Inspection on 16/12/08 for Clifford House

This inspection was carried out on 16th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clifford House 20/08/07

Clifford House 19/09/06

Clifford House 07/10/05

Clifford House 17/06/05

Clifford House 25/01/05

Clifford House 26/07/04

Clifford House 09/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Blenheim House

Prince Bishop Court

Park View (15)

Craigmore House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Clifford House Lucy Street Blaydon Gateshead Tyne & Wear NE21 5PU     The quality rating for this care home is:   one star adequate 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: Mary Blake     Date: 1 6 1 2 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. that people have said are important to them: They reflect the things 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Clifford House Lucy Street Blaydon Gateshead Tyne & Wear NE21 5PU 01914148178 01914148959 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Clifford House Homes Limited care home 10 Number of places (if applicable): Under 65 Over 65 0 6 0 learning disability physical disability sensory impairment Additional conditions: Date of last inspection Brief description of the care home 10 0 1 Clifford House is a large two storey building converted into two large flats. Five people live in each flat. The home provides care for people who have learning and / or physical disability, some of whom are over 65, but cannot provide for people who need nursing care. It is situated in the Blaydon area of Gateshead and is close to a variety of local shops and other facilities and is near to transport routes, which give good access to Newcastle and Gateshead. The home also has its own transport, which can be used by service users. Each flat has separate facilities including kitchen, dining and sitting areas. All service users share other parts of the building such as the laundry, gardens and patio areas. The design, layout and facilities provided in the downstairs flat are suitable for those Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home people who have a physical disability. All necessary facilities are provided including an emergency call system and a lift that takes people to and from the first floor. The fees from the home vary and further information can be obtained from the homes manager. Additional charges are made for toiletries, newspapers / magazines, and hairdressing. Items which are included in the cost, are listed in the homes terms and conditions. Care Homes for Adults (18-65 years) Page 5 of 28 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. We have reviewed our practices when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the services are not being put at significant risk of any harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the visit we looked at information we have received since the last inspection of Care Homes for Adults (18-65 years) Page 6 of 28 this service completed on 20th August 2007, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people and the views of people who use the service & their relatives, staff and other professionals. An unannounced visit was made on 16th December 2008. During the visit we talked with people who use the service, staff, the manager and visitors, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for and looked around parts of the building to make sure it was clean, safe and comfortable. We told the manager what we found. What the care home does well: What has improved since the last inspection? What they could do better: A recognised system of Person Centred Planning (PCP) must be used within the home. This will help people to receive more individualised support and a better quality of life and experience. Service users and their representative must be involved with this plan. A person centred activity plan is devised for each individual. Staff must know how to provide stimulating activities for people with profound learning disabilities. This will help to ensure that people are able to lead a fulfilling and stimulating life that suits their needs and abilities. Provide suitable medication storage and stock control to ensure that medications are safely managed. Review and update menus for nutritional content, choice and variation to provide service users with a choice of healthy diet. Staff training in key statutory areas must be updated on a regular basis. This will help ensure that staff have the skills and knowledge they need to provide people with safe Care Homes for Adults (18-65 years) Page 8 of 28 care. Staff must receive regular formal supervision and an annual appraisal. This will help ensure that staff are well supported, appropriately supervised and aware of their responsibilities in protecting the welfare of people living at the home. Prepare an improvement plan. This will help people who use the service, and their families, to see that there is a written programme that sets out how the homes furnishings, fittings and fabric of the building are to be renewed, repaired and improved. They will also be able to see how the provider intends to improve the care and services provided at the home. Implement a quality assurance system which will take into account how service users and their representatives can be involved in the running of the home. 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 Adults (18-65 years) Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Admissions to the home are appropriately managed and people who use the service know how their needs will be met. Evidence: There had been no new admissions. The home has a detailed preadmission process involving multi agency, service user and their families. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. The system of care planning adopted by the home and the arrangements in place for assessing risk were adequate but did not fully involve the people who use the service or their representative People who use the service are not fully consulted about or enabled to participate in decisions about their lives. The arrangements in place for assessing the risks posed to people as they lived their daily lives were adequate. Evidence: The person centred plan format and the quality of the information was not consistent. On sampling the care plans they were found to be detailed enough to assist people who use the service to receive the care they need. The manager had ensured that all recorded information was reviewed and summarised on a monthly basis but Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: acknowledged that all people who use the service will need to have their care plans reviewed. There was no evidence of the involvement of people who use the service or their representative involvement. Peoples care records contained limited information about what choices and decisions they could make. Independent advocates had not been used to help identify what support people required to make daily choices and decisions. Risk assessments were in place but had not been consistently reviewed and updated. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. The opportunities for people to develop and maintain social, emotional, communication and independent living skills, were not fully satisfactory. This meant that people did not always have positive opportunities to enjoy a full and stimulating lifestyle. Evidence: People who use the service are offered the opportunity to join in a limited range of social and leisure activities. They have the opportunity to use community facilities for leisure activities e.g. cinema, pub, meals, shopping. People who use the service are offered the opportunity to experience some activities and leisure pursuits as well as supported where necessary to continue with hobbies and interests. There had been issues raised about reduction in day care service provided. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Staff assist and encourage people to maintain family links as agreed and previous friendships, respecting the individual wishes of people who use the service. There was little evidence of in house activities or staff interaction and staff had not undertaken training in this area. People who use the service were observed having a leisurely lunch in a relaxed and social setting with good staff support evident. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service receive personal support in the way they prefer and their physical needs are met. Medication storage is unsatisfactory, which could put people at risk. Evidence: Some of the people who use the service are given personal choice and support in areas such as getting up, personal care and how they spend their time but this is limited for the people with more profound needs, as communication methods have not been developed. The individual health needs of people who use the service are identified and they are supported to access community health services such as doctor, district nurse, dentist and optician. They receive physiotherapy, psychiatry and psychology health support. Staff training has been undertaken to provide awareness and additional support for health related needs Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: No person who uses the service currently self medicates. The ordering, administration and disposal of medication was satisfactory. The medication storage was unsuitable and unsafe, as medicines were not within a suitable locked cupboard. A cupboard has since been purchased and is waiting to be suitably secured. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. The arrangements in place for handling complaints and protecting people from harm were satisfactory. This means that people could be confident that their complaints are dealt with appropriately and they are protected. Evidence: The complaints procedure provided staff with guidance about how to handle complaints. Neither the home, nor the Commission, had received any complaints since the last inspection. The safeguarding policy provided staff with guidance about how to handle adult protection concerns. There had been no concerns raised with either the home, or the Commission, since the last inspection. All staff had received or were about to have training in the protection of vulnerable adults and spoke knowledgeably about safeguarding procedures. Care Homes for Adults (18-65 years) Page 18 of 28 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. The facilities are adapted to meet the needs of the people who use the service. It is homely, generally well maintained and clean. Evidence: A check of the ground floor accommodation was carried out. Bedrooms visited were clean, tidy and generally well maintained. Toilet and bathrooms were clean and hygienic. There was evidence of personalisation in some, but not all, bedrooms. There were areas within the home which required attention. The kitchen had damp to the wall and food cupboard, flaking paint and food shelves unvarnished all of which could contaminate food. On the ground floor there were some stained/unsightly carpets(details given to the manager). There was a damaged light fitting in the dining room and the tiles around the extractor fan in the laundry need to be repaired. The nurse call system did not appear to be working or have been regularly maintained. The level of cleanliness throughout the home was good. Care Homes for Adults (18-65 years) Page 19 of 28 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. There are adequate numbers of appropriately skilled and experienced staff to care for the people who use the service. The recruitment processes in place protect people who use the service. Evidence: Staffing rotas showed that there are enough staff on duty to meet the necessary staffing levels. Recruitment procedures within the home are safe. Records confirm that appropriate checks are carried out for staff. Applicants for employment complete an application form and two references are obtained. A reference from the last employer is requested, plus another. Any gaps in employment are explored at interview. Each member of staff receives a contract of employment and job description. Discussions with the manager and staff and examination of individual staff training files confirmed that staff had undertaken refresher training, in some, but not all of the mandatory training. Staff said that they are undertaking or had completed National Vocational Qualification in Care level 2 (NVQ) or over. All staff(except new starter) have NVQ 2 and five staff also have NVQ 3. The home has an induction programme but there is no training programme for all staff Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: working in the home. Staff spoke knowledgeably about the individual needs of the people who use the service. Staff supervisions were not consistently undertaken. Care Homes for Adults (18-65 years) Page 21 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. The views of people who use the service and their families are not fully supported to underpin the development of the home. Their health, safety and welfare are protected. Evidence: The manager is qualified and has worked for several years at the home. The Provider is currently reviewing management arrangements to provide an assistant/deputy role. Regulation require that the provider (or their representative) visit the home on a monthly basis and this had now been done with well completed reports in place. It was unclear what quality assurance systems are in place and how the individual services users views are obtained in relation to the operation of the home. Accidents were appropriately recorded and actioned as necessary. Fire system testing and fire drills were being carried out sufficiently. Maintenance of equipment was in place. The Fire Officer recommendations had not been fully met. The Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: manager is aware of these concerns and had begun to address them. Care Homes for Adults (18-65 years) Page 23 of 28 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 Adults (18-65 years) Page 24 of 28 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 1 6 15 To consult with the service user and/or their representative in the preparation and update of their care plan This will ensure that the service user and/or their representative are fully involved in the care they are receiving 07/04/2009 2 7 12 To involve service user and/or their representative in their decision making To ensure that service users are fully involved in decision making which affect their lifestyles 07/06/2009 3 13 16 To detail within service user plan how individual social needs will be met This will ensure that service users are engaged in individual and community activities 07/04/2009 Care Homes for Adults (18-65 years) Page 25 of 28 4 17 16 To review and update menus 16/04/2009 for nutritional content, variety and individual choice This will ensure that service users have access to a more varied and nutritional menu 5 20 13 To provide secure storage for medication and maintain a record of stock control of controlled medication This will ensure the safe storage and management of medication 10/04/2009 6 24 23 To address the following 07/04/2009 building issues a) Repair damp and damaged areas within the kitchen b) clean or replace damaged carpets c) repair broken light fitting d) repair damaged tiling in laundry This will ensure that service users live in a safe and comfortable home 7 29 23 To provide a working nurse call system that is maintained as required This will ensure there is a working call system to assist service users 07/04/2009 8 36 18 To ensure that all staff have supervision on a regular basis This will ensure that the manager has an overview of staff skills and needs 10/04/2009 Care Homes for Adults (18-65 years) Page 26 of 28 9 39 24 The provider must have a 07/07/2009 quality assurance system which takes into account the views and wishes of the service users and/or their representatives This will ensure that service users are more actively involved in the running of the home. 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 1 2 3 13 35 35 Staff be given training to provide suitable activities to meet individual needs The manager to prepare a staff training programme identifying mandatory and other training completed. Staff to undertake training in providing individual activities for adults with learning disabilities. Care Homes for Adults (18-65 years) Page 27 of 28 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 © (2009) 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 Adults (18-65 years) Page 28 of 28 - 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. 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