Inspection on 04/11/08 for Clayton Brook House

This inspection was carried out on 4th November 2008.

CSCI 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

Clayton Brook House 27/09/06

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Clayton Brook House Clayton Brook House 90 Atlas Street Clayton-le-moors, Accrington Lancashire BB5 5LT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Mulcahy     Date: 0 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Clayton Brook House Clayton Brook House 90 Atlas Street Clayton-le-moors, Accrington Lancashire BB5 5LT 01254875340 01254238688 davidwoof@nas.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): National Autistic Society Name of registered manager (if applicable) Mr David William Woof Type of registration: Number of places registered: 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: 6 Date of last inspection Brief description of the care home 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 Care Homes for Adults (18-65 years) Page 4 of 26 care home 6 Over 65 0 6 Brief description of the care home 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 are determined by a thorough needs assessment and can be discussed with the manager 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. Care Homes for Adults (18-65 years) 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 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: A key unannounced inspection, including a visit to the home was conducted on 4th November 2008. Information was obtained from care plans of the people using the service,records, management systems, relative and staff questionnaires and care observations. The inspector spoke to 2 staff and the deputy manager. The quality rating for this service is 2 Star. This means that people who use this service experience good quality outcomes. Care Homes for Adults (18-65 years) Page 6 of 26 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 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 8 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, 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. Comprehensive needs assessments were carried out for the people who were planning to use the service so that the support workers could help to fully meet their needs and aspirations. Evidence: Comprehensive written information about the home, its objectives and philosophy was available to the people who use the service. These documents showed what people who use the service can expect and clearly detailed the specialist services provided, quality of the accommodation, staff experience and how to make a complaint. Copies of these documents are made available in pictorial format so that the information can be understood by the people who use the service. People who were new to the service received a full and thorough needs assessment before moving into the home. The needs assessment focused on residents achieving their full potential with the support of specialist services and the use of community resources. Case tracking of a person who was new to the service confirmed that a needs Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: assessment had been completed before moving into the home. Information gathered had been collated over a 12 month period and developed at a one day seminar for the workers who would be involved in the persons care. To ensure the support workers were clear about their duties, the residents relatives, carers and representatives were invited to contribute to the needs assessment which would eventually form the care placement plan. A visual contract using images and photographs had clear information about fees, charges, complaints and the responsibilities of the service and resident. Care Homes for Adults (18-65 years) Page 10 of 26 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. The needs of the people who use the service were set out in a plan of care to help them maximise autonomy and choice. Health and safety procedures ensured residents were involved in decisions about their lives and wellbeing Evidence: Case tracking of one of the residents confirmed that there was a plan of care that held enough detail for the support workers to meet the residents identified needs. The plan of care showed that the resident had received a thorough needs assessment and the staff were fully committed in supporting the resident to lead a purposeful and fulfilling life as independently as possible. The plan is a comprehensive up to date working tool used by the staff team, relatives, professionals and the resident where appropriate. It can be used easily and quickly by new staff so there is a continuity in delivering a personalised service. Relatives of the resident and professional workers developed the care plan and sets out how the residents needs and aspirations are to be met through positive support. The care plan is person centered and includes comprehensive risk Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: assessments for health and daily living and this is regularly reviewed within a continual review process. Staff have the specialised training and skills to support, engage and encourage the resident to be fully involved in daily living activities. A key worker system actively provides one to one support and communication and was observed ensuring the needs and wishes of the resident were met. The good practice of addressing religious, cultural and relationship needs in the care plan was noted. There were very good examples of how the service would meet specific communication needs of the resident through picture images. All staff were aware of the way in which they should present opportunities and choices and that this should be done through a catalogue of pictures and photos. This means that staff were able to use strategies and systems in place to meet the diverse learning and cultural needs of the people using the service. Care Homes for Adults (18-65 years) Page 12 of 26 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. Leisure and recreational activities available met the social needs and interests of the people who use the service. Visiting from relatives and friends is supported. A regularly reviewed menu ensured meals and snacks provided variety and nutrition. Evidence: The homes philosophy strongly promotes the residents right to live an ordinary and meaningful life both in the home and in the community. The person in charge said that wherever possible residents were able to make choices, with support, about aspects of their lives like waking, going to bed and handling their own money. There is a strong commitment to enable residents through a person centered approach to integrate into community life and use facilities that develop their abilities and social skills like day centre attendance, swimming, meals out and cinema visits. A newly decorated sensory room at the home provides residents with an opportunity to experience a therapeutic Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: and relaxing environment in the home if they want some peace and relaxation. Daily attendance to the Atlas Street Day Service, run and managed by the National Autistic Society, provides the people using the service with meaningful activity, support and supervision, through a person centered planned process of structure and routine. The home has access to two vehicles which staff are trained to drive and the person in charge said that the vehicles are used for things like visit to places of interest, shopping, going swimming or just general assess to community resources. Observations of the care provided and variety of activities available in the home confirmed that as far as possible residents independence was maintained. A sensory room, robust outdoor swings, large enclosed garden area, personal hi-fi and audio visual equipment actively encouraged independence in and around the home. Religious and cultural needs had been assessed and identified at the initial assessment process before moving into the home. Where these had changed the person in charge said that records would be updated and staff would be sensitive to these changing needs and support the residents in their decision. Care Homes for Adults (18-65 years) Page 14 of 26 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 care