Inspection on 28/11/09 for Clifford House

This is the latest available inspection report for this service, carried out on 28th November 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Clifford House 21/09/06

Clifford House 12/12/05

Clifford House 31/05/05

Clifford House 15/09/04

Clifford House 28/04/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Clifford House Clifford House Westlinton Carlisle Cumbria CA6 6AG     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: Margaret Drury     Date: 2 8 1 1 2 0 0 9 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 Adults (18-65 years) Page 2 of 25 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 Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Clifford House Clifford House Westlinton Carlisle Cumbria CA6 6AG 01228791514 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Oriel Graham care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability 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: Learning disability - Code LD. The maximum number of service users who can be accommodated is: 5 Date of last inspection Brief description of the care home Clifford House is a modern detached property, approximately 3 miles north of Carlisle. It is based in the village of West Linton, which has a pub and cafe and is served by a regular bus service to Carlisle and Longtown. The people that live at Clifford House access day services by either taxi, or minibus provided by that service. Mrs Graham arranges taxis or uses her own car to transport people to town or to visit relatives. Private bedrooms are all above the National Minimum Standard size and all have hand wash basins installed. There is a bathroom and shower room on the first floor and a shower room and separate toilet on the ground floor. Communal space is provided by a large lounge additionally there is a large entrance hallway/lounge that has comfortable seating, a gas fire and a television. There is a large combined kitchen and dining room, Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 5 1 8 0 2 2 0 0 9 Brief description of the care home which also has a settee and two easy chairs. A conservatory has been added to the rear of the house. The owner provides care and accommodation to five people with a learning disability. Care Homes for Adults (18-65 years) Page 5 of 25 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was the main or key inspection of this service that took place over a couple of weeks and included a visit to Clifford House. We - the Care Quality Commission sent an Annual Quality Assurance Audit (AQAA) to the home to be completed by the registered manager. This document must be completed annually by every registered provider and is the main way in which we gather information about the level of care and support provided. We arranged for surveys to be sent to the home for completion by those people living there but unfortunately these were not received. We were, however able to speak to three people living in Clifford House at the time of the visit. During our visit we looked at care documentation, spoke to residents and made a tour of the premises to inspect the environmental standards. We checked for any notifications of incidents sent to CQC by the manager and looked to see if we had received any information from other agencies regarding the provision of care. Care Homes for Adults (18-65 years) Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Adults (18-65 years) Page 7 of 25 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 Adults (18-65 years) Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 25 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. All those living in Clifford House have had their individual needs fully assessed. This ensures this service is the appropriate place for each to live in. Evidence: There have been no new admissions to Clifford House for some time but there are good systems in place for the assessment of anyone who is considering moving in. The manager did advise us (The Care Quality Commission) that she is, currently, considering the admission of a new resident. The person has already been assessed and has visited the home to look at the vacant room and meet with those already living in the home. Mrs Graham, the manager has a system in place whereby any prospective resident visits the home on several occasions usually having a meal or maybe even staying overnight. This gives ample opportunity for a considered decision to be made about moving in. The manager is careful to ensure that any new resident will be suitable and that all assessed needs can be met. During our visit we were able to speak to three of the residents about living in Clifford House and they were able to tell us how much they enjoyed living there and how kind Oriel (manager) was. Care Homes for Adults (18-65 years) Page 10 of 25 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Clifford House have their needs met and their care is provided in a manner that protects their privacy and dignity. Evidence: All those living in Clifford House have an individual plan of care based on the initial assessment of their needs. We looked at two of them to see if they were appropriate to the level of care required. Since the last inspection the manager has purchased new care planning documentation and has spent considerable time in bringing these records up to date. This now shows the care required in a more organised and consistent way thus ensuring appropriate care is available at all times. All the care plans centred on each resident and recorded what care was needed and how this was to be provided. Health requirements were detailed as were all doctors visits and appointments. As the residents have lived in the home for a number of years the manager knows them extremely well and was able to give detailed information about the level of support required. She ensures that the care plans and risk assessments are reviewed every month with the resident taking part in the review. Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: We saw that decision making came naturally to those living in the home and this was confirmed during our conversations with the residents. They choose what they want to do during the day when they are not at work or the day centre and also told us what they did in their spare time. One lady goes to night school for computer studies and another goes for a cookery class. They like to go out for meals and were planning to go out for their evening meal on the day of our visit. They were all excited as they had arranged to spend the new year in New York and looking forward to the eight hour flight. They had already been to Spain earlier in the year. The care records now show details of all risk assessments for activities inside and outside the home. These include taking the dogs for a walk and going into Carlisle on the bus. Care Homes for Adults (18-65 years) Page 12 of 25 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 Clifford House are able to take part in various activities and enjoy a lifestyle that supports their individual needs and choices. Evidence: Those using this service were able to tell us that they are able to make their own decisions about how they wish to live their lives. Two people go out to work and both enjoyed their jobs. Unfortunately one had been made redundant the day before our visit but the manager was already looking for other job opportunities for her and in the meantime was hoping to arrange a place at a local centre. She felt this was important for the resident to retain her independence. The home offers family style accommodation, which means that the daily routines are sufficiently flexible to meet the needs and wishes of those living in the home. The residents help round the house by loading the washing machine, helping with light housework and keeping their own rooms tidy. They all agreed they enjoyed doing their Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: own jobs. They all spend time in the local community and the manager supports them to enjoy the company of others. Whatever activity they enjoy, the residents are encouraged to participate in. They told us that they only have to ask and, if she is able, the manager will organise it. Holidays abroad are enjoyed and they have already spent time in Spain and are going to New York for part of the Christmas holiday. All those living in Clifford House