Inspection on 19/09/08 for Clifton Cottage

This inspection was carried out on 19th September 2008.

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

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

Other inspections for this house

Clifton Cottage 16/02/07

Clifton Cottage 21/02/06

Clifton Cottage 06/07/05

Clifton Cottage 26/01/05

Clifton Cottage 04/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 16/12/2008.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Clifton Cottage 1 High Street Ryde Isle Of Wight PO33 2PN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nick Morrison     Date: 1 9 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for 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 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Clifton Cottage 1 High Street Ryde Isle Of Wight PO33 2PN 01983566316 01983564008 suethornton@rydehouse.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Suzanne Diana Thornton Type of registration: Number of places registered: Mr John Raymond Clewley,Mrs Miranda Cruz Clewley care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Clifton Cottage is a residential care home offering care and accommodation to up to seven residents with learning disabilities. It is located in a central, yet secluded, site in the centre of Ryde town and is close to all the local amenities including shops, cafes, and boat, bus and train routes. The property is a Grade Two listed building that offers single room accommodation on three levels. Communal areas include a large kitchen/diner, a sitting room, and a games room. Residents have access to a garden area and a small courtyard. The home does not have a lift and as a consequence would not be suitable for residents with mobility difficulties. The current scale of charges is £413.91 per week with additional and varying charges for chiropody, activities, holidays and transport. 7 Over 65 3 Care Homes for Adults (18-65 years) Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home 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: This report represents a review of ll the evidence and information gathered in relation to the service since the previous inspection. This included a site visit to the home on 19th September 2008 that lasted five hours. During this time we toured the premises, looked at files for four service users, spoke with three of them and observed the support they received. We also met with the Manager, spoke with two members of staff and observed them interacting with people living in the home. All records and relevant documentation referred to in the report was seen on the day of the inspection visit. We have also referred to the homes own self-assessment of the service. Care Homes for Adults (18-65 years) Page 5 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 25 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 7 of 25 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. Service users benefit from having their needs assessed prior to moving into the home. Evidence: The home requires a full care management assessment for each person prior to them moving into the home. In addition to this, the home does its own comprehensive assessment. Records and letters showed that all assessments had been completed prior to the person moving in and that service users and their families were involved in the process. The home manages transition to the home by liaising with multi-disciplinary teams and arranging visits and overnight stays for prospective service users. The home is also in the process of updating its information pack for service users. Care Homes for Adults (18-65 years) Page 8 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having clear care plans and risk assessments in place and from being supported to make their own decisions. Evidence: Care plans in the home are devised and written as person centered plans. Service users are fully involved in the process of identifying their own aspirations, needs and the way in which they want to receive support. The plans contained pen portraits of the person along with information about their ethnicity, religion and preferred form of address. They covered a whole range of need areas that were important to the person. Service users spoken with were aware of their plans and confirmed that they were fully involved in devising them. The plans were produced in individual formats that were accessible to the particular person. Staff were aware of each persons plan and were observed supporting people in accordance with them. All plans were kept under regular review and updated as necessary. Each service user met with their keyworker on a monthly basis to review their care plan. Care Homes for Adults (18-65 years) Page 9 of 25 Evidence: Daily records were kept in relation to the care plans and these contributed to the monthly review meetings. All the plans seen were aimed at personal development for service users based on their own aspirations. Where risks had been identified there were risk assessments in place. These were linked to skills assessments and aimed at encouraging personal development within a safe framework. From observation throughout the inspection it was clear that staff were aware of the need to support service suers in making their own decisions rather than making decisions for them This was covered in the staff induction programme. Staff highlighted the choices available to service users and encouraged them to make up their own minds. This included day to day decisions such as what time to get up, what time to go bed and what to eat as well as decisions about the home and about how people wanted to spend their time. Care Homes for Adults (18-65 years) Page 10 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their rights respected and from balanced and nutritious meals. They also benefit from having the opportunity to engage in a wide range of activities both inside and outside of the home. Evidence: The home has a very positive approach to activities for service users. Individuals make their own choices about the amount and type of activities they get involved in. Some people choose to do a lot of activities and others choose to do much less. The home is able to demonstrate that it has offered a lot of options to people and that they have made individual decisions about how much or little they want to do. There are some older people living in the home who are very active and have a lot of interests. Service users spoken with had a very positive attitude to all the activities they did and were clear that they could choose what they wanted to get involved in. Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: Activities outside the home include bowling, swimming, visiting pubs and cafes, shopping clubs, church, going to college and using a range of day service opportunities. Inside the home staff arranged activities for people such as reading, playing board games and caring for the garden. On the day of the inspection visit a member of staff was playing board games with two service users, who told us they really enjoyed such activities at home. Each person has their own individual timetable in an accessible format so that they are clear about what activities they are doing each day. Staff support is arranged around service users social lives to ensure that staff are available to support them to participate in the things they wanted to. There was provision for one to one support for people to follow their chosen activities. The home has done some very positive work in supporting people to maintain relationships with their families. For some people this has involved close liaison with other professionals to ensure that relationships are maintained. People living in the home are supported to have ordinary relationships with others. Families are welcome to visit the home at times that are suitable for them and the person they are visiting. On the day of the inspection visit a relative came into the home and it was clear that staff had good relationships with her and that she found them easy to talk to. The food in the home was of good quality and service users spoken with said that they enjoyed the food and thought there were always enough different options available. Service users were able to contribute ideas to the menu through discussion at house meetings and there was evidence that menus had been changed in response to ideas raised through these meetings. The home catered for different dietary requirements related to peoples health needs or individual preferences. Care Homes for Adults (18-65 years) Page 12 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having their healthcare needs met and are protected by the homes medication policies and practices. Evidence: Care plans contained information on how people preferred to be supported with their personal care. Each person had their own individual healthcare file and these demonstrated that healthcare needs were monitored regularly and that good records were kept of all healthcare appointments for each person. Staff liaised closely with healthcare professionals in the interests of people living in the home. On the day of the inspection visit one person living in the home had just returned from hospital after an operation. Staff had been concerned about his health and had arranged a visit to the doctor for him and supported him at his appointment. After the visit staff continued to be concerned about the persons health and had advocated for further investigation, which resulted in the need for an operation being recognised. Staff supported him in the hospital and also provided the hospital staff with written guidance and contact details. Since he came out of hospital staff in the home were clear about his needs and limitations and were supporting him to recuperate. Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: The system for administering medication in the home was clear and was stated in the homes policies. Staff involved in administering medication had received training and demonstrated that they had a good understanding of the issues involved. Medication records were clear, accurate and up to date and all medication was stored appropriately and safely. There was a comprehensive system in place for monitoring medication with regular checks and crosschecking to minimise the possibility of any errors occurring. Service users medication records contained information about their allergies and also had a photo of them to minimise the risk of errors. The home is in the process of updating their procedures for dealing with as and when required medication so that it is clear under what circumstances this medication can be administered. Care Homes for Adults (18-65 years) Page 14 of 25 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. Service users benefit from having their views listened to and are protected by the homes policies and practices. Evidence: The home has a complaints policy in place and service users spoken with said they were clear about how to complain if they needed to. There were no recorded complaints over the past twelve months, although the home has a system in place for recording and responding to complaints should they arise. The complaints procedure was clear and was available in an accessible format for service users. The home gave service users clear information about their rights. People living in the home had opportunity on a day to day basis as well as through keyworker meetings and house meetings to raise any issues and the fact that the service responded effectively to any points raised contributed to the fact that there were no formal complaints. There were behavioural support plans in place where the behaviour of individuals necessitated them and staff were aware of those. The home has good policies and procedures in place for dealing with allegations or suspicions of abuse. Service users were referred to independent advocates where necessary and the home encouraged service users to voice their opinions. One person living in the home looked after her own money and was able to budget for Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: herself. The other people in the home all had building society accounts which their allowances were paid into. Their personal allowances were drawn from these