Care Home: Clarondene Residential Care Home

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What the care home does well People living at the home told us they were well cared for by competent, well trained staff. They said: "The staff keep me really clean; cheer me up when I`m low; always have my best interests at heart and really care." "I am looked after really well." "The staff are patient and spend time talking to residents to make them feel at home in a happy family atmosphere." "There is just a feel about the home; that it is run for the benefit and comfort of the residents, and the fact that there is a business is secondary to that." Residents are supported to maintain contact with family and friends, enabling people living in the home to continue to enjoy relationships that are meaningful to them. People told us that they enjoy the activities provided and that the food is very good. The menu offers choice and staff are aware of the likes and dislikes of those living there. The complaints and adult protection procedures ensure that residents and their representatives well-being and comfort is important to the home and that any concerns raised will be properly investigated and resolved. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the care needs of people. Recruitment procedures are good ensuring that staff are suitable to work in the home and residents are well protected. What has improved since the last inspection? Since the last inspection the medication procedures have improved and residents can be assured that they will receive the medicines prescribed for them in a safe manner. There is a programme of refurbishment, which has helped to ensure the health and safety of residents is maintained and the home is a comfortable place to live. What the care home could do better: The registered person must ensure that care documentation, including assessment and care planning is reviewed regularly and kept up to date. This will help to ensure that people living at Clarondene will receive the care they need. Staff training records need to be completed so that the Registered Person is aware in any shortfalls in training. Staff need to receive regular supervision so that they are made aware of how well they are doing and any extra help or supervision can be made available. Key inspection report Care homes for older people Name: Address: Clarondene Residential Care Home View Road Lyme Regis Dorset DT7 3AA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Amanda Bell     Date: 1 9 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Clarondene Residential Care Home View Road Lyme Regis Dorset DT7 3AA 01297442876 01297442025 clarondene@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ms Mary Alison Curtis Name of registered manager (if applicable) Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Clarondene residential care home is registered to provide care and accommodation for up to twelve older people who require assistance with personal care. The home is situated in a quiet residential area of Lyme Regis. All but one bedrooms are situated on the ground floor. Communal facilities comprise of a large lounge dining room. There is also a large bathroom and shower room with appropriate adaptations. The home has a small garden with seating provided, that can be accessed from the lounge. The proprietor lives on the premises and seeks to provide a homely feel. Ms Curtis takes an active role in the running of Clarondene and is present within the home each day. Care Homes for Older People Page 4 of 24 1 8 0 6 2 0 0 9 0 Over 65 12 Brief description of the care home Weekly fees range from £474 to £540 with additonal charges being made for hairdressing, chiropody and newspapers. Care Homes for Older People Page 5 of 24 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: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection took place on the 19th April 2010 and took approximately five hours. The purpose of the inspection was to assess all of the key standards. The inspection was carried out by one inspector however the term We is used throughout the report to reflect the findings of the Care Quality Commission, (CQC). The Registered Person, Ms Alison Curtis, was on hand throughout to aid the inspection process. We gathered information in a variety of ways, which included reports made to CQC by the home; the annual quality assurance assessment, (AQAA), completed by the Registered Person; a tour of the premises; completed surveys from people living and working at Clarondene and discussion with those people at the home. We also reviewed a number of care records, recruitment and training records and maintenance documentation. We were made welcome throughout our stay. Care Homes for Older People Page 6 of 24 Care Homes for Older People Page 7 of 24 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 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 24 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 24 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to go and stay at Clarodene are told about the care and facilities available. Their needs are assessed and the home confirms that those needs can be met. However a Statement of Purpose or Service User Guide are not available for people to take away and review at their leisure. Pre-admission assessments are not always documented or used to make a plan of care. Evidence: The AQAA told us: We respond to enquiries with comprehensive information about the home, describing in detail its advantages and disadvantages. We have a professionally designed leaflet which reflects the homely nature of Clarondene with several pictures to illustrate it. The Registered Person confirmed that she was in the process of producing a new Statement of Purpose and Service User Guide but they were not available to prospective residents to take away and look at to help them make an informed Care