Inspection on 22/06/05 for Clayton House

This inspection was carried out on 22nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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 House 08/06/06

Clayton House 07/11/05

Clayton House 26/10/04

Clayton House 18/06/04

Clayton House 05/02/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Clayton House 49 Brighton Road Southgate Crawley, West Sussex RH10 6AX Lead Inspector Ms G Moorey Unannounced 22 June 2005, V224806 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 H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Clayton House Address 49 Brighton Road, Southgate, Crawley, West Sussex, RH10 6AX 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) 01293 553722 Outreach 3 Way Mrs Lisa Oxlade Care home only-CRH(PC) 6 Category(ies) of LD-Learing Disability - 6 Places registration, with number of places Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for six adults a learning disabilitiy. Date of last inspection 26 October 2004 Brief Description of the Service: Clayton House is a care home which is registered to provide accomodation for up to six adults with a learning disability. The house is set in the grounds of two other services belonging to the Outreach 3 Way group. The establishment is close to Crawley town centre and the local facilities and amenities including public transport. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware the Care Standard Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Clayton House will be referred to as both ‘service users and residents’. This inspection was unannounced and took place on Monday 2nd July 2005 between the hours of 3.00pm and 7.00pm. Five residents were accommodated at the home on the day of the inspection. The inspection included a tour of the premises and it’s facilities, with all of the residents arriving home at 4.15 pm. The service users’ were consulted before the Inspector saw their bedrooms. All of the service users were observed and seen at the inspection however due to their profound disabilities it was difficult to chat and ascertain their opinions of the home. The manager and two support workers were spoken to during the visit; the staff were also observed carrying out their duties. Records and documentation inspected included: resident files, policies and procedures, complaints book, health and safety records and paperwork relating to adult protection incidents over the last eight months. What the service does well: What has improved since the last inspection? The service is currently updating and revising all of its working systems and documentation some of this process was seen at the inspection. The new systems appeared to be bringing a greater sense of organisation and slim lining of paperwork. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 6 The service has undertaken some work within the home to improve health and safety measures and facilities for the service users’. 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. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 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 H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 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, The home provides good information for prospective service users and their representatives to make an informed decision about whether or not to move in. The service gathers together information on each potential resident and assesses the appropriateness of each person related to the facilities and services at the home and how the possible new resident would fit in and relate to the service users already residing in the home. The contracts for each of the service users are produced in written word and in a pictorial format. Information is fed back to each service user in the most appropriate manner according to their communication need so that the residents can have some understanding of the guidelines set down for them whilst living at the home. EVIDENCE: The statement of purpose, service users guide and the complaints procedure are produced in written word alongside pictorial signs. Due to the complex needs of the service users any information being given to them needs to be appropriate for their individual levels of understanding. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 9 The service users files contain their original pre-assessment documents and other information and reports related to backgrounds and past experiences. A majority of the service users have been at the home for a significant period of time. Statutory review paperwork was noted to indicate that some of the service users have not had a formal review since 2003. The service users do undergo reviews within the homes own systems and updates to care plans can be seen. Within the care plans risk assessments where seen to be undertaken but again some of these documents had not been reviewed since 2003. All of the service users have a contract which is produced in written word and pictorial format. The information is shared with each resident through verbal communication and visual aids due their specific needs. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 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) 9 The home has a comprehensive set of risk assessments and management strategies in place to ensure staff know how to support the service users to maintain and develop their independent living skills, while so practicable, minimising the risks associated with them engaging in activities and daily life. EVIDENCE: The home has developed risk assessments in line with each service users’ required needs and it is clear how these have been translated into the care plans. However some of the risk assessments do date back to 2003 and have not been reviewed, although there was evidence that new risk assessments had been undertaken and some of the older assessments had been updated. A clear consistent approach to reviewing would ensure that risk assessments and care plan remain up to date. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17, Meals appear to be nutritionally well balanced, and clearly based on the service users food and preferences. EVIDENCE: The service users’ plan their own menus and a decision is made on what meals are to be eaten over the course of the week. This is supported by a visual aid where the manager has put together a file with pictures of different meals and food in order for the service users to be able to identify their favourite meals. The food on the menus was seen to well-balanced and healthy. Service users’ likes and dislikes are listed in their care plans, as are any dietary needs and allergies. Evidence was seen that all staff working within the home had undertaken food hygiene training. The last environmental health report was available and there were only minor requirements which were now seen to have been amended. