Inspection on 04/07/07 for Clifford Lodge

This inspection was carried out on 4th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clifford Lodge 12/10/06

Clifford Lodge 10/10/05

Clifford Lodge 25/04/05

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

CARE HOME ADULTS 18-65 Clifford Lodge 12 Clifford Road Blackpool Lancashire FY1 2PU Lead Inspector Mr Wesley Cornwell Unannounced Inspection 4th July 2007 09:30 Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 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 Lodge DS0000064036.V338441.R01.S.doc Version 5.2 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 Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clifford Lodge Address 12 Clifford Road Blackpool Lancashire FY1 2PU 01253 628793 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) Pro-Care Disperse Housing Ltd Post Vacant Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 6 service users with a Mental Disorder, excluding learning disability or Dementia (MD). 12th October 2006 Date of last inspection Brief Description of the Service: Clifford Lodge is a care home registered for 6 young adults with mental health problems aged 18 to 65 years. The home is situated in the North Shore area of Blackpool close to the town centre. The accommodation provides 6 single rooms, which are located on the first floor. Toilet and bathing facilities are also located on the first floor. There is no lift available at this home. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice whether to move into the home. The range of fees at the home are £282.00 to £292.00 covering all aspects of care, food and accommodation. The owner provided this information on the 4th July 2007. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was undertaken as part of the homes Key Inspection. The site visit commenced at 9:30am and took place over 4 hours. Prior to the site visit a member of staff completed an Annual Quality Assurance Assessment form (AQAA) providing basic information about the service they are providing. A number of residents, their relatives and health and social care professionals were contacted for their views about the home and these have been included in this report. During the site visit the Inspector spoke to five residents, one staff member, one health and social care professional and the owner of the home. Staff, care, maintenance and financial records were also examined. A full tour of the premises was undertaken with the staff member on duty. What the service does well: What has improved since the last inspection? The home has 100 of staff who have achieved National Vocational Qualifications (NVQ) ensuring residents are supported by competent and qualified staff. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The care plan records of two residents had full assessment information including the religious/cultural and relationship needs of the residents. The staff member on duty confirmed they had access to this information and could describe in detail the care needs of the residents. The staff member said they were responsible for the preparation of meals and had been informed about residents who had special dietary needs and these were being accommodated. All residents spoken to confirmed they were happy their needs were being met. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of residents health and personal care is taken seriously and closely monitored to ensure they are met. EVIDENCE: Individual records are kept for each resident with a plan of care which had been generated through Care Management Assessment arrangements, setting out the action that needed to be taken by support staff to ensure all aspects of health, personal and social care needs of the residents were met. Residents spoken to said staff members were supportive in encouraging them to live independently with the knowledge that help and assistance is available if required. The daily records of two residents described the level of support and assistance being provided by the staff team with their daily living routines. Both residents said they liked living at the home and were happy with the level Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 10 of support being provided. One resident said, “ I am very independent and require very limited support. I attend to all my own needs and make my own decisions about how to live my life”. Observation of care plan records confirmed the home has clear risk assessment management strategies in place for dealing with potential risks to residents. The home has a good record of dealing promptly with any unexplained absences of residents according to written procedure and ensuring all appropriate organisations are kept fully updated. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Education and employment opportunities are not being promoted to ensure the residents have opportunities for personal development. EVIDENCE: Observation of care plans and discussion with residents confirmed opportunities for the personal development is not being encouraged. There was no evidence that educational or employment opportunities had been discussed with residents and where appropriate explored. Activities are not being organised and there appeared to be no structure to daily living within the home. Residents spoken to all said they liked living at the home but were bored. One resident said, “ You do get fed up doing the same thing every day. I would like some activities to be organised as this would give us something to do”. The relative of one resident said, “ In the 13 months my son has lived at this home he has never been out on a group event. There are no purposeful or meaningful activities organised within or outside the home whatsoever”. One resident said they had recently been informed by their social worker that he is Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 12 to be moved elsewhere to receive some rehabilitation with the view to moving into independent living. The resident said, “ I accept this is needed. I have lacked motivation for some time and spend most of my time in my room watching television. I am bored and fed up”. The owner of the home needs to give serious consideration to devising a personal activity plan for each resident identifying educational, employment and social opportunities. The plan should be agreed with each resident and include information about the day and time the activities are to be undertaken, venue, meal provision, transport arrangements and support to be provided. This will enable residents to enjoy a full and stimulating lifestyle. Residents said they were happy with arrangements in place for receiving their visitors and were encouraged to maintain contact with their family and friends. One resident said, “I haven’t lived at the home very long but have found friends can visit me whenever they want”. Health and Social Care Professionals said they were able to see residents in the privacy of their own room whenever they visited. All residents spoken to confirmed they were happy with the routines within the home and could come and go as they please and go to bed and get up when they want. All residents seen during the visit said they were provided with the choice of spending time on their own or in the lounge areas and the staff respected their privacy. Residents spoken to confirmed they had access to the kitchen to prepare snacks and drinks. One resident said, “We make our own breakfast and lunch and the staff member on duty makes the main meal at tea time”. The home does not have a set menu with food being purchased for the week and then residents can choose daily what they would like to eat. One resident with special dietary needs confirmed this was being accommodated. The relative of one resident was not very complimentary about the food being provided for her son and expressed concern that a healthy diet was not being offered and as a result several residents were obese. Although residents spoken to said they enjoyed the meals being provided consideration should be given to devising menus that provide a varied and balanced diet. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously and personal support is provided in a flexible and sensitive manner. EVIDENCE: Discussion with residents confirmed they were happy with the level of personal care support they received and said they were encouraged to be independent and attend to their own needs. The staff member on duty confirmed residents have responsibility for their own personal care needs and choose when to go to bed and get up, have a bath and change their clothing. A healthcare worker said the staff were very friendly and helpful whenever they visited and the residents seemed happy with the level of support being provided. Observation of care plans confirmed residents have access to healthcare services both within and outside the home and their healthcare needs are monitored and appropriate action taken when required. The care plan of one resident confirmed action was taken by one staff member following an incident within the home and appropriate treatment was received. A healthcare Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 14 professional said staff at the home were helpful and friendly and usually had the skills and experience to support the health care needs of residents. The healthcare worker said, “ Generally I am satisfied with the level of support being provided”. Medication practices observed were safe and good records had been maintained. The staff members responsible for the administration of medicines had received training to ensure they had basic knowledge of how medicines are used and how to recognise and deal with problems in use. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Arrangements for dealing with complaints are in place but are not taken seriously ensuring people feel listened to. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission to the home. Residents spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. The relative of one resident contacted prior to the site visit also said they were aware of the complaints procedure and had made several complaints about the home and was unhappy that her complaints hadn’t been taken seriously. The relative said, “ I have complained on several occasions but nothing changes. They don’t listen and nothing changes”. All residents seen during the visit said they were happy living at the home and didn’t feel the need to complain about anything. The home has a procedure in place for dealing with allegations of abuse. The staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Staff members on duty said abusive practices and how to recognise these had been covered during training provided by the home. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of a planned maintenance and renewal programme for the redecoration and refurbishment of the home does not ensure residents live in a comfortable, homely environment. EVIDENCE: There has been no real progress in upgrading the environmental standards in the home since the last inspection. Carpets and furnishings are old and in need of replacing. Resident bedrooms are all in need of redecoration and refurbishment. The environment throughout the building is dark and gloomy and would benefit from an on going refurbishment programme to upgrade the fabric and decoration of the premises and improve the comfort of residents. A tour of the building confirmed resident bedrooms had been personalised with their own belongings. However, most of the bedrooms are small and have inadequate storage space and as a result rooms are cluttered. One resident Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 17 said he was unhappy because there wasn’t enough space for him and his personal possessions. Each bedroom had been fitted with a lock and the resident issued with their own key ensuring their privacy was being promoted. Hot water temperatures throughout the home were checked and found to deliver water at a safe temperature in line with health and safety guidelines. Discussion with the owner and observation of documentation confirmed some recommendations recently made in a fire safety report produced following an inspection by Lancashire’s Fire and Rescue Fire Safety Department had been implemented. The owner said the outstanding requirements regarding the fitting of a suitable and sufficient fire warning system for the premises would be implemented within the timescale set by the Fire Safety Department. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes recruitment procedures are robust and these provide safeguards for the protection of residents. EVIDENCE: Staffing levels were sufficient for the number of residents living at the home. Residents spoken to said staff members were always available if needed. One resident said, “ We can all look after ourselves but there is always a member of staff on duty if we need them”. However, the owner was asked to consider reviewing staffing levels so that additional resources could be made available to assist residents pursuing education and employment opportunities and individual activities of their choice. Records show 100 of staff members have achieved National Vocational Qualifications (NVQ) ensuring residents are in the safe hands of a qualified and competent staff team. Discussion with staff and examination of records confirmed training had been provided for staff members to ensure they had a clear understanding of the specific care needs of residents accommodated at the home. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 19 The home has a small staff team and there has been no new employees recruited since the last inspection. Examination of records during previous inspections showed good systems were in place for obtaining relevant documentation for staff members employed by the home ensuring the protection of residents. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and has policies and procedures in place to ensure the health and safety of residents and staff are promoted and protected. EVIDENCE: The home is presently without a manager who is registered with the Commission. The owner of the home said he was actively seeking to appoint a manager who is qualified, competent, experienced and who will run the home for the benefit of the residents and improve the services presently being offered. During this visit the staff member on duty was positive in her approach to her work and records checked were found to be up to date and were being well maintained. The staff member confirmed the owner of the Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 21 home was visiting on a daily basis and providing support and guidance as required. An annual quality assessment of standards is undertaken within the home by a professionally recognised organisation who completes an audit of the care being provided and seek the views of residents and their relatives. Residents spoken to were very positive in their comments about the staff team who were described as being friendly, approachable and very helpful. One resident said, “ We don’t have formal meetings but we have our say about the running of the home and we are listened to and the staff will act on what we say. This is a very good place to live”. The staff member on duty had a clear understanding of their role and what is expected of them during their shift. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation to provide a safe environment for residents and staff. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 23 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 YA22 Regulation 22 (3) (4) Requirement The registered provider must ensure all complaints are taken seriously and people making a complaint feel listened to. The registered provider must appoint a manager who is suitably experienced and qualified to be registered with the Commission and who will run the service for the benefit of the residents. The requirements made by the Fire Authority must be implemented within the timescale set to ensure the safety and welfare of residents and staff are promoted and protected. Timescale for action 20/07/07 2 YA37 8 26/09/07 3 YA24 23 (4) 01/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA24 Good Practice Recommendations The registered person should produce a programme for the DS0000064036.V338441.R01.S.doc Version 5.2 Page 24 Clifford Lodge routine maintenance of the fabric and decoration of the home. 2 3 YA11 YA14 People who use the service should be supported to pursue education and employment opportunities. People who use the service should be encouraged to engage in recreational activities of their choice. Clifford Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 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 © 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 Lodge DS0000064036.V338441.R01.S.doc Version 5.2 Page 26 - 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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