are supported to maintain links with families and friends and all are in touch with their immediate family members. On the day of our visit one resident went out with her niece. Mealtimes and meals are very much what the residents want. They choose what to eat and mealtimes are organised around the various daily routines. They all help with the shopping and are able to choose what to buy and the manager confirmed that she maintains a healthy diet as far as possible. Care Homes for Adults (18-65 years) Page 14 of 25 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 health, personal and social needs of the people using this service are met effectively and in a way that enables them to maintain their privacy and dignity. Evidence: Most of the personal care and support is provided to those using this service by the manager with the help of one part time member of staff. The residents told us that Oriel is so kind and always there for them to talk to. They always choose what they want to wear and purchase their own clothes. On the day of our visit all the residents were well dressed in a suitable manner and they told us they liked to wear nice clothes. Health care needs are met through external health care professional and recorded in the care plans. All residents have access to optical services through Vision Call who also check on hearing. The organisation has also provided training for the manager and staff. Chiropody and dental care is also available when needed. Doctor and hospital appointments are recorded in the care plans as are the outcome of the visits. In response to a requirement made at the last inspection the manager has arranged for medication to be provided by Boots Chemist in a monitored dosage system. This ensures that medication is administered in a safe and appropriate manner. Medicine Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: records were checked and found to be correctly completed and up to date. All medication is stored securely in a locked cabinet in the office which is also kept locked. There are no controlled drugs currently prescribed. There is also a records kept of any homely remedies. The manager and staff have all recently completed training in safe handling of medication. The manager has now included in the care plans details of end of life care and the action to be taken. The information was obtained through discussion with the residents and family members. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. People using this service feel free to express their concerns knowing they will be listened to and taken seriously. Evidence: We have not received any complaints or concerns about this service and people told us they have never had cause to complain. When we talked to those living in the home they told us that if they had any concern at all they would go straight to Oriel and she would put it right. There is a complaints procedure in place and since the last inspection the manager has produced a copy in an easy read format that is now available. The manager is aware of the procedure to follow with regards to the protection of vulnerable adults. As the people living in the home attend other centres during the day she is mindful to watch for any signs that may indicate there has been a problem. Staff have completed training in safeguarding and the manager is organising a further course for herself in the new year and she recently attended training in Deprivation of Liberty organised by Cumbria Council. She has a good working relationship with Social Services who organise reviews with those living in the home. Most of the people using this service manage their finances with help from the manager or family members. They are supported and encouraged to save for holidays and new clothes and arrangements are in place to ensure the correct benefits are paid. Care Homes for Adults (18-65 years) Page 17 of 25 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Clifford House provides a safe and comfortable home that is well maintained and decorated and furnished to a good standard. Evidence: During our visit to Clifford House we were able to look around the premises to inspect the environmental standards. The people we spoke to were pleased to show us their individual rooms and all agreed they were delighted with their accommodation. The building is a large, but modern, detached house with pleasant gardens to the rear and a garden and car parking area to the front. The home is very well maintained and provides high quality living space. There is a large farmhouse style kitchen and lounge on the ground floor with a conservatory overlooking the rear garden. Residents bedrooms and a pleasant sitting area are on the first floor. There are bathing and toilet facilities on both floors. Individual rooms are very well appointed and decorated, all being personal to the individual. All the residents have chosen their own bedding, curtains and wallpaper. The one vacant room is decorated and ready for occupation although the manager did confirm that any new resident can personalise with items of their own choice. All bedrooms have a fitted wash hand basin. Laundry facilities are situated in the rear of the home, which helps with the control of cross infection and the manager has completed training in this subject. There is fire safety equipment throughout the building and the manager is arranging Care Homes for Adults (18-65 years) Page 18 of 25 Evidence: for fire doors to be fitted in the new year as a further safety measure. The house was very clean and the people living there confirmed that it is always clean and sweet smelling. Care Homes for Adults (18-65 years) Page 19 of 25 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 receive care and support from staff who have the skills to support them correctly. Evidence: Clifford House is run as a family business with Mrs Graham , the owner and registered manager responsible for the care and support. She has assistance from one part time member of staff and occasionally from other family members. All those who help in the home have been suitably recruited and have full enhanced criminal records bureau (CRB) checks in place. The manager keeps a record of all staff training and accesses as much as possible for herself and the staff. Training has been completed in, manual handling, medication, first aid, tissue viability, medication and deprivation of liberty. Two members of staff have now completed their National Vocation Qualification (NVQ) in care at level 2. Athough some training in adult protection has been completed the manager is hoping to access an update in the new year. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. Clifford House is well managed so that it is run in the best interests of the people who live there. Evidence: Clifford House is owned and managed by Mrs Oriel Graham who has owned the home for a number of years. She is experienced and qualified in that she has completed her registered manager award. She knows the residents extremely well and ensures the aims and objectives are met at all times. She has also completed training in, medication, infection control, food hygiene, adult protection and deprivation of liberty. She is arranging her manual handling update for the early part of next year. There is an open and inclusive atmosphere in the home which is run very much on family lines. Clifford House is also her own home ensuring that she has daily contact with the residents, their families and regular contact with Cumbria social services. There is a plan in place to evacuate the building in case of fire and a detailed fire risk assessment completed by Beacon Fire protection has been completed. As a result of recommendations made during the last inspection all electrical equipment has now been tested and the central heating boiler has been serviced. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: These checks will now be completed on a regular basis. These measures ensure that Clifford House is a safe place to live and work in Care Homes for Adults (18-65 years) Page 22 of 25 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 Adults (18-65 years) Page 23 of 25 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 Care Homes for Adults (18-65 years) Page 24 of 25 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. Care Homes for Adults (18-65 years) Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!