Care Home: Cleveland Park Care Home

What the care home does well People are provided with good information about the home which helps them decide whether it is a suitable place for them to live. Thorough assessments are carried out by the home and information is sought from health care professionals prior to people being admitted to the home. This helps ensure their needs can be fully met. Training continues to be provided to the staff to help ensure they have the correct skills to meet individual needs. The home has a robust recruitment and selection process to help protect people from abuse and to help ensure appropriate staff are appointed to meet the needs of the people living in the home. The manager is committed to making improvements and ensuring good standards are met. The atmosphere in the home was relaxed and friendly. The staff were observed to be treating people with dignity and respect. Three visitors who were present said the staff were caring and they were always made welcome in the home. What has improved since the last inspection? A permanent manager has been appointed in the home. She has lots of plans and ideas to provide people living in the home with care which is unique to the individual. She has also produced a plan of how the environment can be improved to fully meet each person`s needs. The care plans have been audited and are up to date which provides the staff with the information they need to meet individual needs. Three members of staff have been nominated to complete a test to drive the mini bus which will provide people with more outings. Storage facilities have been provided to all en suite facilities throughout the home. The staff on duty said they felt more settled and were well supported by the new manager. What the care home could do better: Ensure that `end of life` preferences are completed in the care plans so staff are aware of how to carry out people`s wishes. Ensure all the people living in the home are aware of the choices available at mealtimes. Ensure a risk assessment is carried out on the glass fronted cabinet in one of the bedrooms to help protect people`s safety. Ensure paperwork is removed from one bedroom to elminate the fire risk. Replace shabby bedroom furniture and chairs. Continue with the plans to enhance the lives of the people living in the home by providing an environment that fully meets their individual needs. Key inspection report Care homes for older people Name: Address: Cleveland Park Care Home Cleveland Road North Shields Tyne And Wear NE29 0NW     The quality rating for this care home is:   two star good 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: Anne Brown     Date: 1 4 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 28 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 28 Information about the care home Name of care home: Address: Cleveland Park Care Home Cleveland Road North Shields Tyne And Wear NE29 0NW 01912585500 01912584141 cleveland.park@ashbourne.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 66 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 66 The registered person may provide the followingcategory of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the followin categories: Dementia Code DE, maximum number of places 66 Date of last inspection Brief description of the care home Cleveland Park provides residential and nursing care for older people with an enduring mental health problem. The home is on Cleveland Park Road in North Shields, and is close to local shops and good public transport links. The building has 66 bedrooms, all with en-suite facilities. Bedrooms are located at ground and first floor levels and there is a passenger lift to help people who may have mobility problems access the first floor. There is a large lounge and dining room on each floor as well as additional bathrooms, toilets and shower facilities. The home has its own kitchen and laundry. Care Homes for Older People Page 4 of 28 Over 65 0 66 Brief description of the care home Care in the home is provided by Registered Mental Nurses supported by care staff. Fees depend on the service provided and the type of bedroom occupied. They range from £373.99 to £426.00 a week. The home has a statement of purpose and service user guide that give information to help people decide if their, or their relatives needs can be met. Care Homes for Older People Page 5 of 28 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: two star good 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: How the inspection was carried out:Before the visit we looked at:Information we have received since the last inspection on 20th August 2009. How the home dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who live in the home and their relatives. Care Homes for Older People Page 6 of 28 An unannounced visit was made on 14th April 2010. During the visit we:Talked with staff. Talked to the people using the service. Talked to the manager and area manager. Observed the interaction between the staff and the people living in the home. Looked at information about the people who live in the home and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the premises to make sure they were clean, safe and comfortable. Checked what improvements had been made since the last inspection. We told the manager of the home what we found. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Ensure that end of life preferences are completed in the care plans so staff are aware of how to carry out peoples wishes. Ensure all the people living in the home are aware of the choices available at mealtimes. Ensure a risk assessment is carried out on the glass fronted cabinet in one of the Care Homes for Older People Page 8 of 28 bedrooms to help protect peoples safety. Ensure paperwork is removed from one bedroom to elminate the fire risk. Replace shabby bedroom furniture and chairs. Continue with the plans to enhance the lives of the people living in the home by providing an environment that fully meets their individual needs. 