Care Home: Clover House

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What the care home does well We received a good response to our written survey and a number of completed questionnaires were returned to us from people who live and work at the home. The questionnaires contained some very positive comments which included; `The staff always do their best for me.` `The home looks after us well and gives us independence.` `The home is a lovely home to live.` `The way the home is managed and run is very efficient. Routines are upheld and clients are very happy.` `I like having my own bedroom and my own things. I can have help to save my money.` During our visit we spoke with some residents. Most residents appeared happy and relaxed in their surroundings and clearly got along very well with staff. One resident commented ``I like living here because the staff are all nice and help you when you need it.`` During our visit we viewed a selection of residents` care plans and found these to be completed to a very good standard. The plans contained a good level of information about people`s individual care needs and how they wanted their care to be provided. People`s plans also contained some social history and information about their hobbies andtheir important relationships. It was pleasing to note that people`s plans contained person centred information which was also produced in a pictorial format to ensure that it was accessible and meaningful to the individual resident. We found that the home had a very thorough approach to risk assessment and each plan we viewed had a very comprehensive set of risk assessments to help ensure people are supported in a safe manner. We spoke with one resident who liked to manage her own medication. She told us that she had all the help she needed to do this and also showed us the secure storage in her bedroom which was provided for her medication. We were also able to confirm that the home had carried out thorough risk assessments to ensure that the resident was able to manage her medication safely. The home has a complaints procedure in place which gives the reader advice in how to go about raising any concerns they have. We were able to confirm that the procedure was available in a large print easy read version, helping to ensure that more people had access to the information. All the people who responded to our written survey and those we spoke with during our visit, told us that they knew how to make a complaint should the need arise. What the care home could do better: Whilst we noted that people`s care plans contained a good amount of information about their heath care needs we were unable to find specific health action plans for people who live at the home. We have made a recommendation that a health action plan be developed for every resident to help ensure that people`s health care needs, including preventative health care needs, are regularly assessed and reviewed. During our visit we viewed the home`s medication stock and records. We have made a requirement and a number of recommendations in relation to our findings. We noted that the home has a system in place for recording medication stock when it is received. However, this system was not always properly used and there were no processes in place to record running totals of boxed medicines . This means that it would not be possible for the manager to carry our effective audits of medication stock. We advised the manager that it is important to have records of all medicines held in the home at any one time. When viewing medication records we noted that some days earlier, one resident had ran out of a medication. This did not result in the resident missing their medicine because staff were able to get an emergency supply from the `out of hours` health care service, however we have made a recommendation that ordering processes are reviewed to ensure that people do not run out of their medication. We carried out some cross checks of records and medicines and found that they did not always add up. We found one example, that showed one resident had recently missed a dose of his medication, despite the fact that staff had signed to say all doses had beengiven. We pointed this out to the manager and advised that regular checks should be made of stock and records to ensure that people always receive their medicines as prescribed. We have made a requirement in relation to this matter. A number of people who responded to our written survey told us that they felt that residents would benefit from there being more staff on duty at the home. A number of people commented that residents often missed out on social activities because there were not adequate numbers of staff to facilitate them. Comments we received on surveys included; `Some of our residents can go out on their own but others can`t and they are constantly being let down.` `We need more staff so that residents can go out and do things they enjoy.` `Staff are constantly moved to different houses which means clients can`t make plans.` On the day of our visit we became aware that one resident had missed a planned social activity because the additional staff member who was on duty to support her had been moved from the house to another service. Staff and residents who we spoke with told us that this happened quite a lot. One resident said ``I do not need to have staff with me when I go out and I am glad because the other residents are always getting let down. It`s not the staffs` fault, its because they get moved all the time.