needs of the people using the service were set out in a plan of care. Residents were protected by the homes medicine policies and procedure and care practices showed that residents privacy and dignity was respected. Evidence: Examination of personal health records that belonged to 2 of the people using the service showed they were up to date and there was sufficient health care information for staff to meet the identified needs. Evidence of contact with General Practitioners, and other health professionals were clearly recorded and kept in the residents care plan. Discussion with the person in charge confirmed that the health care and support delivered to people using the service was consistent, sensitive, and met the identified needs of the people using the service. An effective medicines policy supported by written procedures and practices was available for staff to follow. Examination of the medicines cabinet and MAR sheets showed that medication in the home was stored and managed appropriately. Medicine records were fully completed and signed by appropriate staff. There is a good Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: record of compliance with the receipt, administration, and safekeeping of medicines in the home and 100 of the staff team have received accredited training in safe handling of medication. Care Homes for Adults (18-65 years) Page 16 of 26 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. Complaints made by residents and relatives were acted on and recorded. Staff training and the homes safeguarding policies and procedures ensure residents are protected from abuse and have their rights protected. Evidence: The person on charge said that the culture within the home was for residents to express their views and concerns in a safe and understanding environment. There is an effective, clearly written, easy to understand complaints procedure and a copy is given to all residents on admission to the home. The document is described has been recently reviewed and explains the complaints process and deadlines in detail and in pictorial format to meet the learning needs of people using the service. The person in charge said that residents know and trust the staff well enough to feel confident that wherever possible problems will be dealt with and diffused before becoming major problems. No complaints have been made to the CSCI about the service since the last key inspection. There is s robust policy and procedure for safeguarding adults and gives clear guidance to those using them. 100 of the staff team is trained in safeguarding adults. At the time of the inspection the registered manager was undertaking mandatory Studio 3 refresher training in diffusing difficult situations. A member of staff when asked about safeguarding policy and procedure was fully aware of where to find the policy and how Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: it should be used. Care Homes for Adults (18-65 years) Page 18 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, 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. The standard of decoration and furnishings in the home ensured the environment was comfortable and homely. The home was clean, pleasant and hygienic Evidence: The organisation has provided a suitable and appropriate living environment for people using the service. The environment is well maintained, decorated and furnished to a high standard. The sensory room has just been re-decorated and there are plans to refurbish the kitchen in the coming weeks. All residents have a single ensuite room adapted to meet the needs of current occupants. Residents are encouraged to personalise their own bedrooms with hi-fi equipment and other personal belongings to give a sense of belonging and that Clayton Brook House is their own home. The current environment is fully able to meet the changing needs of people using the service and is designed to provide spaces where residents can enjoy maximum freedom in a non-institutional setting. The home is well lit, very clean and tidy and smelled fresh Care Homes for Adults (18-65 years) 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, 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. Staff are well trained and in sufficient numbers to support the people using the service to meet their aspirations and needs. Recruitment policies and procedures ensured the protection of people using the service. Evidence: The staff rota showed there were sufficient staff on duty to meet the needs of the people using the service.Particular attention was given to busy times of the day and specific needs of the residents like medical appointments, educational or day centre activity. A copy of the training matrix was examined and showed staff training was ongoing. The person in charge said that the organisation expect all employees to undertake external qualifications and attend essential training including refresher training. The training is always focused on delivering improved outcomes for the people using the service the results of which are demonstrated in the homes successful record of staff attendance at training courses. Currently 100 of the staff team are qualified in level 3 NVQ in care, 100 in safeguarding, 100 in safe handling of medication and 100 in studio 3 ( low arousal techniques). Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: There is a good recruitment procedure that clearly defines the process to be followed and ensures the protection of people using the service. Staff files examined showed that staff were only recruited after essential pre employment checks were carried out. Case tracking of one care staff showed that this had been done to ensure the protection of the residents but an up to date CRB was not available at the inspection. Staff were observed working effectively with residents demonstrating a variety of skills required to meet the residents needs. Staff meetings, supervision and appraisal sessions take place regularly and relevant records are kept. Care Homes for Adults (18-65 years) Page 21 of 26 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. The management and administration of the home is based on openness and clear systems of working Policies and procedures in the home ensure safe working practices with routines that safeguard the people who live there. Evidence: On the day of the inspection the person in charge of the service had the required qualifications, experience and competency to run the home. Through discussion she was able to demonstrate a clear understanding of the key principles and focus of the service, was person centred in her approach, and was aware of current developments within the service. Records of residents finances was examined and saff sigatures verified the transactions and these records were included in the staff duty handover at change of shift to ensure the security of residents monies. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: The homes policies and procedures are reviewed regularly to ensure safe working practices Records and documents showed appliance, equipment and safety checks were done regularly and staff are trained and know how to follow these. Good practices, risk assessments, monitoring and record keeping ensure there is a very low number of preventable accidents. The manager and the staff team have a good understanding of the risk assessment process amd this is taken into account in all aspects of running the home. All staff are trained in health and safety matters. Training records reflect this and regular updates are planned. All staff sign and date to confirm they have received fire training. Fire records show th last test was done on 24th October although their is guidance that recommends this is done weekly. a fire drill was done on the day of the inspection and there was an excellent response from staff and people using the service. Small appliance testing was being done on the day of the inspection Record keeping was of a good standard and records are kept securely. An internal audit is carried out to determine residents and their relatives satisfaction. The outcome of these surveys are passes on to the CSCI and the manager complies with statutory reporting requirements and other relevant legislation. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!