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 9 of 28 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 10 of 28 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. People are given good information about the home and assessments are carried out prior to them moving in. This helps ensure the home can meet their individual needs. Evidence: The homes statement or purpose and service user guide are displayed in the foyer. They contain good information about the home and the services that are offered. People are given a copy of the documents and holders are currently on order so they can be placed behind each bedroom door. The care records of four people living in the home showed that assessments are completed about each persons needs before they move into the home. A care management assessment is obtained from the local authority and the home completes their own assessments which include nutrition, mental health, oral health, continence, dependency, social history, moving and handling etc. This helps ensure each persons needs can be met. Care Homes for Older People Page 11 of 28 Evidence: People are encouraged to visit the home and spend time there to help them decide if their needs can be met, prior to moving in on a permanent basis. Care Homes for Older People Page 12 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are well supported by the staff and there are good arrangements in place to help ensure the health needs of the people living in the home are met. Evidence: Four care records were looked at. Risk assessments are carried out and reviewed on a regular basis to determine the risk of falls, pressure ulcers, malnutrition, continence etc. This information is used to draw up the care plans. People living in the home and/or their representatives are involved in this process. The care plans are evaluated each month and reviews take place every three or six months depending on need. Specialist advice is sought from health care professionals when necessary. The staff on duty were respecting peoples dignity and dealing with their needs in a caring and sensitive manner. The home also employ two dignity champions who will be completing training with the organisation and this will be cascaded to all staff. The medication records were up to date and appropriately signed. Medications are Care Homes for Older People Page 13 of 28 Evidence: administered by qualified nurses and the system is audited regularly by the manager. Advice is readily available from the pharmacist. Three files did not include information on end of life preferences. The manager was aware of this and has requested that this be discussed with people as soon as possible. Care Homes for Older People Page 14 of 28 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 adequate 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 provided with a range of activities. The menus provide choice but some people may not be aware of the choices available to them if staff do not discuss this with them during the mealtime. Evidence: The activities organiser has recently terminated her employment in the home and the post is currently being advertised. Until it is filled the manager is nominating a care assistant each day to organise activities for the people living in the home. The activities programme is flexible to deal with the peoples changing needs on a daily basis. Activities include trips to the local pub, shops and a tea dance at a local church. People also enjoy music, videos, arts and crafts and making sweets and scones etc. Pampering sessions are provided by the staff and they spend time talking to people on a one to one basis. A clothes party had been arranged on the day the inspection took place. A church service is held in the home once a month and one person receives holy communion on a regular basis. Care Homes for Older People Page 15 of 28 Evidence: The staff also arrange birthday parties, themed evenings and entertainers. The home has access to a mini bus but at present no one is qualified to drive this. The manager, a care assistant and the handyman have been identified to take a test so they can drive the mini bus and get people out and about in the community. A record is kept of the activities each person enjoys and when they participate in them. The manager is also in the process of introducing a life history book in order to develop a more person centred activity plan. Family and friends are encouraged to join in any events which take place and activities are discussed in the residents/relatives meetings. The people living in the home can see their visitors in private if they wish. The manager has plans to provide a sensory garden and encourage people to plant flowers and vegetables. Each person living in the home has their nutritional needs assessed and this information is fed into the menu planning with the chef. Special diets are catered for. A new head chef has recently been appointed who has completed training on specialised diets and another member of the kitchen staff is due to commence this. Lunch was being served during the inspection and a choice of two main meals were on offer. Alternatives can also be requested. The atmosphere was relaxed and unhurried and the staff were meeting peoples needs in a sensitive manner. The manager plans to produce a pictorial menu so people can make more informed choices. The majority of people who were able to comment said they had enjoyed their meal and two said they did not like the dessert. The staff said ice cream was available as an alternative if requested. However at the time of the inspection this was not automatically offered as a choice. The manager said she would ensure the staff always informed people of the choices available at each meal time. Care Homes for Older People Page 16 of 28 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 living in the home are protected from abuse and there is an effective complaints procedure in place. Evidence: The complaints procedure is displayed in the home and this is also referred to in the service user guide. The deputy manager said the staff explain the complaints procedure to people on a regular basis to help them be aware of the process to follow to make a complaint. A complaints book is maintained to record any complaints received and the outcome of the investigation. One complaint had been received and investigated since the last inspection. Complaints are analysed each month and reported to the companys headquarters so they can be monitored. The manager is aware of the need to report any safeguarding issues to the appropriate authorities so appropriate action can be taken. The company provides training for all staff on safeguarding vulnerable adults. They also attend sessions run by the local authority so they are fully aware of local procedures. The staff on duty were aware of the procedure to follow if they observed Care Homes for Older People Page 17 of 28 Evidence: bad practice. Care Homes for Older People Page 18 of 28 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 adequate 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 provided with a safe place to live but their needs may not fully met as the environment is not user friendly. Evidence: All areas of the home were clean and comfortable. Specialist facilities are provided e.g. bathing facilities, handrails etc. There is a redecoration programme in place and when rooms become vacant they are redecorated. A handyman has recently been appointed and was carrying out an inspection of the premises along with two experienced handymen from other homes owned by the company. They were also carrying out safety tests on the fire fighting and detection equipment. Each person living in the home has their own bedroom. People are encouraged to bring personal belongings to individualise their rooms. Some communal areas are decorated with pictures and activity boards