Inspection on 08/06/06 for Clayton House

This inspection was carried out on 8th June 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clayton House 07/11/05

Clayton House 22/06/05

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 Mrs S Rodgers Unannounced Inspection 8th June 2006 03:30 Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 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 House DS0000014458.V291947.R01.S.doc Version 5.1 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 House DS0000014458.V291947.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Clayton House Address 49 Brighton Road Southgate Crawley West Sussex RH10 6AX 01293 553722 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) Outreach 3 Way Mrs Lisa Oxlade Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2005 Brief Description of the Service: Clayton House is a care home that is registered to provide accommodation 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. The weekly fees are £736.50. Extras include hairdressing/barbers, toiletries, holidays, and activities out, transport. The homes report is displayed within the hallway of the home. The registered manager responsible for the day-to-day running of the home is Mrs Lisa Oxlade. The responsible individual on behalf of the providers is Mrs Vanessa Keen. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 3 hours. Planning for this inspection included reviewing the pre inspection questionnaire, previous inspection reports and general correspondence. During the course of the inspection the inspector toured the home and reviewed records. The majority residents were seen at the inspection however due to their profound disabilities it was difficult to chat and gain their opinions of the home. The inspector took the opportunity to observe residents at their leisure activities and observe their interaction with staff. Residents and staff appeared relaxed and confident in each other’s company. Both support workers were spoken with in order to gain a sense of the support they receive to assist them to carry out her duties. Comments will be included in the main body of the report. Where standards have not changed since the previous inspection this report reflects that. The providers are requested to submit an action plan by the 20 July 2006 stating action to be taken and timescales in which compliance with the regulations will be achieved. What the service does well: What has improved since the last inspection? Although the homes quality assurance and quality monitoring system has not been completed the providers have developed a system that will enable them to ascertain the views of residents and other stakeholders and monitor systems and services. The service is in the process of updating the Statement of Purpose, Service User Guide and residents contract to make is more user friendly for residents. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 6 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 DS0000014458.V291947.R01.S.doc Version 5.1 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 House DS0000014458.V291947.R01.S.doc Version 5.1 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 the following standard(s): 1, 2 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose, Service User Guide and the pre admission process ensures that staff, relatives, placing social workers and residents know that the care needs of the perspective resident can be met by the home prior to them being admitted. EVIDENCE: The Statement of Purpose and Service User guide submitted with the pre inspection questionnaire clearly informs interested parties of the services provided. There have been no new admissions since the last inspection. The majority of residents admitted to the home have a Social Services Care Management assessment. A member of the homes senior care team meets with the prospective resident (with in their own environment if possible) prior to them being admitted, to ensure that the service can meet their needs. The admissions and discharge policy clearly states that all prospective residents will be invited for a 3 day trial visit to ensure that the service can meet their needs. Information gained form the Social Services Care Management plans; implementation plans and the homes own assessment form the basis for the initial care plan. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents assessed needs and personal goals are reflected in care plans. Service users are assisted to make decisions about their own lives. Residents are supported to take risks. EVIDENCE: Three care plans were reviewed. Each gave detailed information on the personal, health and social needs of residents. Due to the profound learning disabilities of the current residents it is difficult to assess whether they know their assessed needs however, the care planning documentation demonstrates that each resident is consulted with regards their changing needs and personal goals. Daily records and leisure activity logs record residents reactions to different situations, this information is then used as a process to involve residents in decision making processes. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 10 The risk assessments seen at this inspection indicate that all residents are supported to lead an independent lifestyle with in a risk-assessed framework. Action plans to minimise risk are also devised and kept on individual care plans. The pre inspection questionnaire indicates that the organisations administrator is appointee for 3 residents. Records were not seen as they are held at the head office. The inspector was advised that the organisation is working with a high street bank to develop a national framework for people with learning disabilities to open their own bank accounts. 1 resident who was admitted from home does have a bank account. Small amounts of cash are held in safekeeping for residents. Money is kept in individual lockable cash boxes and records of transactions and receipts are kept. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15, 16, 17 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are offered and take part in appropriate leisure activities and access the local community. Residents are supported to maintain appropriate relationships. Residents are assisted to maintain a balanced diet. The rights of residents are respected. EVIDENCE: Each resident has a daily activities programme. All attend a day centre during the week where they can experience activities such as yoga, work aid and arts and crafts, bowling and swimming. Residents also have the opportunity to go to Gateway club two evenings a week. The weekday evenings are generally taken up with watching television, listening to music or quietly doing jigsaws. Activities at weekends include going to the shops, going to local theme parks and those who wish go to the local church for Sunday services. Residents are encouraged to maintain contact with their relatives and friends. Some residents go home for short stays on a regular basis. Residents are encouraged and enabled to invite friends to their home in the evenings. From Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 12 observation during the course of the inspection and from reviewing residents care plans it is evident that the rights of residents are respected. Staff were observed to be discrete when carrying out care tasks such as toileting. Records of meals provided indicate that a balanced diet is being offered. Residents help to plan the weekly menu. Staff have cut out pictures of different types of food i.e. sausages, roast dinner, chocolate mousse etc, this enables residents to indicate what they want by pointing to appropriate picture. Monday to Saturday the main meal is eaten in the evenings, Sunday lunch is at eaten in the early afternoon. During the week residents are provided with a packed lunch. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Every effort is undertaken to ensure that residents receive support in the way they prefer. Systems are in place to promote the physical and health needs of resident. Systems are in place to promote the safe handling of medication. EVIDENCE: Care plan review documentation demonstrates that residents are consulted on how they wish to receive support. Each resident has a review. Residents are assisted to complete the review form 6 weeks prior to the review. The form is in pictorial and written text. Due to the profound disabilities of some of the residents it is difficult to identify their preferences. However as stated previously resident reaction to situations and new activities are monitored and recorded so that staff can identify a preference in the way a resident wants support, staff would evidence that preference by recording patterns of behaviour or incidents. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 14 All residents are registered with a local General Practitioner. Records of visits to the Doctors surgery are kept along with brief details of the outcome of the visit. Residents have access to other health professional such as dentist and opticians within the local community. Residents also have access to the Community Team for People with Learning Disabilities. Systems are in place for the receipt, recording, storage, handling administration and disposal of medication. The home has a contract with a local pharmacy. The Monitored Dosage System is used. The pharmacist dispenses medication into individual ‘ blister packs’. Residents go to the office one at a time, medication is dispensed into a pot for ease of handing to residents, resident take medication and staff sign the Medication Administration Record sheet. Records seen were in good order. All medication is stored in a metal wall hung medicine cupboard. Training records submitted with the Pre inspection questionnaire material records that all staff who administer medication have received training in the procedures for administration of medication. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 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 the following standard(s): 22, 23 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are taken seriously and are managed in accordance with the complaints procedure. Systems are in place to promote the protection of vulnerable adults. EVIDENCE: A complaints procedure is in place. The procedure is in written text and symbol format. The procedure informs residents and their relative who they should address their concerns to in the first instance and timescales in which a response will be made. The procedure contains the address and telephone number of the Local office of the Commission for Social Care Inspection so that in the event that they are not satisfied with the outcome of the homes investigation they can contact Commission directly. A complaints book was available. There has been no complaint since 2004. Training records evidence and staff confirmed that they receive training in adult protection procedures. Staff are aware of the indicators of abuse and confirmed that they would report any suspected incidents of abuse to the manager. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 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 the following standard(s): 24, 30 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well maintained. Every effort is made to maintain a clean and hygienic environment. EVIDENCE: From touring the home the inspector was able to determine that the home is generally appropriately maintained and decorated. Communal areas of the home were welcoming. The inspector was advised that one lounge is going to be redecorated and new furniture has been purchased. Each bedroom is individually decorated and personalised by each resident. It was noted that two rooms smelled of urine, it was confirmed that new none slip washable flooring covering will be laid in the near future, quotes are in the process of being maintained. It was noted that the architrave to one door was splintered due to staff having to gain assess to the room following a resident losing the key. This needs to be repaired promptly. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 17 All areas of the home was generally clean and every effort was being made to reduce any offensive odours. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,35 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff on duty were competent and appropriately qualified. The staff-training programme is appropriate to the needs of residents EVIDENCE: The previous inspection report demonstrates that an appropriate recruitment procedure is followed. Staff on duty at the time of this visit did not have access to staff files. There have been no new employees since the last visit therefore this standard was not assessed at this inspection. Duty rotas seen at this inspection demonstrated that there are sufficient staff on duty to meet the needs of the current service users. Information from the pre inspection questionnaire indicates that the home employs 6 staff 3 of whom have obtained a National Vocational Qualification level 2 or 3. The staff member on duty confirmed that the organisation has an annual training calendar which enables them to access regular training. The Learning Disabilities award Framework induction training is completed by all staff within 6 months from date employed. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well run home. A quality assurance and quality monitoring system is in the process of being completed. The health, safety and welfare of residents are protected. EVIDENCE: Mrs Oxlade has obtained her National Vocational Qualification level 4 and Registered Managers Award. . Staff confirmed that they feel supported by management. Regular staff meetings are held and all staff receive supervision that enables them to discuss care and training issues. Both staff confirmed that they feel supported by management. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 20 Records seen on the day of this inspection indicate that a quality assurance and monitoring system has been started. The information received via resident, relative, other stakeholders and reviews of internal record keeping is in the process of being collated in order that a report can be published. Risk assessments are carried out and training is provided for ensuring safe working practices such as manual handling, fire safety, first aid, food hygiene and infection control are in place and understood. Maintenance records indicate annual maintenance systems are in place to maintain the Health and Safety of residents. Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 21 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 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 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 22 Yes 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 YA39 Regulation 24 Requirement A quality assurance and quality monitoring system must be implemented. This remains outstanding from the previous inspection. 05/12/05 The premises must be kept in a good state of repair. Timescale for action 20/07/06 2 YA24 23 (2)(b) 20/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Clayton House DS0000014458.V291947.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Worthing LO 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 DS0000014458.V291947.R01.S.doc Version 5.1 Page 24 - 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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