Inspection on 14/07/05 for Clayton House

This inspection was carried out on 14th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clayton House 12/06/06

Clayton House 08/11/04

Clayton House 16/08/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Clayton House 11 Lea Road Gainsborough Lincolnshire DN21 1LW Lead Inspector Doug Tunmore Unannounced 14 July 2005 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 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 Stationary 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 House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Clayton House Address 11 Lea Road Gainsborough DN21 1LW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01427 613730 Kingsway Mrs Kathleen McCoull Care Home (CRH) 16 Category(ies) of Learning Disability (LD) - 15 registration, with number Learning Disability - over 65 (LD(E)) - 1 of places Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 8 November 2004 Brief Description of the Service: The home is an adapted property, achieved through converting two semidetached properties into a detached unit. It is situated in the town of Gainsborough, close to all the main facilities and services. There is a small front garden and a combined back garden, which offers privacy to residents in the summer. The home provides accommodation for sixteen residents who have a learning disability. They are acommodated in three double bedrooms and ten single bedrooms. Accommodation is provided on the ground and 3 floors with communal facilities located on the ground floor. There are no shaft lifts or chair lifts in this home and all those residents who live in this home are ambulant. The homes philosophy of care is to enable residents to live as independent a life as possible in a homely environment. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 8.20 am. The main method of inspection used was called case tracking, which involved selecting two residents and tracking the care they receive through the checking of their records, discussion with them and five other residents, the care staff and observations of care practice. Two service users showed the inspector around the premises. The manager, trainee manager, staff and service users were very open to the inspection and made it a very enjoyable experience for the inspector. A partial tour of the premises took place. What the service does well: What has improved since the last inspection? What they could do better: Recruitment practices still need to be addressed, thereby ensuring that only suitable staff are employed. Residents and/or their representatives should sign their reviews to confirm that they agree with the outcome of the review and those changes that then could Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 6 be made to their care plans. The home must ensure that medication records are correct and up to date. 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. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3, 4 & 5 The home has updated its service users guide, which now provides the information required by those wishing to choose a home. EVIDENCE: A tour of the home found that residents’ bedrooms contained a copy of the service users guide, which included written text as well as pictorial information. Residents commented that they have some knowledge of Makaton (pictures) and that they have a copy of the guide in their rooms. Another resident stated that he ‘found it (service users guide) very interesting actually especially about complaints and our rights’. Staff commented that a number of residents are able to use pictures to help demonstrate their wishes and another resident can read and discus his needs very well. Assessments are now carried out by the home with social services and health care workers. The two residents files showed that they were admitted in 1990 and at that time little information was made available to the home regarding assessments. Files now contain full and ongoing assessments of residents needs and reviews are held, in which social services and health care professionals are involved. Residents stated that they had visited the home prior to admission and were happy living in this home. The home could not demonstrate that they send letters to prospective residents informing them that the home can meet their needs or not. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 9 Residents’ contacts were seen and are made with the Social Services Department. The homes terms of conditions were available in the service users file and detailed personal goals and lifestyle aspirations of individual residents. These were signed and dated by the resident and or their representative. Residents confirmed that their care needs were met and that they discuss their needs with the staff on a regular basis. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 & 9 Residents individual needs were promoted and documented appropriately. Residents must be empowered at reviews so that they take a full and meaningful part. EVIDENCE: Each service user had an individual detailed care plan. Both care plans seen had been reviewed on a regular basis and reflected the changing needs of the resident. Both care plans were also signed and dated by the residents. From the documentation and from discussion with residents it was clear that they were fully aware of the plan, the changes and why it had changed and the goals towards which they were working. However, residents risk assessments and reviews had not been signed by residents agreeing to the risk identified and/or the change in their care plan and how this might effect their daily living. The home operates a key worker system, residents have a say in who their key worker is and also who they wish to go on holiday with. Residents stated that they are able to discuss anything they wish to with staff that ‘also help us clean our rooms and go shopping with us’. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 11 The home’s last residents’ meeting was held on the 1604/05, the minutes showed that all residents attended. Issues discussed included holidays, the service users guide other issues regarding the running of the home. Residents confirmed that they were actively involved in residents meetings and this year decided where they wished to go for their holiday. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 15 & 17 Service users had busy and varied lifestyles with opportunities to engage in a range of leisure activities within the community. The home actively encouragers relatives and friends to visit the home and maintain links with residents. EVIDENCE: Each service user has a calendar of weekly events and activities. A number attend a local authority day centre, whilst other access activities from the home. Some residents attend the Monday drama group, which is held in the Gainsborough arts centre. A regular disco is also held in town, which is a firm favourite with residents. One resident stated that she goes to church on a Saturday and helps in the Café. She also said that she takes another resident ‘who I look after, with crossing the roads’. Regular shopping trips were also mentioned in discussion with residents and on the day of the inspection five went to Scunthorpe for a pub lunch and a walk around town. Residents spoken with said that they had enough to do and that they were supported with individual activities and hobbies. They also said that staff help them with their daily cleaning of their rooms and other tasks around the home. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 13 Family and friends were encouraged to visit at any reasonable time. Residents were supported to maintain contact through visits, telephone calls and letters. Staff provided appropriate guidance and support to service users with regards to personal relationships to ensure they had sufficient information on which to make informed decisions. One resident stated that he had a girlfriend who he saw regularly with this relationship supported by the family and the home. Ten relatives and visitors comment cards were returned to the Commission and these documented that relatives were made welcome at the home. During discussions with residents they said that the meals are good at this home and they discuss the menu anytime they want with staff. Residents comment cards returned to the Commission showed that 8 out of nine resident like the food at this home. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 20 Service users received personal and health care in line with their needs and independence in all areas was encouraged. The administration of medication was not appropriately recorded. EVIDENCE: Residents’ files showed that they receive the health care input they require. During discussions with residents, they confirmed that they see GPs, dieticians and psychiatrists. Residents confirmed that staff give them their medication when it is required. The pharmacist visited on 26/05/05 and the report showed that administration records were good and storage and stock control was good. However, the medication sheets showed that medication given to one resident that morning had not been signed for. The medication pack (blister pack) indicated that the medication had been given. The home must keep an accurate record of medication given to residents. Only staff that had received training administered medication. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home takes the issue of addressing complaints very seriously and has a comprehensive complaints policy. The home does not have the appropriate adult protection policies and guidance. EVIDENCE: All residents have the homes service users guide, which has user-friendly information in pictorial form concerning the making of a complaint. Residents spoken to were aware of their rights. Residents comment cards confirmed that they ‘feel safe in the home’. The majority of visitors and relatives comment cards showed that they were aware of the homes complaints procedure and they were kept informed of important matters affecting their relative/friend. The appropriate adult protection information was not in place for the information of care workers. The provider must obtain the Lincolnshire Adult Protection Guidance, and DOH No Secrets document. Discussion with staff showed that they had a clear understanding of what adult abuse was and what action they would take if it came to their attention. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27 & 30 The home is well maintained, the standard of the environment and its facilities are appropriate and safe for the needs of residents. EVIDENCE: Two residents showed the inspector around the home, taking in the bedrooms, toilets, bathrooms, showers and communal areas. Not all of the bedrooms were seen, as some service users were out and others did not want them to be seen. Those seen were large and had been personalised by the occupants. Six residents share bedroom, with the rest having single room accommodation. Residents comment cards showed that all but one felt that their privacy was respected and one did not tick the appropriate box. The tour of the environment found that all toilets were in working order and bathrooms and showers had clean non- slip bath mats. The home was found to be clean and no offensive odours were detected. Some residents look after their own rooms and carryout all of the cleaning tasks with support required to maintain a good level of cleanliness. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 Recruitment processes in the home needs to improve. EVIDENCE: Recruitment practices were in place and two staff files for permanent staff did not contain all of the documentation required by law. One file did not have the required two references and neither had photographs of the staff. Discussion took place with the trainee manager who said that she would check all personnel files to ensure that they meet this standard. Each worker in the home has been given the General Social Care councils pack relating to the registration of care workers and the philosophy of the Care Council for all social care homes. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 Systems are in place to ensure that service users, relatives/friends views were sought regarding the running of the home. EVIDENCE: Residents and relatives/friends questionnaires were used on a six monthly basis to seek their views relating to the Commissions comment cards covering a wide range of issues. A summary of responses to the survey has been produced and is available to residents and relatives. Discussions took place regarding ways of developing this: including changing the questions on a regular basis and auditing the residents reviews, risk assessments, filling, personnel files and policies and guidance in the home as well as involving care staff and visiting social workers and health professionals in the process. Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 2 x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 2 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 3 x 4 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Clayton House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 4 x x x x C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 20 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. 2. Standard YA3 YA7 Regulation 14(d) 15(2) Requirement All prospective residents must be written to confirming that the home can meet their care needs. All residents or their representatives must be enabled to signed their annual reviews confirming that they agree with the ouitcome. Appropriate consultaion regarding the homes risk assessment must be undertaken with the resident or their representative. The home must record and administer medication as per the homes policies and procedures (The timescale of 23/03/05 not met). The home must obtain the appropraite adult protection documentation for the protection of residents. The registerd person must ensure that staff have two written refrences and that up to date photographs are also available in care workers files. The (timescale of 8/11/04 not met). Timescale for action 16/10/05 16/10/05 3. YA7 14 ( C) 16/10/05 4. YA 20 13(2) 16/10/05 5. YA23 12(a) 16/10/05 6. YA34 19 16/10/05 Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 21 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. Refer to Standard Good Practice Recommendations Clayton House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unity House The Point Weaver Road, Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 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 House C53 CO4 S2308 Clayton House V238006 140705 Stage 4.doc Version 1.40 Page 23 - 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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