Homes for Older People Page 10 of 24 Evidence: decision about whether to stay at Clarondene or not. We reviewed the care documentation for one new resident. There was no written preadmission assessment on file. However the Registered Person confirmed she had met with the person and confirmed the home could meet their needs. The Registered Person must ensure that the needs of people are thoroughly assessed and recorded to that the information gained through this process can be used to formulate a plan of care for the individual. Care Homes for Older People Page 11 of 24 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. Residents generally receive the care they need but care records do not always provide sufficient guidance and information to staff to ensure that the appropriate care is given. The safe medication processes within Clarondene ensure that the people living there have the medication they need. Evidence: We reviewed the care files for three people living in the home and found that the standard of record keeping was variable. Each file contained a variety of assessments, information from which was then used to formulate care plans. Much of this information was out of date. Some assessments were last carried out in June 2009 and had not been reviewed since. We saw that some additions to care plans had been made but not dated or signed. One care plan failed to include the information that the person needed a cream applied. A cream chart was seen on file but there were no instructions as to when, why or where to apply the cream. Weights were not regularly recorded, which would highlight significant weight loss or gain. We saw that one person had an alarm mat in their room so that when that person got out of bed staff Care Homes for Older People Page 12 of 24 Evidence: would be made aware and give assistance. There was no risk assessment for the use of this mat and no written consent for its use. However everyone we spoke with said that they got the care they needed and that staff were attentive and knowledgeable. We spoke with a visiting health care professional who said that they had a good working relationship with the home and Staff do all that we ask. One visitor said: I am thrilled with the care. We observed staff undertaking their work during the course of our inspection and found them to be kind and courteous. They were respectful of peoples privacy and there was a calm and friendly atmosphere throughout the home. We saw that people living in the home had access to healthcare professionals as necessary and these included GPs, physiotherapist, chiropodists, dentists and opticians. We reviewed the medication processes in the home and found them to be good. The medication administration records (MARs) showed us that people got the medication they were prescribed in a safe manner. Care Homes for Older People Page 13 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are supported to maintain their life skills and are encouraged to make choices as far as possible. Social, spiritual and recreational activities meet the needs of the residents very well. Evidence: The home provided an excellent level of social, religious and recreational support to residents. People told us that they were very happy with the lifestyle that living at Clarondene afforded them. Some chose to spend time on their own but knew they could join in with any organised activities if they so wished. Activities were based on the preferences of the residents and were recorded. Activities included arts and crafts, visiting entertainers and regular gentle exercise sessions. On the day of inspection all the people in the home enjoyed a programme of songs from visiting entertainers. There was a lot of audience participation and everyone appeared to enjoy it. People told us that they were supported by staff if they wanted to attend events outside the home. Residents benefited from the home having access to a minibus so that they could get out on regular trips to places of local interest. Residents said that they could entertain their visitors in private and that they were Care Homes for Older People Page 14 of 24 Evidence: always made very welcome. People told us that they were free to choose whether they wanted to handle their own financial affairs. Some preferred to have a family member to act on their behalf. All the people we spoke with confirmed they enjoyed the food provided. Records showed that residents likes and dislikes with regard to food were known and people were aware that alternatives to the main menu were always available. Food was regularly discussed with residents and alterations were made to the menu according to peoples wishes. Care Homes for Older People Page 15 of 24 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. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Protection from abuse is promoted. Evidence: People living at Clarondene told us that they knew how to complain and felt confident that if they had concerns or complaints they will be listened to and taken seriously. There had been one complaint made in the last year, which had been fully investigated and action taken in accordance with the homes complaints policy. The home had written policies and procedures for the protection of residents from abuse or neglect and provided all staff with training in the understanding of abuse and their role in protecting residents from abuse in its many forms, including neglect. Care staff told us that they had received such training. Care Homes for Older People Page 16 of 24 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 standard of the environment at Clarondene is good providing residents with an attractive, homely and safe place to live. Evidence: A tour of the premises and review of maintenance documentation showed us that the home was well maintained inside and out. There was evidence that equipment was serviced regularly. The