Inspection on 31/05/05 for Clifford House

This inspection was carried out on 31st May 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Clifford House 18/02/09

Clifford House 21/09/06

Clifford House 12/12/05

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 Announced 31 May 2005 14:00 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 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 Stationary 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 F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Clifford House Address Westlinton Carlisle Cumbria CA6 6AG 07958 390 002 Telephone number Fax number Email 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 3 Category(ies) of Learning Disability (3) registration, with number of places Clifford House F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1) A maximum of three adults with a learning disability (3LD) may be accommodated Date of last inspection 15/09/04 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 F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 3 hours across the afternoon and all three residents were spoken to individually and as a group. The manager and her family were spoken to. A full tour of the premises took place and residents files were examined. A pre-inspection questionnaire was received from the manager. Residents also returned a questionnaire, which was completed with the help of day services staff, on their experience of living at Clifford House. What the service does well: What has improved since the last inspection? What they could do better: Residents did not have awareness of, or control over their own finances and did not know what benefits they were receiving. These were managed by relatives. To further increase independence and empower residents the manager should explore these areas with relatives, social workers and residents. Clifford House F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 6 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 F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Clifford House F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 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 standard(s) 1,2 The homes statement of purpose and service users guide contain very good information in guiding a person when trying to decided on choice of a home. However, both these documents would be even more user friendly if they were typed up and in a larger format. EVIDENCE: The statement of purpose and Guide had been up-dated and included clear details on how to complain and services on offer. These were both handwritten and did not include any photographs which would assist a person in making an informed choice. Community care assessments were available for all three 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 F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 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 standard(s) 6,7,9 The home had well written, clear care plans, which ensured residents health, and social care needs were met in a way that promoted their privacy and dignity. Encouraging residents control over all financial matters of their lives could develop further self-growth and independence. EVIDENCE: All three care plans were individual to each resident and reflected each persons interests and lifestyle which led to individualised weekly programmes and day services. One resident discussed their plan and the levels of support that she received from the manager. She stated that she had gained in confidence since entering the home, and relative comment cards referred to increase in confidence and maturity since living at the Home. Residents did not have awareness of, or control over their own finances and did not know what benefits they were receiving. These were managed by relatives, who gave personal allowances. 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. To further increase independence and empower residents the manager should explore these areas with relatives, social workers and residents. Clifford House F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 10 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 standard(s) 11,12 The family style of care home promotes good positive relationships and stability and this leads to residents having the confidence and personal growth to take part in a wide range of activities. EVIDENCE: Residents spoke of a wide range of activities that they took part in, they particularly enjoyed going out in the evening to night clubs for special occasions and shopping. Two residents were due to go on holiday with a local advocacy group and the other had chosen to go abroad with the manager. Residents had been given a choice of holiday and had been involved in planning their trips and buying new holiday clothes. Clifford House F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 11 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 standard(s) 18,19 Residents health and personal care needs are well met by promoting independence and self-help skills that allow the individual to do as much for themselves as possible. EVIDENCE: Care plans and residents files detail appropriate levels of support and referrals and appointments to health professionals for specialist advice when required. Residents were having access to general and specialist advice that ensured that they were in good health and some long-term health problems had consequently some long-term health problems had recently improved. Clifford House F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 12 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 standard(s) 22 The homes complaints procedure had recently improved making residents and relatives even clearer on the process. The open style of management of the home encouraged residents to be empowered to speak up and have concerns resolved in a non-confrontational manner before they develop into major complaints. EVIDENCE: All three residents said that they would speak to Mrs Graham if they had any concerns or complaints, and said that they felt they would be listened to and she would try to sort things out. One resident was confident and empowered to be able to call-in to see her social worker to up-date them when she felt this was necessary. All three residents had different work or day placements and said that their were people here they could also speak to, and Mrs Graham had sent their comment cards for the Inspection through to these service to assist in completing them to give a more objective view and to enable residents to speak freely. Clifford House F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 13 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 standard(s) 24,25,27 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 F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,35 Residents needs are well met by Mrs Graham who provides supportive and enabling care with warm relationships which promotes independence and confidence. EVIDENCE: The relationship between Mrs Graham and the service users was observed and judged by the inspector to be open, warm and friendly. One resident said “ I get on really well with Oriel And she takes me lots of places”. Since the move a good relationship had been developed with neighbours and residents had developed positive relationships. In discussions with a neighbour they stated that from their observations they felt Mrs Graham was very caring and service user always appeared well cared for and happy. She also stated that they frequently went out. The registered manager was judged to have the relevant experience, competencies and qualities to meet the needs of the service users, and had completed the Registered Managers Award, choosing units to promote independence and participation. She had also recently completed a four day First Aid course. Clifford House F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,42 The home is run in an efficient manner which is appropriate to a family style of living and residents are safe guarded by the systems Mrs Graham has put in place. EVIDENCE: Mrs Graham runs the Care Home on her own and has policies and procedures that are appropriate to this setting. For example these included fire safety, handling of medications, complaints, protection of vulnerable adults. At the previous inspection a requirement was issued to ensure that family members living within the Home had a Criminal Record Bureau disclosures check carried out. This had now been carried out and were all satisfactory. The Home complied with fire and environmental health department requirements. The fire log was examined and found to be in order. The manager had completed a course on basic first aid and food hygiene. The manager uses HSE forms to record and report accidents and injuries. All these measures demonstrate an efficient well run home where the care and well-being of residents lead any administrative activity. Clifford House F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 16 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 2 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 x x x Standard No 11 12 13 14 15 16 17 3 3 x x x x x Standard No 31 32 33 34 35 36 Score 3 x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Clifford House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 17 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action 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 1 9 Good Practice Recommendations The service users guide should be made more user friednly being typed and with photographs. Resdeints should be supported to take more control over their finances were this is assessed as approrite Clifford House F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 18 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 F58-F10 s56548 Clifford House v170721 310505 ai Stage 4.doc Version 1.30 Page 19 - 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. 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