Care Home: The Clitheroe Residential Care Home

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What the care home does well Plans of care had been developed with the aid of people who used the service to take account of their wishes. Plans of care contained good, up to date information for staff to deliver effective care. Both people questioned said medication came at the right times. The administration of medication was safe for people who used the service. People had access to specialists to help meet their health care needs. People who used the service said, "they treat me very privately. They knock on my door. I like my bath. I use the bath hoist." and "they treat me very privately". Staff treated people who used the service privately to help preserve the dignity of people who used the service. People were allowed choice within the routines of the home to remain as independent as possible. People who used the service said, "The food is all right - if you don`t like it you can have something else. We get a cup of tea in bed" and "The food is lovely and I ask for more and get it. We can have what we want". The food served at the home met peoples nutritional needs and tastes. The facilities and services provided a good atmosphere for people who used the services. People who used the service said, "I have a very nice room - its warm" and "I have a nice room and have put lots of photographs and pictures in it". Private space met the expectations of people who used the service. There were sufficient numbers of well trained staff to meet the needs of people who used the service. The recruitment procedures were safe for people who used the service. Health and safety systems protected the health and welfare of staff and people who used the service. People who used the service said, "I join in with the activities. I like to watch television. I like murder mysteries. I like reading and I go out with friends for tea on Sunday and out every Thursday" and "I like doing crosswords". There were suitable leisure activities to keep people occupied. People who used the service said visiting was unrestricted for them to remain in touch with their family and friends. People who used the service said, "the staff are lovely and we have a bit of banter. The girls are very nice" and "the care staff are good. We have a very good laugh. I call the manager my fifth child. The staff are all nice". People who used the service enjoyed the good humored banter with staff. Staff said, "I love it. I do three afternoons a week. Every day is different. I like making people happy and I like them all. It`s not like work. I feel supervised and supported. Management are approachable. The owner is approachable as well as the manager" and "I like working here. There is a good staff team. I think we are well supported. The manager is very approachable. I get job satisfaction helping people, I like interacting with people. We get supervision". The staff spoken to felt motivated and supported to enjoy their work. What has improved since the last inspection? The administration of medication had been improved and recording of medication was safe. Care plans had been redeveloped to give staff better information to care for people who used the service. The recruitment procedures were more robust and helped the home employ suitable and safe staff. The reason for as required medication was clear and informed staff what to give and why the medication should be given. Suitable leisure activities were offered to people who used the service to help keep them occupied. There was a record of complaints which showed how the service responded to concerns. Staff had undertaken training in safeguarding adults to help protect people who used the service. Faulty windows in the home had been replaced to provide better facilities. The home did not have any offensive odours providing a better atmosphere for people who used the service. There was a good quality assurance to gain and react to the needs of people who used the service. What the care home could do better: The registered person should ensure all the assessment form is completed to help meet the needs of people who use the service. The registered person should ensure a suitably qualified and experienced person is registered with the Care Quality Commission to meet current legislation. Key inspection report Care homes for older people Name: Address: The Clitheroe Residential Care Home Eshton Terrace Clitheroe Lancashire BB7 1BQ     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: Graham Oldham     Date: 2 4 0 2 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 26 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Clitheroe Residential Care Home Eshton Terrace Clitheroe Lancashire BB7 1BQ 01200428891 01200442166 admin@primecarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Prime Care Homes Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 28 Date of last inspection Brief description of the care home The Clitheroe provides care and accommodation for 28 older people. Prime Care Homes Ltd owns the home. The house is a detached property located in a residential area, near to town centre shops and facilities and close to a bus route. There is a car park and enclosed patio area with garden seating at the front. Care Homes for Older People Page 4 of 26 Over 65 28 0 2 6 0 2 2 0 0 9 Brief description of the care home Accommodation is on 3 floors, linked by a passenger lift. Altogether there are 18 single bedrooms (two with an en-suite) and 5 double bedrooms (with privacy screening), a two part lounge, a conservatory and two dining rooms. Various adaptations and equipment (such as handrails and toilet aids) are provided to assist service users with independence and mobility. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owner and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide is issued to all residents and their relatives/representatives on admission. The fees from 1st April 2010 ranged from £378 to £425 for care and accommodation. Additional charges are made for such things as hairdressing, papers and private chiropody. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This unannounced key inspection, which included a visit to the home, took place on the 24th February 2010. Much of the information gained was obtained from talking to people who used the service and staff members. The views of people who used the service were obtained on a variety of topics. Two people were case tracked. Case tracking gave the inspector an overall view of the specific care for the individual resident by checking the plans of care, other documentation and talking to residents and staff. Two staff members were questioned about the care of the residents case tracked. Some of the views have been reported collectively with specific comments contained within the body of the report. The inspector took detailed notes during the inspection, which have been retained as evidence. Staff were directly and indirectly observed carrying out their tasks and interacting with residents. Paperwork examined included plans of care, assessment Care Homes for Older People Page 6 of 26 documentation, policies and procedures or documents