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Inspection on 18/11/08 for Cliffdale

Also see our care home review for Cliffdale for more information

This inspection was carried out on 18th November 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This is a service that the people who live there say they find homely with the staff being friendly and caring. The healthcare of those living there is managed well with their health being carefully monitored so that the appropriate healthcare professionals can be contacted if necessary. The overall environment within the building is pleasant, clean and well maintained and the garden is also maintained as a pleasant place for service users to be.

What has improved since the last inspection?

Three requirements were made at the last inspection relating to the regulating of hot water temperature, carrying out background checks on new staff and the use of bed rails. All three requirements have been met The procedures used for assessing whether or not the home can meet the needs of anyone who wants to live in the home have also been improved as has the documentation that tells them what service they can expect.

What the care home could do better:

More activities should be made available to people who live in this home. Few group activities take place and therefore there are fewer opportunities to provide social stimulation for them.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cliffdale Shrewsbury Road Pontesbury Shrewsbury Shropshire SY5 0QD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Moloney     Date: 1 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Cliffdale Shrewsbury Road Pontesbury Shrewsbury Shropshire SY5 0QD 01743790261 01743792493 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Lesley Passant Type of registration: Number of places registered: Usha Odedra,Rajan Odedra care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 27 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 27 Date of last inspection Brief description of the care home Cliffdale is a private care home registered to provide care and accommodation for up to 27 older people. It is situated in the village of Pontesbury, some 8 miles south west of Shrewsbury, within easy reach of all local amenities and set in pleasant gardens. Accommodation is available on first and second floors accessed by a shaft lift. Fees are reviewed annually and range from £375 to £390 per week. This information applied at 0 Over 65 27 Care Homes for Older People Page 4 of 24 Brief description of the care home the time of inspection and people may wish to obtain more up to date information from the care home. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People looking to live in the home and their representatives have the information needed to choose a home which will meet their needs. They have their needs assessed and a contract which clearly tells them about the service they will receive. Evidence: The home was seen to have a statement of purpose as well as a service user guide. Both documents contained information about the home such as what to do if somebody had a complaint, what the qualifications of the manager and her staff were, information about the previous Commission for Social Care Inspection report about the home as well as many other things that someone might want to know if they were deciding whether or not they wanted to live at the home. The records of someone who had recently started to live in the home were also looked Care Homes for Older People Page 9 of 24 Evidence: at. These showed that the home staff had assessed her needs before they had decided whether or not they could look after her. She had then been offered a place in the home and a copy of a contract for her care was seen that outlined what the cost of that care would be and who would pay for it. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that a person living in this home receives is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The records of three people who live in this home were looked at. All were seen to have care plans that were drawn up after their needs had been assessed. Records were also seen that showed that these care plans were reviewed by the staff each month so that any comments made by people such as doctors and district nurses could be noted and acted upon. Notes of visits by health care professionals were seen to be kept within each persons records. A variety of risk assessments were seen to be in place. Not only were the more general issues assessed but so were such things as falls, manual handling and nutrition. Talking to people living in the home and to staff as well as watching how they assisted the people concerned showed that they were aware of what these documents said. Care Homes for Older People Page 11 of 24 Evidence: During the last inspection it was identified that reasons why bed rails were used were not fully recorded. Looking at a current example of a bed rail assessment showed that they now do. A full set of records was found discretely placed by the bed concerned and these gave detailed information about how the rails should be fitted and maintained. The medication room was looked at and this was found to contain two medication trolleys, a fridge and a controlled drugs cabinet which had been secured to the wall. The general medication records as well as those for the controlled drugs were looked at and seen to have been fully completed. Looking at the staff training records and talking to the manager and her staff confirmed that only staff who had received appropriate training were allowed to administer medication. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are able to choose their life style and keep in contact with family and friends. Social, cultural and recreational activities do not meet their expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. Evidence: The records of a number of the people living in the home were looked at. Each contained the name by which the person wished to be known as well as agreements that showed that the person concerned or their family had accepted that personal care may be given by someone of the opposite sex. Few references were seen in their daily notes to any social activities that they had taken part in. An activities book was seen and most entries were about religious services with a few being such things as quizzes, ball games and discussions but these were infrequent. When asked what activities had taken place during the afternoons one person said, not a lot and another said I watch a lot of television. The manager explained that this was Care Homes for Older People Page 13 of 24 Evidence: an area that she hoped to develop with the staff so that more activities would be available during the afternoons. The people living in the home made many positive comments about the manager and her staff. Watching and listening to the conversations going on between staff and residents it was clear that both parties enjoyed chatting and residents were confident about asking for help. Light hearted banter was heard on various occasions and when someone had difficulty forming words staff were seen to be waiting patiently for replies. The menu was seen to be posted outside the kitchen were it could easily be seen. It looked varied and nutritious with diners saying such things as, always very nice, nice to have a choice and more than sufficient. Talking to the cook and the manager confirmed that the home does and has catered for a number of people with special dietary needs. On the day of the inspection the meal served looked well presented and appetising. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home have access to a robust and effective complaints procedure, are protected from abuse and have their legal rights protected. Evidence: The home was seen to have a complaints procedure displayed in the hallway as well as being contained in each persons Service User Guide. Translations were also seen to be available for staff whose first language is not English. The home had received no complaints relating to the welfare of the people living there since the last inspection. It had not been necessary to make any referrals within the locally agreed policies and procedures designed for the protection of vulnerable adults. The procedures employed by the home when storing cash for people who live there were looked at and were seen to be robust and transparent. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home gives anyone living there a safe, wellmaintained and comfortable environment. Evidence: Looking around the building showed it to be well maintained, decorated and clean. It is an older building that has been modified to its current use by the addition of a large purpose designed extension to the rear as well as the addition of a conservatory. Both parts of the building are on two floors with access to both being assisted by a shaft lift. A number of the bedrooms were looked at and it was seen that they had been personalised with the addition of the occupants pictures and ornaments. There were a number of communal areas. These included the main lounge dining area, a smaller dining area, a small lounge area and the conservatory. The home also has pleasant and secluded gardens to the rear. Care Homes for Older People Page 16 of 24 Evidence: Car parking is available at the front of the building. The home has a laundry that is equipped to deal with heavily soiled items. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the personal care needs of people who live in this home. Evidence: The employment records of two of the staff were looked at and these showed that appropriate references had been obtained before people had access to service users as part of the procedure that ensures that they are fit do so. Looking at the staff rota as well as talking with the residents, the manager and staff showed that there are enough staff on duty to make sure that the care needs of the people living in the home are met. Talking with the manager established that since the increase in numbers of people living in the home it had become necessary to consider whether or not more staff would be required to ensure that social activities could take place. During the inspection a lot of conversations between residents and staff were seen and heard. The staff were always professional, clear and polite when they spoke. A lot of good natured banter was also seen and heard and the residents appeared to enjoy this. Care Homes for Older People Page 18 of 24 Evidence: Talking with a number of the staff confirmed that they have received the training that would ensure that they are able to meet the needs of the people living at the home. This was confirmed by talking with the manager and looking at the training records. Talking to staff, the manager and looking at records also confirmed that a significant number of staff had achieved National Vocational Qualification level 2 or above in care. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: The manager confirmed that she had achieved the Registered Managers Award and National Vocational Qualification level 4 in care both of which are qualifications that are appropriate for someone who is in such a role. Records were seen that showed that a member of the proprietors senior management visits the home at least once a month. Equality and diversity for the service users were seen to be promoted throughout the home within the assessments, care plans and policies. The home does store cash for some of the people living there. The system for Care Homes for Older People Page 20 of 24 Evidence: recording this was seen to be transparent and accurate. Various records were seen to be kept that monitored systems and the environment in order to make sure the people living in the home safe. These were found to be kept up to date. Hazardous materials such as some cleaning fluids were seen to be kept securely and instructions about how they should be used safely were also available. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 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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