Inspection on 06/07/05 for Clifton Cottage

This inspection was carried out on 6th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 21/02/06

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 6 July 2005 9:30 th 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. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Clifton Cottage Address 1 High Street, Ryde, Isle of Wight PO33 2PN 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) 01983 566316 01983 564008 Mr John Raymond Clewley and 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 H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26/1/05 Brief Description of the Service: Clifton Cottage is a residential care home offering care and accommodation to up to seven residents with learning difficulties. It is located in a central, yet secluded site in the centre of Ryde town. It 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 H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Clifton Cottage took place unannounced over 3¾ hrs. Three of the residents were not in the home at the time of the inspection, 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 two members of staff and all the residents. Due to differences in their cognitive abilities it was difficult to obtain informed views about life in the home from all the residents. However, two who were more able to express their views made very positive comments about the service. The others presented as being relaxed and happy. Interactions between staff and residents were warm and friendly. What the service does well: What has improved since the last inspection? What they could do better: Apart from a recommendation that the home fits a hazard strip in front of a low step there were no identified requirements. Based on the outcomes from this inspection the home is providing a good service in line with its aims and objectives. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 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. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 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 Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 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) 2 Clifton Cottage provides a service for long-term residents and there have been no new admissions for over five years. Those who live in the home have had their needs assessed and regularly reviewed during that time. EVIDENCE: There are no vacancies at Clifton Cottage, all residents having lived there for at least five years and one for nearly twenty years. They have all been referred through Social Services care management. The home has a written admissions procedure. In discussions with the manager, although she had no experience of introducing a new resident to this home, she was fully aware of the importance of a thorough pre-admission assessment. Apart from the assessment the procedure includes pre admission visits to ensure that prospective residents feel comfortable in the home and are able to integrate with others who live there. An assessment was available with each of the care plans seen by the inspector together with a Social Services purchasing agreement. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 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 and 9 The home develops a comprehensive plan for each resident, which describes how individual health, social and personal needs will be met. Staff enable residents to take responsible risks, details of which are included in their individual plans. Risk assessments contain guidelines for staff on how risks are to be managed. EVIDENCE: An individual care plan was available for each resident and the inspector looked at a sample of two. They are set out in a ‘person centred’ format covering a range of needs including personal care, mobility, health, communication, social and leisure. Plans highlight what is important to the resident and contain appropriate risk assessments around the activities that make up their daily lives. The emphasis is very much focused on residents’ independence. Although the needs of most residents change little from month to month reviews are carried out and significant events recorded. One resident was fully aware of his care plan and confirmed that the manager talked to him about it. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 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) 16 and 17 Residents at Clifton Cottage experience a good deal of independence and are given freedom of choice and movement within the scope of their abilities and identified risks. Food served is well cooked, varied and nourishing. There are three main meals each day, which are served flexibly around the commitments of the residents. EVIDENCE: Residents have complete freedom of movement around the home. Those who wish to keep their rooms locked are given keys, while those who do not have their wishes recorded in their care plan. Freedom extends to their movements outside the home with established routines, which allow residents to variously go out alone to day services, employment, local cafes and in one case busking in Ryde town centre. The inspector was able to talk with them about their daily excursions, which were a valued part of daily life. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 11 The manager said that while residents typically receive mail only on special occasions staff do not interfere unless requested to help. A general four week menu and a two week summer menu showed food to be varied and nutritious. The home does not have a dedicated cook as support workers take turns to prepare meals. This was seen to work well in what is a small domestic setting. The inspector came back to the home when all residents had returned for their evening meal. They ate together in the large kitchen/diner and the atmosphere was very sociable. On the day of the inspection the meal included fresh meat and a choice of fresh vegetables, which all but one seemed to eat with relish. They all agreed that the food on offer was to their liking. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 12 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) 20 Residents are assessed as being unable to retain, administer and control their own medication. Medication for residents is held under secure conditions and appropriate records maintained. EVIDENCE: Medication is dispensed by means of a monitored dosage system by staff deemed competent by the manager. At the time of the inspection medication for residents was held in appropriate, secure conditions. Records relating to the safekeeping and administration of medicines were checked and found generally to be in order. A minor anomaly with the system of administration was noted. The manager explained the situation and advice was given as to the procedure in future. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 13 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 home has a clear complaints policy and procedure in place. EVIDENCE: The home has a complaints book in which all complaints are recorded together with outcomes. The manager said that the home holds bi-monthly informal meetings with the residents, normally when they are gathered together after the evening meal, which gives them an opportunity to raise concerns or issues if they have any. Four positive comment cards were received from relatives of the residents and no concerns were raised. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 14 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) 30 All areas of the home are generally clean, hygienic and free from unpleasant odours. EVIDENCE: The inspector toured the home with the manager. All areas were generally clean and hygienic with no unpleasant odours. Laundry facilities are located in a recently extended utility area adjacent to the kitchen. Staff use a covered trolley to carry soiled articles through the kitchen to the laundry, which is equipped with domestic machines capable of handling hot temperature washes. The manager said that machines are replaced promptly when they become defective. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 15 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) 34 and 35 A robust recruitment procedure ensures residents are protected. Staff at Clifton Cottage have appropriate skills and experience to meet the needs of the people who live there. EVIDENCE: Two new part time staff had been recruited since the standard was last assessed. Their recruitment records were checked and found to be in order. The inspector looked at a sample of staff training profiles, which showed a wide range of statutory and care related training. The manager said that plans were in place to centralise information on staff training within the Ryde House group of homes to more easily identify needs and to co-ordinate the training. All staff are scheduled to receive training and refreshers in first aid, health and safety, food hygiene, manual handling and infection control. They take advantage of other courses as and when they become available. Records showed that currently one support worker had achieved the NVQ at level 2. The manager confirmed that two more would be put forward for training. Induction training for new staff follows the appropriate TOPSS Induction Foundation Programme. A sample of the evidence books was available for inspection. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 16 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) 42 Policies, procedures and staff training are in place to ensure so far as is reasonably practicable the health, safety and welfare of residents and staff. EVIDENCE: There are policies and procedures in place to ensure safe working practices in the home and all care staff undertake statutory training, which includes health and safety, food hygiene, first aid and manual handling. The Ryde House group has a designated member of staff who undertakes a full safety audit of the home every six months. A sample of records were viewed including TOPSS induction training, fire drills, alarm tests, and public liability insurance, all of which were in good order. The pre-inspection information submitted by the manager showed that all maintenance and associated records were in place and appropriate maintenance checks of equipment carried out. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 17 During the tour of the building the inspector noted a low step immediately in front of a resident’s room. The pattern of the carpet made it somewhat difficult to see. While the resident was seen to negotiate the step with ease it is recommended that a hazard strip be fitted to highlight what is potentially a hazard. Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 18 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 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 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Clifton Cottage Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 19 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 42 Regulation 13(4)(a) Requirement To fit a hazard strip in front of a step to a residents room. Timescale for action 31/7/05 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 Good Practice Recommendations Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Clifton Cottage H55-H03 S12477 Clifton Cottage V236237 060705 stage 4.doc Version 1.30 Page 21 - 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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