`` We spoke with another resident who was on a break from college. He was disappointed that extra staff had not been rotad on for him to carry out some social activities during his break and he complained of feeling bored. We were unable to view previous staff rotas as these were not available during our visit. We were told that they had been transfered to the company`s head office. We advised the manager that staff rotas should be kept within the home and available for inspection at all times. We have also made a requirement that there are adequate numbers of staff on duty at all times to meet people`s needs, including their social needs. Random inspection report Care homes for older people Name: Address: Clover House 40 St Johns Road Morecambe Lancashire LA3 1EX three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Marie Cordingley Date: 0 1 0 6 2 0 1 0 Information about the care home Name of care home: Address: Clover House 40 St Johns Road Morecambe Lancashire LA3 1EX 01524426444 01524426937 ian@clovercaregroup.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Claire Louise Edington Type of registration: Number of places registered: Conditions of registration: Category(ies) : Clover Care Group (Mrs M Bradley) care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 6 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home Clover House is a care home offering personal care and accommodation to 6 people with a learning disability. The home is a 3-storey semi detached building offering residents the choice of various Care Homes for Older People Page 2 of 10 Brief description of the care home types of room. 4 residents have a single type of bedroom and 2 residents share a twin room from choice. The home is situated at the West End of Morecambe relatively close to the promenade and its amenities. There are 2 lounges and a kitchen/dining room. There is a conservatory at the rear of the home offering the residents further opportunity to have shared space or use on their own. The home has a rear garden and a drive way to the front and side of the home. The people who live at Clover House are enabled to access local community health care e.g. G.P, Dentist and Chiropodist. The home actively promotes the integration of people with a learning disability and enabling them to achieve their goals, in an age appropriate and respectful manner. Care Homes for Older People Page 3 of 10 What we found: The random inspection of this home included an unannounced site visit. As the inspection was unannounced residents, staff and the manager did not know it would be taking place until we arrived. During the visit we spent time talking with residents and some staff. We also viewed a variety of paperwork including residents personal files and medication records. We carried out a tour of some communal areas of the home and a selection of residents private accommodation. Prior to our visit we asked the manager of the home to complete a detailed self assessment which gave us information about all aspects of the homes management. In addition, we wrote to a selection of residents and staff and asked them to take part in a written survey about the standard of the service provided. The purpose of the inspection was to ensure that the home was still operating to the same excellent standards as assessed in their last key inspection in June 2007. We focused on two areas which were Personal and Health Care Support and Complaints and Protection. What the care home does well: We received a good response to our written survey and a number of completed questionnaires were returned to us from people who live and work at the home. The questionnaires contained some very positive comments which included; The staff always do their best for me. The home looks after us well and gives us independence. The home is a lovely home to live. The way the home is managed and run is very efficient. Routines are upheld and clients are very happy. I like having my own bedroom and my own things. I can have help to save my money. During our visit we spoke with some residents. Most residents appeared happy and relaxed in their surroundings and clearly got along very well with staff. One resident commented I like living here because the staff are all nice and help you when you need it. During our visit we viewed a selection of residents care plans and found these to be completed to a very good standard. The plans contained a good level of information about peoples individual care needs and how they wanted their care to be provided. Peoples plans also contained some social history and information about their hobbies and Care Homes for Older People Page 4 of 10 their important relationships. It was pleasing to note that peoples plans contained person centred information which was also produced in a pictorial format to ensure that it was accessible and meaningful to the individual resident. We found that the home had a very thorough approach to risk assessment and each plan we viewed had a very comprehensive set of risk assessments to help ensure people are supported in a safe manner. We spoke with one resident who liked to manage her own medication. She told us that she had all the help she needed to do this and also showed us the secure storage in her bedroom which was provided for her medication. We were also able to confirm that the home had carried out thorough risk assessments to ensure that the resident was able to manage her medication safely. The home has a complaints procedure in place which gives the reader advice in how to go about raising any concerns they have. We were able to confirm that the procedure was available in a large print easy read version, helping to ensure that more people had access to the information. All the people who responded to our written survey and those we spoke with during our visit, told us that they knew how to make a complaint should the need arise. What they could do better: Whilst we noted that peoples care plans contained a good amount of information about their heath care needs we were unable to find specific health action plans for people who live at the home. We