were aware of what was “going on”. Apart from details about games and activities that take place within the home, it gave information about trips out. The home also produces a monthly news letter which is very informative. This is displayed on the notice boards. One of the residents spoken to stated that she did not want to get involved in any of the activities and was not forced to do so. She did not like the “silly games”. Residents told the Inspector that they are able to have visitors at any reasonable time and they can see their visitors in private. Relatives told the Inspector that the staff at the home always made them very welcome. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 12 The Inspector did not dine with the residents but she observed the meal being served. The meal was salmon with a sauce and lemon garnish, chips and butter beans. The residents could have a choice of meal if they wished. The tables were nicely set with tablecloths, napkins and cruets. Hot and cold drinks were served. The residents spoke positively of the food provided. Of the 10 questionnaires received from the residents, all said that they liked the food. One resident said “Very good is David”(the chef). THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 &18. The complaint system in place enabled the residents to feel that their views were listened to and acted upon. Staff had a good knowledge and understanding of adult protection procedures thereby reducing the possible risk of harm or abuse EVIDENCE: A discussion with residents and relatives indicated that there was a general awareness of how to make a complaint. The complaints procedure was displayed in the reception area. It was easy to understand and gave an assurance that complaints would be responded to within 28 days. The complaints procedure had also been given out to each resident. A copy of the Local Authorities Vulnerable Adults Procedure was in place and a discussion with the senior staff identified that they were very aware of the procedure to follow in the event of any allegation of abuse. All the staff had undertaken training in the protection of vulnerable adults. This was documented in the training file. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Standards 19 & 26 will be looked at during the next inspection. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 15 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) 27 & 28. Although the absence of a laundry assistant may impact on the care being delivered, the residents were cared for by sufficient numbers of care staff that were suitably trained and therefore had the knowledge and skills to meet their needs. EVIDENCE: Examination of the duty rotas and a discussion with staff identified that there was sufficient care staff on duty to meet the needs of the 29 residents. Of the 2 relative questionnaires returned, both said that they felt there was enough staff on duty. Staff stated that problems occurred when staff went off sick at short notice. Concerns were expressed in relation to the home not having a laundry assistant. In view of the increasing dependency of the residents and the fact that the home do work on minimum staffing levels, especially at night, a laundry assistant must be provided. The home continues to provide training in NVQ Care. Presently 50 of the care staff have achieved NVQ level 2 or above. The home is to be commended for achieving the Standard. Further training continues to be provided in first aid, moving in handling, medication administration and health and safety. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 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) 35. The systems in place for handling residents’ money ensured that their financial interests were protected. EVIDENCE: The home had a satisfactory accounting system in place. Written records of all transactions were maintained and receipts were kept for any purchases. Secure facilities were in place for the safekeeping of money and valuables. The records were checked and signed for on a monthly basis. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 17 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x 3 x x x THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 18 Yes 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 24 Regulation 23(1)(a)& 12(4)(a) Requirement Timescale for action 30/11/05. 2. 25 13(4)(a) 3. 25 13(4)(a) 4. 27 18(1)(a) To ensure the privacy and dignity of the residents is upheld locks must be fitted to the remaining bedroom doors. The locks must be suited to service users’ capabilities and accessible to staff in emergencies. Residents must be provided with a key unless their risk assessment suggests otherwise.(The previously agreed time frame of 31/3/05 was not complied with) The radiators in the 2 remaining 30/11/05. bedrooms and the medic bathroom must be guarded,or low surface temperature radiators fitted.(The previously agreed time frame of 31/3/05 was not complied with) The radiators in the lounge must 31/1/06. be guarded,or low surface temperature radiators fitted..(The previously agreed time frame of 31/3/05 was not complied with). In view of the difficulty finding suitable guards due to the design and age of the radiators a longer time frame has been allowed. A daily laundry assistant must be 30/9/05. Version 1.40 Page 19 THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc provided. 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 7 Good Practice Recommendations Staff should look at developing the daily care reports so that they give a clearer picture of how the residents spend their day. THE CLOUGH F56 F06 S9285 The Clough V219205 300605 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton, BL6 6HG 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 THE CLOUGH F56 F06 S9285 The Clough V219205 300605 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. 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