Inspection on 27/09/06 for Clayton Brook House

This inspection was carried out on 27th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clayton Brook House 04/11/08

Clayton Brook House 19/01/06

Clayton Brook House 28/06/05

Clayton Brook House 18/11/04

Clayton Brook House 18/05/04

Clayton Brook House 24/03/04

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 08/07/2008.

CARE HOME ADULTS 18-65 Clayton Brook House Clayton Brook House 90 Atlas Street Clayton-le-moors, Accrington Lancashire BB5 5LT Lead Inspector Mrs Lynn Mitton Unannounced Inspection 27th September 2006 10:00 Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clayton Brook House Address Clayton Brook House 90 Atlas Street Clayton-le-moors, Accrington Lancashire BB5 5LT 01254 875340 01254 238688 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) National Autistic Society Mr David William Woof Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: Clayton Brook House is registered to accommodate 6 persons aged over 18 years. The NAS is a charitable organisation specialising in caring for those diagnosed with Autistic Specific Disorders. Clayton Brook House is a detached purpose built establishment with six single en-suite bedrooms. Service users accommodation is based on the ground floor. The home had been decorated and furnished to meet the needs of service users, bearing in mind the specific needs of those with Autistic Spectrum Disorder. A secure and private garden is also available. Facilities are available for guests to stay overnight. Clayton Brook House is located in a popular residential area, within walking distance of local shops and bus routes. Parking is available at the front of the home. Fees for the cost of a weeks care at Clayton Brook House is £2308.82. There was information available to potential service users advising them of the home and giving them details about the type of service they could expect. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted on 27th September 2006. A tour of the premises took place. The inspection was conducted with the registered manager, the deputy manager and two other staff members were formally spoken to and interaction between staff and service users was observed. Throughout the report there are various references to the “tracking process”, this is a method whereby the inspector focuses on a small representative group of staff member and service users. Records pertaining to these people were inspected, as were policies and procedures. Quality assurance surveys were sent to the families/next of kin of service users. The commission received 5 responses. All indicated that they were very happy with the level of service received at Clayton Brook House. There were 5 service users living at Clayton Brook House at the time of the inspection. What the service does well: One service users relative said; “we are delighted with the way our son is cared for. He is very happy and settled and does things we never thought he would be able to. He is well respected by all the staff”. Another relative said; “I cannot speak highly enough of the staff at Clayton Brook House. My son is happy there and the staff are caring, sensitive, kind and highly motivated. I am made welcome at any time, by friendly people who I trust implicitly. I am always informed on my weekly visit about the ups and downs of my sons week, and strategies they have used to deal with situations”. Service users care plans contained detailed health and care information to ensure their needs would be met. Service users were supported in taking responsible risks. Personal support was offered to service users in a way that promoted empowerment, choice, dignity, respect and autonomy. The home was run to make sure the service users had opportunities to enjoy their life and to fulfil their potential. Service users had regular access to their local community, and were supported in maintaining family links. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 6 Staff spoken to and observed by the inspector demonstrated a good understanding of the needs of the service users. Overall the standard of décor and furnishings provided a comfortable and homely environment for service users. There were sufficient staff on duty to ensure that service users needs could be met. The home was well managed, and recruitment records demonstrated efforts to ensure the safety of service users were in place. The home was run to ensure the safety and welfare of service users and staff were safeguarded. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. YA2 & YA5 This judgement has been made using available evidence including a visit to this service. Needs assessments were in place identifying the care needs of service users and enabling support staff to have a clear understanding of how they should be supported. EVIDENCE: There had been no new admissions to the home since the last inspection. Whilst case tracking the inspector noted that assessments had been undertaken prior to service users admission to Clayton Brook House and these were suitable documents to ascertain service users needs prior to admission. Service users contracts were seen. The inspector and registered manager discussed the contents of this document and it was agreed that the format and content was in need of revision, to be more appropriate to the residential service, the service users and to include recent policies such as the no smoking policy. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. YA6, YA7, YA9 This judgement has been made using available evidence including a visit to this service. Detailed information on care plans ensured that support staff could meet service users needs in a thorough and consistent way. Risk assessments were a fundamental element of the service users care plan, enabling service users to take responsible risks. EVIDENCE: One service users care plan was examined. This documents contained detailed information about the service users and the level of support needed for staff to ensure continuity of care. The care plan had been recently reviewed. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 10 Numerous risk assessments were seen on the care plan. These included information explaining, once the risk had been identified, how it would be managed, and what action was to be put in place to reduce the risk to an acceptable level. All service users had a next of kin who represents their best interests. The registered manager is appointee for all the service users. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. YA12, YA13, YA15, YA16, YA17 This judgement has been made using available evidence including a visit to this service. The home was run to make sure that service users had opportunities to enjoy their life and to fulfil their potential. Individual dietary needs were catered for. EVIDENCE: Service users were able to make day-to-day decisions about their lives, and had opportunities to fulfil their potential. Service users had regular access to their local community; and activities accessed within the local community include swimming, trampolining, 10-pin bowling, local supermarket, Gateway social club, Space (soft play area) and Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 12 local pubs for meals. Music sessions had recently been introduced and the inspector was advised that service users were really enjoying these sessions. Each service user had an individual activity programme, which included community-based activities. The inspector noted that the service user case tracked had an up to date activity programme in place. All service users living at Clayton Brook House access the NAS Atlas St day centre facilities 5 days per week. The service users had access to 2 vehicles. Service users were supported in maintaining family relationships, and reference to this was made in the care plan. At Clayton Brook House there is a sensory room, new equipment had been obtained since the last inspection. The inspector and registered manager discussed how more new equipment was being sought and how effectively this provision was being utilised. The inspector was advised that all the service users had had a holiday or days out. The inspector observed service users being spoken to with respect and support staff were also observed respecting service users rights and wishes. The inspector spoke to one staff member about how service users privacy and dignity was promoted and maintained. The staff member spoke with confidence and could demonstrate his awareness of the importance of meeting the needs of the service users The 6 weekly menu was seen (last updated September 2004) and during the inspection it was observed that alternatives to the menu were offered to accommodate all service users preferences. A record of food eaten was also kept. Staff were observed working closely and flexibly with individuals, knowing their likes and dislikes, monitoring food intake, staggering mealtimes and accommodating “fads”. Service users are regularly weighed. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. YA18, YA19, YA20 This judgement has been made using available evidence including a visit to this service. Personal support was offered to service users in a way that promoted empowerment, choice, dignity, respect and autonomy. Service users health needs were well documented and being met. Minor amendments would ensure good practice was in place with regards to the administration, safekeeping, storage and disposal of service users medication. EVIDENCE: Service users required varying degrees of prompting, guidance and one to one personal support. The inspector was satisfied that the care staff team endeavour to ensure sensitive, consistent and flexible support for service users by understanding each persons preferred routines, likes and dislikes, and by working in close partnership with the service users, their families and other significant people involved in the service users life. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 14 One staff member told the inspector “We work well as a team, and we are now better at passing information on between shifts”. The service user case tracked had a health check document dated September 2006. There was detailed information regarding meeting all the service users health needs. This included regular weight checks and records of all optical, dental GP, chiropody and psychiatry appointments. Policies and practices for managing and administering medication were in place. Medication was administered using the Boots Monitored Dosage System. All service users had their medication administered by care staff. Information regarding consent to medication being administered by staff was on each service users care plan. All staff had completed basic Boots medication system training, and accredited training for staff regarding the safe administration of medication was ongoing at the time of the inspection, and it was expected that all staff team will of completed this training by November. Administration records were completed correctly. Patient information leaflets were in place. Medication not suitable for the MDS was stored in plastic boxes named for each service user. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. YA22 & YA23 This judgement has been made using available evidence including a visit to this service. The complaints procedures enabled service users to express their views, which were then acted upon. The adult protection policies and procedures safeguarded the service users. EVIDENCE: There had been no complaints since the last inspection. The complaints procedure had been developed in a pictorial format, which was more appropriate for some service users living at Clayton Brook House. The complaints policy and procedure was seen – this had not been reviewed since its publication in March 2004, and therefore may not contain up to date information. Staff spoken to were able to describe the complaints procedure and how they would deal with someone making a complaint. Staff spoken to were also able to give definitions of different types of abuse and how they would act if they witnessed abuse of any kind. All staff had undertaken prevention of abuse training. The homes Abuse policy and procedures was seen – they had not been reviewed since its publication in March 2004, and therefore may not contain up to date information. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. YA24 & YA30 This judgement has been made using available evidence including a visit to this service. The standard of décor and furnishings provided a comfortable and homely environment for service users. The standard of cleanliness and hygiene in the home was good. EVIDENCE: The inspector toured the building during the inspection. The home was warm clean, and odour free. Furnishings and décor provided a comfortable and appropriate environment for service users. The inspector was advised that the tired looking kitchen was due to be refurbished in next years budget. New fibre optic luminous lights, an exercise ball and a bubble lamp had been purchased for the sensory room since the last inspection. The inspector and Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 17 manager discussed facilitating further improvements to the sensory room so that this valuable space could be better utilised. A new lounge carpet had been fitted, and one service user had a new bedroom carpet. The deputy manager and the inspector discussed curtains/blinds around the home. The inspector noted that fridge and freezer temperatures were recorded daily, however, the freezer temperature was fluctuating to as high as -10 degrees. The inspector advised that this situation must be resolved. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. YA32, YA34 & YA35 This judgement has been made using available evidence including a visit to this service. The number and skills of the staff team ensured that service users needs are met. The recruitment practices and staff training protect service users. EVIDENCE: The inspector noted that 12 out of 16 care staff members had now obtained their NVQ level 3. All new support staff completed induction training to LDAF specification. Each member of staff had a training and development programme. A training matrix was in place. Staff training was ongoing and relevant to the service users living at Clayton Brook House. Staff were undertaking accredited medication training. The inspector case tracked one staff member’s files. This contained information which demonstrated that checks had been taken to ensure that service users were safeguarded. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 19 The staffing rota was seen this demonstrated that there were at usually 4 members of staff on duty during the waking day, and 1 wake and watch and 1 sleep in person during the night. The home was fully staffed and two “flexi” staff were available to cover leave and sickness. The inspector observed service users being supported by competent staff. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good YA27, YA39 & YA42 This judgement has been made using available evidence including a visit to this service. The home has an experienced and competent manager. The home was run to ensure the safety and welfare of service users and staff were safeguarded. EVIDENCE: The registered manager had completed his NVQ4 training in May 2006. The inspector was satisfied that there were clear lines of accountability within the home and with the registered person. A service users survey had taken place in September 2006. This information should now be collated and published. A service users families survey was Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 21 conducted and received a very positive response/comments about the service received at Clayton Brook House. Appropriate accident records were being completed. Fire evacuation drills were completed monthly, and fire alarm tests were completed weekly. Safety certificates were seen for fire prevention systems, gas and electrical installations and appliances. Risk assessments for around the home had been completed. The faulty dorguard had been repaired. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA5 Regulation 5(1)(b) Requirement The registered person shall produce terms and conditions in respect of accommodation to be provided including the amount and method of payment of fees. Closely monitor the freezer temperatures and undertake remedial work as necessary. Timescale for action 01/12/06 2 YA30 13(3c) 27/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA22 YA23 Good Practice Recommendations Policies and procedures should be routinely maintained and kept up to date with current practices. Policies and procedures should be routinely maintained and kept up to date with current practices. Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Clayton Brook House DS0000009567.V315672.R01.S.doc Version 5.2 Page 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. 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