have made a recommendation that a health action plan be developed for every resident to help ensure that peoples health care needs, including preventative health care needs, are regularly assessed and reviewed. During our visit we viewed the homes medication stock and records. We have made a requirement and a number of recommendations in relation to our findings. We noted that the home has a system in place for recording medication stock when it is received. However, this system was not always properly used and there were no processes in place to record running totals of boxed medicines . This means that it would not be possible for the manager to carry our effective audits of medication stock. We advised the manager that it is important to have records of all medicines held in the home at any one time. When viewing medication records we noted that some days earlier, one resident had ran out of a medication. This did not result in the resident missing their medicine because staff were able to get an emergency supply from the out of hours health care service, however we have made a recommendation that ordering processes are reviewed to ensure that people do not run out of their medication. We carried out some cross checks of records and medicines and found that they did not always add up. We found one example, that showed one resident had recently missed a dose of his medication, despite the fact that staff had signed to say all doses had been Care Homes for Older People Page 5 of 10 given. We pointed this out to the manager and advised that regular checks should be made of stock and records to ensure that people always receive their medicines as prescribed. We have made a requirement in relation to this matter. A number of people who responded to our written survey told us that they felt that residents would benefit from there being more staff on duty at the home. A number of people commented that residents often missed out on social activities because there were not adequate numbers of staff to facilitate them. Comments we received on surveys included; Some of our residents can go out on their own but others cant and they are constantly being let down. We need more staff so that residents can go out and do things they enjoy. Staff are constantly moved to different houses which means clients cant make plans. On the day of our visit we became aware that one resident had missed a planned social activity because the additional staff member who was on duty to support her had been moved from the house to another service. Staff and residents who we spoke with told us that this happened quite a lot. One resident said I do not need to have staff with me when I go out and I am glad because the other residents are always getting let down. Its not the staffs fault, its because they get moved all the time. We spoke with another resident who was on a break from college. He was disappointed that extra staff had not been rotad on for him to carry out some social activities during his break and he complained of feeling bored. We were unable to view previous staff rotas as these were not available during our visit. We were told that they had been transfered to the companys head office. We advised the manager that staff rotas should be kept within the home and available for inspection at all times. We have also made a requirement that there are adequate numbers of staff on duty at all times to meet peoples needs, including their social 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 set out on page 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 20 13 Processes must be in place to 01/07/2010 ensure that residents receive their medication as prescribed at all times. This is to help ensure the health and safety of people living at the home. 2 33 18 There must be sufficient numbers of staff on duty at all times to meet the needs, including social needs of all the people living at the home. This is to help ensure that people receive the care and support they require. 01/07/2010 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 19 A Health Action Plan should be in place for every person who lives in the home. This is to help ensure that peoples health care needs are thoroughly assessed and regularly reviewed. Page 8 of 10 Care Homes for Older People 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 2 20 It is recommended that formal competence assessments are carried out on all staff who deal with residents medication and that these checks are regularly reviewed. This is to help ensure that people dealing with residents medication are competent to do so. Processes for ordering residents medication should be reviewed and improved. This is to help ensure that people do not run out of their medications. Processes for auditing medication stock and records should be reviewed and improved to ensure that the manager can carry out effective checks on a regular basis. This is to help ensure that people receive their medication at the correct times. All staff who work at the home should be provided with training in the area of Safeguarding. This is to help ensure that staff are aware of their responsibilites to protect people in their care from abuse. Copies of previous rotas should be maintained in the home and available at all times. This is so that the manager can ensure and demonstrate that staffing levels are sufficient within the home. A training matrix should be maintained within the home with up to date information about all the training provided to each staff member. This is so that the manager can monitor this area and demonstrate that appropriate training has been provided. 3 20 4 20 5 23 6 33 7 35 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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. 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