relevant to each standard. A tour of the building was conducted. The service returned a self assessment questionnaire which told us of the current and projected standard for the home. Notifications, which are events the home tell us about were also used to influence the inspection. Care Homes for Older People Page 7 of 26 What the care home does well: Plans of care had been developed with the aid of people who used the service to take account of their wishes. Plans of care contained good, up to date information for staff to deliver effective care. Both people questioned said medication came at the right times. The administration of medication was safe for people who used the service. People had access to specialists to help meet their health care needs. People who used the service said, they treat me very privately. They knock on my door. I like my bath. I use the bath hoist. and they treat me very privately. Staff treated people who used the service privately to help preserve the dignity of people who used the service. People were allowed choice within the routines of the home to remain as independent as possible. People who used the service said, The food is all right - if you dont like it you can have something else. We get a cup of tea in bed and The food is lovely and I ask for more and get it. We can have what we want. The food served at the home met peoples nutritional needs and tastes. The facilities and services provided a good atmosphere for people who used the services. People who used the service said, I have a very nice room - its warm and I have a nice room and have put lots of photographs and pictures in it. Private space met the expectations of people who used the service. There were sufficient numbers of well trained staff to meet the needs of people who used the service. The recruitment procedures were safe for people who used the service. Health and safety systems protected the health and welfare of staff and people who used the service. People who used the service said, I join in with the activities. I like to watch television. I like murder mysteries. I like reading and I go out with friends for tea on Sunday and out every Thursday and I like doing crosswords. There were suitable leisure activities to keep people occupied. People who used the service said visiting was unrestricted for them to remain in touch with their family and friends. People who used the service said, the staff are lovely and we have a bit of banter. The girls are very nice and the care staff are good. We have a very good laugh. I call the Care Homes for Older People Page 8 of 26 manager my fifth child. The staff are all nice. People who used the service enjoyed the good humored banter with staff. Staff said, I love it. I do three afternoons a week. Every day is different. I like making people happy and I like them all. Its not like work. I feel supervised and supported. Management are approachable. The owner is approachable as well as the manager and I like working here. There is a good staff team. I think we are well supported. The manager is very approachable. I get job satisfaction helping people, I like interacting with people. We get supervision. The staff spoken to felt motivated and supported to enjoy their work. 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 Care Homes for Older People Page 9 of 26 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 10 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The good assessment process ensured each person was suitably placed at the care service. Evidence: Two people who used the service were involved in the case tracking process. A suitably qualified person had assessed each person prior to admission. Most of the details required to meet each persons needs had been obtained although one form had not been fully completed. This means in general that the assessment process was good although all the form should be completed to ensure each person wishes are fully taken into account. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The good plans of care gave staff sufficient information to meet the needs of people who used the service. People who used the service had access to professionals to help meet their health care needs. The administration of medication was safe for people who used the service. People were treated privately to help preserve their dignity. Evidence: Two people who used the service were involved in the case tracking process and this included looking in detail at the plans of care. Plans of care had been developed with the assistance of people who used the service to take account of their wishes. Plans of care contained good details of each persons needs for staff to deliver effective care. The plans had been reviewed on a regular basis to keep information up to date. There were risk assessments for falls, tissue viability and nutrition to help keep people who used the service safe. Evidence was observed in the plans of care that people who used the service had access to specialists to help keep their treatments up to date. Care Homes for Older People Page 13 of 26 Evidence: There were policies and procedures for the ordering, storing, administration and disposal of medication for staff to follow good practice. Staff had been trained in medication procedures and had access to medication journals to supplement their knowledge. All medication, including controlled drugs were stored and recorded safely. The medication records had been completed correctly to show people who used the service had taken their medication. Staff were observed carrying out their tasks in a polite and private way. Staff spoke to people who used the service in a pleasant way to help produce a jovial atmosphere. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was a suitable activities program to help people who used the service live a fulfilling life. Visiting was unrestricted to help people who used the service keep in touch with their family and friends. People who used the service were offered choices to help them retain some independence. The food served at the care service was nutritious and satisfactory for people who used the service. Evidence: There was a series of planned activities such as bingo, quizzes and an organist to help keep people who used the service occupied. The care service demonstrated very good links with community. The salvation army and local schools helped entertain the people who lived at the home. People had access to church minsters to follow their religious beliefs. The manager and staff said there were no restrictions to visiting to help people who used the service to socialise. People who used the service said they had choice within the routines of the home. Choice was well documented within the plans of care to enable staff to follow people wishes. Care Homes for Older People Page 15 of 26 Evidence: The food served on the day of the inspection was hot, tasteful and nutritionally balanced and people said it was good. The cook said people had a choice of food if they did not like what was on offer and carried out environmental health checks to help keep people safe. People said food was good and what they asked for. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was an accessible complaints procedure for people to voice their concerns. The robust safeguarding procedures helped protect people who used the service from possible abuse. Evidence: There was a complaints procedure which met current guidelines and gave people who used the service a timescale commitment and the address of the Care Quality Commission should they wish to take the matter further. There have not been any complaints made to the Care Quality Commission since the last key inspection. There were safeguarding policies and procedures for staff to follow safe practice. There was a copy of the Lancashire County safeguarding procedures to follow a local initiative. There was a whistle blowing policy and a copy of the No Secrets document for staff to further supplement their knowledge. Staff had been trained in safeguarding procedures and managing difficult behaviour to help keep people who used the service safe. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care home met people who used the services environmental needs. The home was warm, clean and free from offensive odours, which provided people with a homely atmosphere. Evidence: A tour of the building was conducted on the day of the inspection. The home was warm, clean and free from offensive odours and provided a comfortable environment for people who used the service. There was a lift and grab rails for people to access all parts of the building. The communal areas contained good quality domestic type furniture for people to sit or eat in comfort. There was sufficient lighting for people to read or join in activities. There were table cloths on dining tables, a small flower arrangement and a condiment set for people to enjoy their meals in an attractive setting. Carpets, curtains and other fittings were well maintained and suitable for the people who lived at the care service. There was a system for recording faults and a person employed to maintain the home. Care Homes for Older People Page 18 of 26 Evidence: Two bathrooms visited had a suitable device fitted for bathing people with mobility problems. Each bedroom could be locked to maintain privacy. Hot water temperatures were checked and this controlled to prevent scalding. The opening of windows was restricted and safety type radiators prevented accidents. Rooms had been personalised to each persons tastes and people said their rooms contained sufficient furniture to allow them to live in comfort. There were two conservatories and accessible outside space for people to enjoy in good weather. There were policies and procedures for the control of infection for staff to follow good practice. The laundry contained suitable equipment to keep clothes clean. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were sufficient numbers of well trained staff to meet the needs of people who used the service. The good recruitment procedures ensured staff were safe to work with vulnerable adults. New staff were given an induction to help familiarise themselves with people who used the service. Evidence: Two staff files were examined during the inspection to determine what training staff had undertaken and the recruitment procedures. Staff had undertaken training in NVQ2 or better in care and overall 90 of staff had completed the training. Certificates were seen for safeguarding, food hygiene, first aid, fire emergencies, medication, health and safety, risk assessment, moving and handling, infection control and safeguarding adults. This demonstrated staff had sufficient knowledge to care for the people who lived at the care home. Staff files contained evidence of recruitment such as an application form, criminal records check, a medical declaration of fitness, two written references, personal records of identity and an equal opportunities form to sign. Other information helped supplement the information and staff were given a handbook to understand the key policies and procedures. The system used helped ensure staff were suitable to meet the needs of people who used the service. Care Homes for Older People Page 20 of 26 Evidence: When staff were employed they were taken through an induction period. Staff were given two days prior to working with people to understand the basic of being a member of the care team. Staff were shadowed to ensure they did tasks the right way. New staff were given sufficient information to help them gain confidence to work with the people who used the service. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The excellent quality assurance systems helped management react to the views of people who used the service. The system used for handling peoples money helped prevent financial abuse. The health and safety policies, procedures and staff training helped protect the health and welfare of staff and people who used the service. Evidence: The registered manager had left the service. A new person had applied with the Care Quality Commission to be the registered manager and was awaiting an interview. The proposed manager had completed deprivation of liberty training and had achieved NVQ4 training in care. The proposed manager was completing the NVQ level 4 leadership and management award. When registered and the training has been completed this person will meet the requirements of the Care Quality Commission. The manager held formal meetings with staff and people who used the service to discuss any issues. Survey forms had been sent out to people who used the service staff and families to gain their views. The care service held quality recognition with Care Homes for Older People Page 22 of 26 Evidence: investors in people. The manager conducted audit checks to judge how the home was performing. A summary of the survey forms was produced for relevant bodies and showed that the home was performing well in key areas. The service had a safe to hold money securely for people who used the service. Good records were maintained of any transactions that occurred to check for any errors. There were health and safety policies and procedures for staff to follow safe practice. The manager was aware of health and safety legislation to help keep people safe. Gas and electrical equipment and installation was maintained to ensure it worked correctly. There was a fire risk assessment to help plan for emergencies. A health and safety expert ensured the risk assessments were good enough to protect people from harm. Care Homes for Older People Page 23 of 26 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 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 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 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 3 The registered manager should ensure all assessment documentation has been completed, such as a persons religious needs, to demonstrate how the service has fully met the wishes of people who use the service. The registered person should ensure their is a suitably qualified and experienced person to manage the home and register with the Care Quality Commission. 2 31 Care Homes for Older People Page 25 of 26 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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