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 12 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 The health needs of the service users are well met with evidence of good multi disciplinary working taking place on a regular basis. The medication at this home is well managed promoting good health. EVIDENCE: All of the service users are registered with a local doctors practice and also have access to a Dentist, Optician and Chiropodist. Appointments are recorded in the health plans in the resident’s main files. The accident and emergency records were up to date and did not indicate any major incidents. Medication is stored in a metal lockable cabinet in the office. A comprehensive system is in place and medical administration records were being appropriately maintained by staff and accurately reflected medication stocks held in the home at the time of the visit. Staff are trained in the distribution of medicines through the home and undertake courses through the local college and the Care Consortium. A Boots pharmacist checks the system used in the home on a regular basis and is said to find it satisfactory. The home has clear protocols and policies in place to guide staff in the issue of resident medication. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 13 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 Arrangements for protecting service users’ are satisfactory in keeping residents safe from risk of harm or abuse. Complaints are always taken seriously by the home. Procedures and policies are in place to ensure that service users are listened to and heard. EVIDENCE: The home has a detailed complaints procedure that is available in a service user ‘friendly format’ using pictures. The process is also fed back verbally using visual aids. The procedure is displayed in the service on the service users’ notice board. No complaints about the homes operation have been receive by the Commission for Social Care Inspection. However one complaint had been received this had been responded to and resolved within 28 days. In general observation and in discussions with staff it became evident that there are supportive appropriate relationships between staff and residents. Over the last six months their had been two reported incidents of Adult Protection which had been followed by the home according to their policy and procedures. However the home did not notify the Commission as to the outcome of both incidents, although evidence was seen of the process used and final decisions and actions taken. Staff are trained in dealing with incidents or disclosures of abuse from the residents. A policy document is also available on dealing with aggression. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 14 Service users care plans include specific guidance to help staff support service users’ whose behaviour may challenge the service from time to time. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 15 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, 25, 26,27,28, 30 The home is furnished and decorated to an adequate standard and is kept clean and tidy ensuring that the residents live in a homely, bright and well kept environment, which suits their lifestyles. EVIDENCE: The environment is adequate and with the service users’ in mind has been developed in to a homely environment that promotes both supportive care and meets the needs of the service users. Records within the home indicate that emergency and fire systems were satisfactory. All of the residents’ bedrooms were seen with their permission. Two of the service users were present while their rooms were viewed. The rooms were seen to be personalised and adapted for service users to be able to use independently when not wanting to spend time with the group. The rooms are furnished to a reasonable standard. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 16 The home has one bathroom and 2 toilets for the service users in the home. None of the rooms have any en-suite facilities. The home has adequate communal areas including two large lounges, and a dinning room. The house has a medium garden which is shared with the other two houses on site this at times can cause problems with other service users’ on site. There are parking facilities at the front. The home was found to be clean, tidy, hygienic and free from any odours or smells. Over the last year the home has improved the flooring in the laundry room and has added a hand basin. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 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, 35, 36 The assessed needs of the residents are met by the numbers and skills of care staff deployed at the home. The home maintain good records and supports and trains the staff to ensure that the residents have all of there needs met and that they are protected and safe. EVIDENCE: The staff records are maintained at the home and were available for the inspection. The records did evidence that a thorough recruitment procedure is in place and references and CRB checks have been undertaken. The service also uses the POVA system. The staff files were not all in order which made checking for records difficult. Staff receive both a job description and contract at the beginning of their employment. Part of the recruitment process is a three-month probationary period. There is clear evidence of the training programme in place at the home which is provided through the company. The staff spoken to confirmed that regular basic and specific training had been offered and undertaken. All the staff had undergone an induction programme this had been recorded and stored in the main records at the head office. The home offers NVQ training to the staff as Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 18 part of their development. Records are kept of each member of staffs training undertaken and objectives. Supervision is given on an eight weekly basis there is evidence provided through a system where both supervisor and supervisee both confirm that sessions take place. Staff confirmed that development plans were undertaken on a regular basis these are used to complete a yearly appraisal. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 19 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) 40 The home has a full and comprehensive selection of policies and procedures that offer guidance to the staff and help to ensure safe working practices. EVIDENCE: The service has a full complement of policies and procedures that were evidenced at the inspection. There is a clear reviewing programme in place for the policies and procedures. Currently the policies and procedures are under review due to and upgrade in all the working systems. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 20 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 3 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x x x x x 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Clayton House Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x 3 x x x H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 21 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 NMSYA 2 Regulation 14 Requirement The service needs to ensure that statutory review are encouraged and held at appropriate times. Timescale for action 30th August 2005 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 NMSYA 9 NMSYA 23 Good Practice Recommendations The home needs to ensure that all risk assessments are reviewed and kept up to date. The manager needs to ensure that follow up information is fed back to the CSCI after any Adult Protection Investigation is completed including what action the home themselves have taken. Clayton House H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 H60-H11 S14458 Clayton House V224806 170605 Stage 4.doc Version 1.30 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. 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. 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