and they were supported by staff to keep their money safe and to budget their money. The home kept good records of all transactions involving service users money. Records were checked each time there was a transaction and also checked on a weekly basis. Furthermore, all accounts were audited every six months by someone from the organisations head office. Care Homes for Adults (18-65 years) Page 16 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in a clean, safe and comfortable home. Evidence: The home was clean throughout, while remaining comfortable and homely. There were cleaning rotas in place for each day of the week to ensure that cleanliness was maintained and good records were kept of what cleaning had been done. The home blends in well with the local community and is situated conveniently close to the main shopping centre while remaining quiet and secluded. Infection control policies were in place and staff adhered to these. There were no concerns regarding infection control at the time of the inspection visit. The home had received a maximum of five stars when assessed by the Isle of Wight Environmental Health Department. Call alarms were available in bedrooms for those people who needed them. Service users were able to have a key to lock their own rooms, although they did not all feel the need to have one as people tended to respect each others privacy and there had been no issues in relation to the security of rooms. Service users were able to have tea and coffee making facilities in their own rooms, subject to an assessment of risk. There were photographs around the building of service users, which added to the homeliness of the service. Care Homes for Adults (18-65 years) Page 17 of 25 Evidence: At the time of the inspection visit the kitchen was in the process of being refurbished. Service users spoken with said they had been involved in choosing the new kitchen and were involved in choosing decor throughout the house. House meetings showed that service users were also involved in decisions about how particular rooms in the home should be used and the service had responded to their views. Service users who have a particular interest are supported to be involved in maintaining the garden area and in deciding how the garden will look. Care Homes for Adults (18-65 years) Page 18 of 25 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. Service users benefit from being supported by adequate numbers of well-trained staff and are protected by the homes recruitment policies and practices. Evidence: There are two members of staff on duty in the home throughout the day, as well as the Manager. At night there is one member of staff sleeping-in. Service users and staff spoken with said they felt there was sufficient staffing. Rotas are organised so that there is sufficient support at the right time for service users to be supported with their chosen activities. Examination of recruitment records demonstrated that all necessary pre-employment checks were undertaken prior to staff beginning work at the home. Staff training was given a high priority in the service. The organisation has appointed a Training Manager to ensure that training is well-managed. The training matrix for the home demonstrated that training updates were planned and delivered as necessary and that staff also had access to training that was specific to the needs of people living in the home (e.g. training in Diabetes). Staff spoken with said they thought the training was of a high standard. Five out of the ten staff have an NVQ at level two and three more staff are in the process of completing theirs. Two members of staff had recently completed their NVQ at level three. Care Homes for Adults (18-65 years) Page 19 of 25 Care Homes for Adults (18-65 years) Page 20 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from living in a well-managed and safe home that is responsive to their needs and individual views. Evidence: The current Manager is registered and has demonstrated that she has the skills, knowledge, qualifications and experience to manage the home. Feedback from service users and staff demonstrated that she is valued as a Manager and that people find her approachable and responsive. Staff told us they receive good support and supervision from the Manager. The service is very focused on the views and needs of service users and those service users spoken with spoke about how they consulted about most aspects of the home and how they were encouraged to voice their opinions and generate their own ideas about the home. There are house meetings on a monthly basis and these are usually based around mealtimes to make them accessible to and comfortable for the people living in the home. Records showed that, at these meetings, service users were encouraged to Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: discuss and consider health and safety issues and asked for views about the decor and refurbishment of the home. They were also kept informed about new staff, new service users and visitors to the home. They were also consulted about the menus. In addition to this, there are survey forms in place and these are in the process of being updated to make them more accessible to people. The organisation undertakes monthly inspections of the home and records of these were kept in the home. Information from house meetings, monthly inspections, staff meetings, staff supervision sessions and from the Managers observations and checks were fed into the management meetings and were all considered in devising a development plan for the service. Health and safety issues were well-managed in the home. Workplace risk assessments were in place and kept up to date and good records were kept of maintenance of the building and equipment. The organisation has employed an independent Health and Safety Advisor to visit all of their homes and advise on best practice. No health and safety issues were identified during the course of this inspection visit. The home maintains good fire records and has an alarm test once a week. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - 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!