home continued to refurbish various rooms as the need arose. Residents had access to all communal areas. The well tended garden was attractive and accessible. Residents rooms were furnished appropriately and, since the last inspection, wardrobes had been made secure to minimise the risk of them toppling over. Bedrooms were personalised with a variety of mementos, pictures and small items of furniture. All areas of the home seen during the inspection were clean, bright and free from any unpleasant odours. Surveys completed indicated that the home was always kept clean. The laundry was well managed. Since the last inspection the laundry floor has been renewed and a new washing machine was in place. Adequate supplies of clean linen were seen to be available. Care Homes for Older People Page 17 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient care staff, are employed to meet the needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are given the training and support so that they can care for the people living at Clarondene. Evidence: At the time of inspection staff rosters demonstrated that there were sufficient staff on duty. During the inspection staff were on hand to meet the needs of the residents. People told us that staff responded to their needs promptly and were very capable and professional in their approach. The home had an ongoing training programme, which included NVQ level 2 and 3 in care and approximately 90 of the care staff hold the minimum of a level 2 award in care. We reviewed the recruitment files for two new members of staff. The files were well ordered and contained all the information required by law. Enhanced Criminal Record Bureau checks had been obtained for all new staff. Staff told us that they were encouraged to take up training opportunities provided and this included induction training. However staff training records were seen to be incomplete. The Registered Person should regularly review staff training records to ensure that any gaps can be clearly identified and appropriate actions taken. Care Homes for Older People Page 18 of 24 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. The management of the home is centred around the best interests of those people living there. However the poor level of record keeping means that the health and welfare of those people living and working at Clarodene can be compromised. Evidence: The Registered Provider and manager is Alison Curtis. She also lives at the premises, and is present within the home each day. People we spoke with held her in high regard and said that she was approachable and listened to any comments or concerns that they had. She held regular resident meetings and staff meetings where people could voice their opinions. We were told that residents either dealt with their own finances or had a representative to do so. The home did not hold any money on any residents behalf. The Registered Person confirmed that staff were not receiving regular supervision session. This must be put in place so that staff are made aware of how well they are Care Homes for Older People Page 19 of 24 Evidence: performing and any shortfalls can be identified and appropriate help can be given so that residents health and welfare are not compromised. Generally care documentation and training records were of a poor standard. The Registered Person must ensure that records are current and accurate so that staff are well informed and are able to give a good level of care which corresponds with assessed needs and wishes. Records showed that staff had received recent training in fire safety and manual handling updates. Substances hazardous to health were seen to be stored securely. Records showed that equipment had been serviced regularly. Accidents were recorded and appropriate action was taken as necessary. Care Homes for Older People Page 20 of 24 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 1 4 A copy of the Statement of Purpose and Service User Guide must be available. This requirement is made for the second time. Prospective service users must be provided with up to date information to ensure that they are able to make an informed choice regarding admission to the home. 26/06/2009 Care Homes for Older People Page 21 of 24 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 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 3 14 The registered person must ensure that the needs of people are fully assessed and kept under review To ensure that the home is able to provide the care that each person needs 16/07/2010 2 7 14 The registered person must ensure that a written plan is drawn up in sufficient detail to meet the health and welfare needs of service users. To ensure that staff have accurate and detailed information to meet each persons health needs. The registered person must make proper provision for the care and supervision of people in the home 16/07/2010 3 8 12 16/05/2010 Care Homes for Older People Page 22 of 24 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 To ensure that the use of pressure mats does not limit any persons rights and freedoms 4 36 18 All care staff must be appropriately supervised. To recognise training needs and personal development of staff. 5 37 17 The registered person must maintain in the care home records specified in Schedules 3 & 4 of the Care Homes Regulations 2001. This will ensure that up to date and accurate information with regard to the care home is available. 16/07/2010 16/06/2010 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. No Refer to Standard Good Practice Recommendations 1 8 Nutritional assessments should be kept under regular review so that any significant weight gain or loss is recognised and appropriate action taken. All care staff should receive supervision at least six times a year. 2 36 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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