Inspection on 21/02/06 for Clifton Cottage

This inspection was carried out on 21st February 2006.

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 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 19/09/08

Clifton Cottage 16/02/07

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 08/07/2008.

CARE HOME ADULTS 18-65 Clifton Cottage 1 High Street Ryde Isle Of Wight PO33 2PN Lead Inspector Neil Kingman Unannounced Inspection 21st February 2006 09:30 Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Clifton Cottage Address 1 High Street Ryde Isle Of Wight PO33 2PN 01983 566316 01983 564008 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) Mr John Raymond Clewley Mrs Miranda Cruz Clewley Suzanne Diana Thornton Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (3) of places Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6 July 2005 Brief Description of the Service: 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 and two lounges. The home does not have a lift and as a consequence would not be suitable for residents with mobility difficulties. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two inspections for the year at Clifton Cottage and took place unannounced over a total of 4 hrs. Two of the residents were not in the home during the morning so the inspector returned in the evening when they were all having their evening meal. The inspector toured the building with the manager, viewed a sample of the home’s records, and spoke with staff on duty and all the residents. Core standards not assessed on this occasion had been assessed at the last inspection. On the day of the inspection the weather was dry and very cold, but this did not discourage the residents from taking part in a variety of activities both inside and outside the home. Staff support the residents to lead fulfilling lives, and it was clear from observations made and comments received that they all get on very well together. The home was found to be fully meeting all but one of the standards assessed. What the service does well: What has improved since the last inspection? What they could do better: There were no requirements or recommendations identified during the inspection. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 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. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 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 Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 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 the following standard(s): 3 The home ensures that residents’ needs are met with the skills and experience of the staff, effective communication and access to specialist services. EVIDENCE: There have been no new service users admitted to Clifton Cottage for almost six years, indeed some have lived in the home for over twenty years and are now well into retirement age. Being centrally located in the town of Ryde it suits the residents, some of whom can walk to their place of work, and others who regularly walk to the nearby shops and cafes. The home provides longterm care/support and not dedicated intermediate care. A mix of male and female staff have the skills to meet the needs of all residents, whatever their age and recently managed well the needs of a resident who fell ill and subsequently needed treatment in hospital. The Ryde House group provides a wide range of statutory and care related training for staff, which is ongoing. The home offers a place only to people whose needs can be met. There was evidence in personal plans that specialist services and clinical guidance are sought as and when required. This was ably demonstrated in the home’s response to the onset of dementia with one resident, and the increased mobility difficulties of another. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 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 the following standard(s): 7 Residents are enabled to take control of their own lives within the limits of their cognitive ability. Management and staff support those with intellectual impairment and/or limited communication skills to make decisions. EVIDENCE: It was clear during the inspection that residents are not denied opportunities to make everyday choices. One was determined to go into the town in spite of the weather. Having ensured he was appropriately dressed the staff encouraged him to go out, not once but twice during the day. Another preferred to watch a film in his room, saying he would go out for a walk later. Two spent the day at the Ryde House garden centre where they work. The manager said that all but one of the residents have family to support them. The advocacy service has been involved with the one resident who is presently unrepresented. No residents are assessed as being fully able to manage their own finances. The home provides a system for administration and safekeeping of their monies and valuables. The integrity of the system provided was checked and found to be satisfactory. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 10 Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15 Two of the residents take advantage of paid employment provided at the Ryde House garden centre. The rest have all reached retirement age. Generally they lead active lives and maintain regular links with the community. All maintain family links and either make or receive visits at regular intervals. EVIDENCE: One resident has worked all of his life and now at retirement age works just occasionally at the garden centre in the summer. Two of the younger men have virtually full-time employment. Others pursue their own interests, which include twice weekly day services for one. There is regular contact with the local community in the form of weekend group excursions, places of entertainment, local cafes and in one case busking in Ryde town centre. The inspector spoke with one resident about his interest in sport, and particularly the ‘Special Olympics’ for which he regularly trains. Another resident was looking forward to her 60th birthday, which was due shortly. A large party was planned at one of the day centres. The home is expecting delivery of a new mini bus, which will afford greater flexibility for Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 12 trips away from the home. The manager said they were fortunate to have a number of drivers in the current staff group. Contact with friends and family varies from regular weekly visits to infrequent trips to the mainland. The manager said that residents are free to enjoy personal relationships with people of their choice, but this was not an issue at present. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 All but one residents are independently mobile and require minimal physical support from staff. Guidance and support regarding personal hygiene is limited to encouragement and reassurance. Residents’ health care needs are regularly addressed. EVIDENCE: There is a mix of male and female, although mostly female staff at Clifton Cottage to provide residents with flexible personal support as and when required. Staff confirmed, and care records showed that residents receive checks from their GP, dentist, optician and specialist health care professionals. They are registered with the new Tower House health clinic and a nearby dental practice. Residents have individual health care files, which contain records of health care needs, visits to practitioners and follow up action where appropriate. The home has done well to help some residents with the transition to older age and staff have shown a commitment to supporting those who become ill or less mobile. One resident told the inspector that he is able to go to shops and cafes with one of the staff with the aid of a wheelchair. This individual has equipment to aid his mobility and make life more comfortable for him. The home has needed the support of a psychiatrist and Community Learning Disability Nurse for two of the residents. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 14 During the tour of the building the inspector noted that all rooms were quite different in their personalisation, reflecting the individual characters of those who occupied them. Residents themselves confirmed that they choose their own clothes and possessions. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. Procedures for responding to suspicion or evidence of abuse are robust. EVIDENCE: Clifton Cottage has an adult protection policy and procedure, which links with the Social Services policy guidance. Additionally, there is a one-page document prominently displayed to inform staff of the reporting procedures. Staff spoken with during the inspection showed a good understanding of what constitutes abuse and what to do if they had any concerns. This is a subject covered in the staff induction programme. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Clifton Cottage provides a domestic style of environment, which in general terms meets the needs of those who live there. EVIDENCE: The inspector toured the building with the manager. Communal areas are spacious, bright and airy. The building has listed status and is somewhat quirky with a curved frontage and winding stairs up to the second floor. Residents in the upper rooms are fit and ambulant. One with some mobility difficulty occupies a room on the ground floor where there is level access. In addition to the main lounge there is a smaller, sunroom. Residents eat together in the kitchen, which is bright and spacious. The lounge contains a large TV, the free-view facility and comfortable seating for up to seven people. Residents’ rooms are arranged on three floors and are furnished and equipped to meet their individual needs. The home has a programme of decoration and maintenance. At the time of the inspection all areas were decorated to an acceptable standard with two residents’ rooms having been recently decorated. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Staff at Clifton Cottage have the necessary skills and experience to meet the needs of the people who live there. However, at the time of the inspection the home had not met the standard of 50 of staff with the NVQ at level 2 or above. EVIDENCE: All staff are scheduled to receive training and refreshers in first aid, food hygiene, manual handling and infection control. Of the seven staff employed at the home 43 have achieved the NVQ at level 2 or above with two support workers working towards it. The Ryde House Group ensures staff in all its homes undertake awareness training in service related subjects, e.g., autism and challenging behaviour. Courses are accessed as and when they become available. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 The registered manager has the experience and qualifications to run the home and meet its stated purpose, aims and objectives. The Ryde House group has an annual development plan for its homes. Clifton Cottage has a process of establishing residents/representatives’ views about the service. EVIDENCE: The manager of Clifton Cottage Mrs Thornton has been in post for several years and has achieved The NVQ at level 4 in care and the Registered Managers Award. She has completed all statutory training and as with the rest of the staff group keeps up to date with service related awareness training, which is accessed as and when it is available. With the age variation of the current resident group Mrs Thornton has recently attended a college course in older persons’ health. The home has achieved the Investors in People Award. Each resident has a named key-worker who gets to know him or her well. This person is involved Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 19 in all decisions about the service provided for their particular key resident. Residents, relatives and care managers are included in the yearly care reviews. The manager confirmed that she maintains regular contact with most of the residents’ families and addresses issues as and when they arise. A representative of the Ryde House group monitors the conduct of the home by carrying out monthly regulation 26 visits. This same individual is involved in regular reviews of policies and procedures. Clifton Cottage has recently had a complete review of all policies and procedures. While not seen by the inspector it is know that the Ryde House group has an annual development plan, which includes a plan for a major service development. Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x 3 x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x 2 x x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Clifton Cottage Score 3 x x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x DS0000012477.V254607.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard Good Practice Recommendations Clifton Cottage DS0000012477.V254607.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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. 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