Inspection on 12/12/05 for Clifford House

This inspection was carried out on 12th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Clifford House 18/02/09

Clifford House 21/09/06

Clifford House 31/05/05

Clifford House 15/09/04

Clifford House 28/04/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Clifford House Westlinton Carlisle Cumbria CA6 6AG Lead Inspector Liz Kelley Unannounced Inspection 12th December 2005 2:00 Clifford House DS0000056548.V266254.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 Clifford House DS0000056548.V266254.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. Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Clifford House Address Westlinton Carlisle Cumbria CA6 6AG 07958390002 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) Mrs Oriel Graham Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 5 service users to include: up to 5 service users in the category of LD ( Adults with Learning disabilities) 31st May 2005 Date of last inspection Brief Description of the Service: Clifford House is a modern five bedroomed detached property, approximately 3 miles north of Carlisle. It is based in the village of West Linton, which has a pub and café and is served by a regular bus service to Carlisle and Longtown. Service users access day services by either taxi, or minibus provided by that service. Mrs Graham arranges taxis or uses her own car to transport service users to town or to visit relatives. Service users bedrooms were all above the National Minimum Standard size and all had hand wash basins installed. There was a bathroom and shower room on the first floor and a shower room and separate toilet on the ground floor. Communal space was provided by a large lounge additionally there was a large entrance hallway/lounge that had comfortable seating, a gas fire and a television. There was a large combined kitchen and dining room, which also had a settee and two easy chairs. A conservatory had been added to the rear of the house and had gym equipment and another sitting area. The owner provides care and accommodation to three service users with a learning disability. Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place late afternoon and across tea-time. Initially one resident was at home and the other residents arrived back later from work placements and day centres. Time was spent talking to all service users and the manager. What the service does well: 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. Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 6 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 Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 7 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): 2 and 4 The Home has developed good systems for assessing and introducing new residents which ensures that both the new resident and the home make the right choice and that care needs can be met. EVIDENCE: A new resident had recently moved into the house and this person was spoken to and their care notes examined. The file contained a full community care assessment and additional notes on the homes assessment. This person was also given the opportunity to have numerous visits and to stay over night. Speaking to this person they said “My new bedroom is really nice and I like having the pets here. I like it here better than the other home”. Community care assessments were available for all four residents and care plans expanded upon these to ensure that care needs could be met living at this home. There was a clear admission procedure to the home, which included trial visits and seeking the views of other residents to ensure a successful placement. Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 8 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 Encouraging residents control over all financial matters of their lives has improved and is an example of how the manager promotes new skills and independence. EVIDENCE: Residents had a better awareness and control over their own finances and did now had information on what benefits they were receiving. There had been a move away from relatives giving personal allowances to ownership of bank accounts by residents. The manager had begun to address this by assisting one resident to open their own bank account, and they had been very happy with this move. Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 9 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): 13,15,16,17 Residents are supported and offered many opportunities to take part in varied activities based on individual choice and interest. This leads to each person having interesting and individual life styles. EVIDENCE: Residents are encouraged to have a range of interests, attend local colleges, follow work placements, and attend the Skills Centres, all of which bring them into a wide circle of social interactions. Residents spoke of their varied lives at the home; individuals are supported to follow individual hobbies and interests; all had individual holidays Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 10 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): 20 The manager makes sound judgements and keeps good records of medications that promotes the health and well-being of each service user. EVIDENCE: The manager keeps MAR sheets and has completed a distance learning scours on the Safe Handling of medications. Good health care records are kept and this includes any referrals or requests to review medications. Medications are kept in a secure locked cupboard, and those that require refrigeration have a separate box for this purpose. Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 11 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): 23 The manager has a good knowledge and understanding of Adult Protection issues which protects residents from abuse. EVIDENCE: The home had polices and practices that safe guarded the handling of residents monies. Personal monies and records were examined and found to be correct, with the signatures of both staff and the resident. This area and training in Adult Protection safeguards residents from abuse. The manager has undergone train as part of the NVQ 4 in Care, and has a good working relationship with the local social work team Residents have contact with advocates and are confident about contacting key workers in their day centres and making contact with social workers if they have any concerns. Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 12 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 and 30 Residents were living in high quality housing that was regularly up-graded to ensure these high standards were maintained and that the environment was comfortable and pleasant to live in. EVIDENCE: There was a good amount of communal space which allowed for residents to have choice. This was provided by one large lounge, exclusively for service users use and additionally there was a large entrance hallway/lounge that had comfortable seating, a gas fire and a television. One resident in particular liked to have sole use of the conservatory to watch television. There was a large combined kitchen and dining room, which also had a settee and two easy chairs in, which was described by the manager as “the hub” of the house. The three bedrooms were above the national minimum standard and were decorated and furnished to a high standard. Since the last inspection hand wash basin had been plumbed into each bedroom, and two separate shower rooms created, one upstairs and one downstairs. Residents said they liked having the choice and being able to have toiletries kept in the vanity units of the hand basins within their own rooms. Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 13 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): 33 and 35 Residents have benefited from increased flexibility provided by an additional member of staff. EVIDENCE: A part-time member of staff has been employed which allows for greater choice and flexibility for residents. One resident said that she had not wanted to go on a Christmas shopping trip with the other residents and had opted to stay at home with the new part time member of staff. All residents said that they liked this new member of staff and said she was kind. The new staff member has a nursing background and Mrs Graham had taken up references and a Criminal records bureau check. To ensure that residents are given appropriate care the manager must ensure that she provides training and a structured induction programme for this person. Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 14 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): 39 The homes family domestic scale of living promotes open and warm relationships where residents freely express their views on a wide range of issues. These views are not sought in a formal manner due to the nature of the service. However, the manager should consider how feedback and a quality assurance system could be developed that is appropriate to the setting. EVIDENCE: On all inspection visit residents have engaged with the inspector in lively discussions about their lives and the home. Resident say and are observed having open and frank discussions with the manager in a warm and convivial manner. While this is a positive aspect of the home the manager should seek to formalise this area particularly with a new service users who may not have the same confidence to speak up. This should also extend to family, advocates, day service and professionals who have contact with residents to ensure that their views are also sought. Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X 3 X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 3 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Clifford House Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X X X DS0000056548.V266254.R01.S.doc Version 5.0 Page 16 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 YA32 Regulation 16 Requirement The new member of staff must have a formal induction and training programme Timescale for action 31/03/06 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. 2. Refer to Standard YA1 YA39 Good Practice Recommendations The service users guide should be made more user friendly being typed and with photographs. A system should be developed for monitoring the quality of care provided to residents Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Clifford House DS0000056548.V266254.R01.S.doc Version 5.0 Page 18 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!