which can be touched and have different textures and items to stimulate and add interest to the environment. Care Homes for Older People Page 19 of 28 Evidence: The manager has plans to further enhance the environment so it will be specifically designed in such a way to help people with dementia in their day to day lives. For example she plans to create a reminiscence room, snoozelen room, memory prompts, user friendly kitchen etc. The manager has provided a resting area with seating in one corridor and this is proving successful. Such areas are to be introduced to all the corridors. Some chairs and bedroom furniture are showing signs of wear and tear. Mechanical ventilation devices were not working in some toilets and en suite facilities. The area manager said she had arranged for the Estates Department to visit the following day to examine these. One bedroom contained a glass fronted cabinet which could pose a risk if someone fell against it. There is a secure garden to the rear of the premises. Some seating is provided. The manager intends to provide more seating, create a sensory garden, flower beds and vevetables plot. The garden hut is to be painted as a beach hut to create another area of interest. People living in the home will be encouraged to access the garden and assist in growing plants etc. A new gardener is commencing employment next week. All areas of the home were clean and hygenic. Protective clothing is provided for the staff and liquid soap and paper towels are provided to help prevent the spread of infection. All staff have been booked to attend training on infection control in the near future. Care Homes for Older People Page 20 of 28 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. There are enough staff, who have been properly recruited, to meet the personal care needs of the people living in the home. Evidence: Policies and procedures supporting the recruitment and selection of staff are in place. A random sample of staff files were examined and these confirmed that Criminal Record Bureau checks and written references were received prior to staff being employed in the home. Job descriptions and contracts of employment are issued to all staff members. There is a programme in place to ensure care staff complete National Vocational Qualification (NVQ), Level 2 and senior care staff completed NVQ Level 3. There is a training and development plan and training matrix in place to help ensure staff receive mandatory health and safety training. Specialist training is also provided to meet individual needs. The manager has recently booked places on a course for infection control. There is a moving and handling facilitator working in the home and the staff on duty confirmed they had completed this training. Care Homes for Older People Page 21 of 28 Evidence: There are two dignity champions in the home who are shortly to complete the companys training on dementia and this will then be cascaded throughout the home. The manager is keen for this to take place as soon as possible so all staff are fully aware of peoples conditions and is to carry out dementia care mapping in the near future. This is a way of examining the needs of people living in the home and observing if they are being met. Formal supervision sessions take place and these are recorded. Training needs are discussed with the staff at these sessions. Three relatives were spoken to and they all said the staff were caring and approachable. Since the last inspection a new head chef, handyman and gardener have been appointed. Care Homes for Older People Page 22 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and managed for benefit of the people who live there and health and safety is promoted. Evidence: A new manager has been appointed since the last inspection and is applying to be registered with the Commission. She has lots of experience is managing care homes and holds appropriate qualifications. She has lots of plans and ideas to help ensure the environment is appropriate for the people living in the home and they have opportunities for personal growth. The manager makes herself available for people living in the home, relatives and staff for any discussions they may wish to have. A surgery is held once a month and regular meetings take place to discuss the day to day running of the home and to help ensure any concerns are addressed. The home is audited bi-monthly by the Service Quality Inspector and visited every Care Homes for Older People Page 23 of 28 Evidence: month by the Area Manager or a manager from another home. This helps ensure standards are maintained and if necessary improvements are made. A 24 hour on call system operates within the home to ensure the manager or deputy can be contacted in emergencies. Policies and procedures are in place for dealing with peoples finances. The staff in the home do not act as appointee or agent for anyone. A random sample of records were examined. They confirmed that appropriate receipts and signatures are retained. The fire detecting and fire fighting equipment were being tested during the inspection. It will be the responsibility of the handyman to carry out these tests at the required intervals. The staff on duty felt the new manager was approachable and supportive. One person said she has a lot of ideas to help both the staf and the residents. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 25 of 28 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 24 13 A risk assessment must be carried out on the glass fronted cabinet in a bedroom. To help ensure peoples health and safety. 07/05/2010 2 25 13 Paperwork stored in one 07/05/2010 bedrom must be removed as this could pose a fire risk. To help ensure peoples health and safety. 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 2 3 11 12 14 Ensure information is kept on end of life preferences for the people living in the home. Ensure that plans continue to provide more outings and maintain links within the local community. Ensure that each person is aware of the choices available to them at mealtimes. Care Homes for Older People Page 26 of 28 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 4 19 Ensure that chairs and bedroom furniture is replaced when it shows signs of wear and tear. This will provide people with a more pleasant place to live. Continue with the plans to enhance the building and the garden so it is user friendly and meets the needs of the people living the home. Create an environment where specialist equipment is provided for people who suffer from dementia so their independence can be maximised. Ensure the mechanical ventilation units are repaired in en suite facilities to provide people with a pleasant environment. Ensure the home continues to develop to meet the complex needs of the people who live there. 5 20 6 22 7 24 8 33 Care Homes for Older People Page 27 of 28 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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