Inspection on 19/12/05 for Cleveland House

This inspection was carried out on 19th December 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cleveland House 17/04/07

Cleveland House 23/05/05

Cleveland House 08/11/04

Cleveland House 07/06/04

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 Cleveland House 20 Granville Road Broadstairs Kent CT10 1QB Lead Inspector Tina Taylor Unannounced Inspection 19th December 2005 15:00 Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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 Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cleveland House Address 20 Granville Road Broadstairs Kent CT10 1QB 01843 866509 01843 600939 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) Miss Nicola Marie Huitson Mr Christopher Peter Ewins Miss Nicola Marie Huitson Care Home 21 Category(ies) of Learning disability (21) registration, with number of places Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Increase registration from 20 to 21. The Owners bedroom to be temporarily included in the schedule of accommodation. 23rd May 2005 Date of last inspection Brief Description of the Service: Cleveland House is a detached property with accommodation on three floors. The home has increased in size in the last year and now has twenty-one single bedrooms, four of which are within a flat on the second floor, and a fifth is within its own flat. There are further communal lounges, games room, conservatory, and a computer room. The home offers accommodation to a high standard. The proprietors, Nicky and Chris, have their own flat within the home, and both work full time at the home. Nicky is the registered manager of the home and Chris co-manages the home. Cleveland House offers care on an individual basis encompassing the physical, social and emotional needs of the residents. The statement of purpose is reflective of the care actually being provided in the home. The home is located close to the seafront, and is a short walk away from local shops, amenities, Thanet College and public transport. The home has its own minibus and people carrier in which to take the residents out and about. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that started at 3pm and lasted for four hours. The inspector was able to speak with seven residents and two of the four staff on duty. Two residents showed the inspector around the home and told her about the changes that had been made since the last visit. The inspector was in the home during the evening meal. The majority of time was spent socialising and chatting with the residents. Some records were examined. What the service does well: This is a home where the residents are looked after very well. There was a great atmosphere in the home with the residents preparing for Christmas and looking forward to parties and visiting relatives. The home had been decorated with an abundance of Christmas lights, tinsel and Christmas trees, and some residents said it looked “brilliant”. Residents spoke to the inspector of a Christmas meal they had been out to in a local restaurant, and how good it had been, a resident said “We had a starter of prawn cocktail, and then Christmas dinner with turkey, sausage, bacon, stuffing, roast potatoes, broccoli, carrot, sprouts and gravy, and then we had Christmas pudding and coffee, and I was stuffed”. The evening meal was a lovely social occasion with a hub of animated conversation between the residents, and a great deal of laughter and gentle teasing between residents. The residents were in great form and some residents were doing very good impressions of characters from the Catherine Tate show, “Do I look bovvered”, and Little Britain, “Want that one”. A resident, who was reading a tabloid paper, discussed forthcoming football fixtures with the inspector, and how well his team were doing in the league. The inspector again noted that the residents really care about each other and look out for each other. Asked about the staff a resident said, “ All the staff look after me”. The staff ensure the residents are given the skills they need to form personal friendships and to maintain these at the levels that are appropriate and meet individual need. A staff member was seen listening to and giving sound advice to a resident who had some problems with a relationship. The resident spoke to the inspector about how she had been able to “let off steam” in a way that did not cause any problems. Some residents said how much Nicky and Chris helped them, and one resident said, “Chris took me to see Arsenal play and they won”. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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 Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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): 3 The home works well to ensure individual needs and aspirations are met. EVIDENCE: The home has worked for some time with other professionals to try and ensure the individual wishes of a resident are established, and to work towards providing the best move forward. A resident spoke to the inspector of this forthcoming move, and other residents were also aware of when the resident would be moving. The services of independent advocates have been sourced. The home has kept the residents appropriately informed as and when matters have been confirmed. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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): 7, 8, The residents are consulted on, and involved in, personal and general decision making of the home. EVIDENCE: The home has an individual rights policy and choices are recorded in the service users plans. The residents are enabled to manage and take responsibility for all aspects of their lives wherever possible. The residents said they were happy in the home and that the owners and staff talked to them about what was happening and their involvement. Some residents spoken with were clear about what they wanted to achieve and how they would do it. The home has details of advocacy services for the residents should they need or request them. The residents get together with staff to decide what they would like to do with regard to personal lifestyles and also in regard to helping around the house. After the evening meal the residents were keen to do their bit in clearing up and making the dining room look clean and tidy. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 Page 10 The assistant managers are hold monthly resident’s meetings and these are well attended. Discussion at these meetings was held on questions that residents would like asked at staff selection interviews, and which residents they would like to represent them on the interview panel. Questionnaires completed by residents and relatives were very complimentary about the level of care provided. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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): 11, 12, 13, 14, 15 The residents are provided with the skills needed for personal development and relationships. Links with the local community are good and support and enrich the resident’s social and educational opportunities. EVIDENCE: Some residents spoke to the inspector about the various college courses, and college work placements they attend; they said how much they enjoyed this. Residents said they had enjoyed the new term at college and were looking forward to going back. Work placements have been found in a local supermarket, cash and carry and airport café. Paid work has also been successfully obtained for a resident. The home has its own games room and computer room. Planned outside activities include archery, basketball, football, swimming, bowling, horse riding, creative arts, and visits to the pub, to name but a few. A resident spoke to the inspector about how good his holiday to Portugal with the owners this year had been. Some residents said they had enjoyed a trip to London in the summer that had included going on the London Eye and a visit to Gordon Ramsey’s restaurant. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 Page 12 The home promotes the residents rights to enjoy personal relationships and supports them through difficulties. A resident said how he was looking forward to going to stay overnight with a friend and that staff would be taking him there and picking him up again. Another resident said he was going to visit a relative in Scotland and that he would be flying up there. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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, 20 The home works well to provide individual support that promotes dignity and independence. The systems for medication are good but some improvement is needed in recording. EVIDENCE: The residents are enabled to carry out as many of their own personal care needs as they can with the appropriate support of staff; independence skills are fully promoted. The residents are encouraged to bathe regularly and to take their own washing to the laundry room. The residents looked smart and were dressed appropriate to their age and personal preference. The residents choose their own clothes and go out shopping on their own or with staff support. Some residents said they had been out Christmas shopping to Bluewater shopping centre, and others to Westwood Cross shopping centre; they were all pleased with the gifts they had been able to purchase. The home operates a monitored dosage system of medication and has a small designated storage room. A staff member said only staff that have received formal training can administer medication and that the assistant managers take overall responsibility. There were a few problems identified in the recording of some medication and this needs to be rectified. A staff member said that an assistant manager had put medication on the agenda for the January staff meeting. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 Page 14 The home has a sound system for the use and recording of homely remedies. Staff do have access to medication guidelines but the inspector asks that the Royal Pharmaceutical Society guidelines be used for reference as identified in the standard. Staff have access to a medicines reference book. Community nurses have provided staff with training in the particular health needs of a resident. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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 The home has a complaints system that enables residents to feel their views are listened to and acted upon. EVIDENCE: The home has a complaint’s procedure that is contained within the policies and procedures file, the staff handbook and the service users guide (this version contains Rebus symbols). The home has a complaints book where it records details of the home’s response, there have been no complaints recorded for some time. Some residents said they would speak to their key worker, Nicky or any staff member if they had a problem or complaint. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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, 26, 28, 30 The standard of the environment is very good and provides the residents with an attractive and homely place to live in. EVIDENCE: The home is located in a convenient part of Broadstairs and is within close walking distance of the seafront, shops, public amenities, and public transport. The owners keep the home well maintained and have an on-going programme of upgrading and refurbishment. New attractive front doors have been added to the home since the last inspection, and the conservatory is finished to a high standard as usual. A resident said the work to complete the coffee shop on the premises was nearly finished and would be ready for use in the summer. A resident said he was looking forward to working in it. The home has a four bedroom flat with its own kitchen, dining room, bathroom and lounge, and a one bedroom flat, both of which are used to promote independence. A further bedroom is being built that will be used to promote independence. There is a computer room, games room, two lounges and a dining area on the ground floor. The home is decorated and furnished to a very high standard throughout. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 Page 17 The front garden has been revamped to a highly individual and attractive standard; this has also provided additional parking spaces. The home was clean and hygienic, and has procedures for the maintenance of safe hygiene practice. The resident’s bedrooms are furnished and decorated to a high standard and each bedroom is arranged to suit individual need. The residents are encouraged to personalise their rooms to suit their own tastes and interests. A resident said he had got posters of his favourite pop stars on the walls of his bedroom and another resident spoke of moving bedrooms in the near future. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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): 31, 33, 36 The staff have a good understanding of the resident’s needs, and are provided with the support they need to meet the changing needs of the residents and in meeting their personal goals. EVIDENCE: The inspector was able to observe some good care practice and staff spoken with had a good understanding of their role and the care of the residents. The residents were complimentary about the help and support they received from the staff, and the interactions between the staff and the residents was good humoured and non-patronising. A staff member said there was a very good team and that they all worked together to provide the residents with continuity of care. The ratio of care staff to residents is determined to provide sufficient staff on duty at key times and for carrying out activities. Regular staff meetings take place and the assistant managers usually take these. A staff member said that staff supervision is held on a monthly basis and is provided by the assistant managers. The assistant managers have been provided with the training necessary to carry out these duties. A staff member said how positive she viewed supervision, and that she felt confident to speak up about any matter. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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): 38 The owners have a clear development plan and vision for the home that is effectively communicated to the residents and staff. EVIDENCE: The owners have had a long-term plan and vision for the home that provides the residents with a supported route to independence. Each stage of the plan has been for the benefit of the residents and enables them to develop life skills through positive experience. Residents said they were very happy at the home, and that they could speak to Nicky and Chris if they had any problems or wanted anything. A staff member said that the owners were very supportive and that she could not think of a better place to work. A staff member said Nicky provided very good leadership. Cleveland House DS0000023377.V255090.R01.S.doc Version 5.0 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 X X 3 X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 4 4 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 4 X 4 X 4 X 3 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cleveland House Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score X 3 X X X X X DS0000023377.V255090.R01.S.doc Version 5.0 Page 21 NA 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 YA20 Regulation 13 Requirement Medication recording to be improved Timescale for action 06/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations The Royal Pharmaceutical Guidelines for medication to be used. 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