Inspection on 25/01/06 for Clifton Gardens, 59

This inspection was carried out on 25th January 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 Gardens, 59 09/01/08

Clifton Gardens, 59 28/06/06

Clifton Gardens, 59 25/07/05

Clifton Gardens, 59 03/12/04

Clifton Gardens, 59 30/06/04

Clifton Gardens, 59 15/02/04

Clifton Gardens, 59 09/10/03

Clifton Gardens, 59 09/12/02

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Clifton Gardens, 59 Clifton Gardens, 59 Chiswick W4 5TZ Lead Inspector Mr Gavin Thomas Unannounced Inspection 25th January 2006 1:30 X10015.doc Version 1.40 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 Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 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 Older People. 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 Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Clifton Gardens, 59 Address Clifton Gardens, 59 Chiswick W4 5TZ 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) 020 8995 1955 020 8742 7322 London Borough of Hounslow Mr Neculai Apetroaie Care Home 35 Category(ies) of Dementia (21), Old age, not falling within any registration, with number other category (14) of places Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th July 2005 Brief Description of the Service: 59 Clifton Gardens is a purpose built home for older people. It is situated close to Chiswick High Road where there are shops, cafes, places of worship and a library. Chiswick Park and Turnham Green underground stations, and a number of bus routes are within walking distance. There is a health centre near to the home. The home is owned and managed by the London Borough of Hounslow. Accommodation is situated over two floors and is divided into four units. They are: Elmwood, Belmont, Savoy and Lavender. Belmont unit is a dedicated unit for dementia care. This is a nine - bedded unit. It is staffed separately and two out of the nine beds are used for respite care. Each unit has a lounge, kitchen and dining area. There are thirty-three single bedrooms and one double bedroom. All of the bedrooms have wash hand basins. There are three assisted bathrooms, one shower room and fourteen toilets. Pleasant grounds surround the home, within an enclosed courtyard in the centre of the building, and a roof garden. The home has a designated room for smoking. This room has a 1940s theme and may also be used for visitors and meetings. The offices and laundry are located on the ground floor. The staff team consists of a Registered Manager, Assistant Manager, four senior Support Workers and a team of day and night Support Workers. There is a separate team of domestic and catering staff, a Business Support Manager and a Handy Person. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of 3.5 hours. During this time, the Inspector met with the Registered Manager, Deputy Manager and spoke with service users and staff. A guided tour of the premises was carried out with the Registered Manager. Service users were engaged in activities in one unit. Staff were having general conversations with service users in another unit. One service user was having lunch after every one else. This is an example of good practice whereby service users do not have to always eat together at set meal times. Some service users were resting after their lunch either in their bedrooms or the lounges. All service users were well dressed and groomed and looked well cared for. All documents required for inspection purposes were accessible and well maintained. What the service does well: What has improved since the last inspection? Four requirements were made at the previous inspection. All four requirements had been implemented. Good progress has been made in developing the environment particularly for service users with dementia. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 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. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 The home’s Statement of Purpose and Service User Guide were very well written and presented. EVIDENCE: A Statement of Purpose and Service User Guide were in place. These documents were in the process of being reviewed at the time of this inspection. A member of the Local Council approved the Statement of Purpose. The contents of the Statement of Purpose included all of the criteria as set out in Schedule 1 of the Care Homes Regulations 2001. The contents of the Service User Guide did not include all of the criteria as set out in standard 1.2 of the National Minimum Standards for Care Homes for Older People. However, all of these details are included in the Statement of Purpose. Service users are given a copy of each of these documents. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 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, 8 & 10 The health needs of service users are well met with evidence of good multi disciplinary work taking place on a regular basis. Care plans including health related documents are well written and maintained. EVIDENCE: Two care plans were examined for the purpose of this inspection. Both care plans were very well written and updated. The contents of the care plan included aspects of the service users health, well – being and social care needs. The care plans were specific and included very clear guidance on how staff are required to assist service users with specific tasks. Services users health needs are assessed prior to admission. Health needs are incorporated in service users care plans. Health related records included a health risk assessment, occupational therapy assessment, medical report and details of primary health care treatments. Care plans examined included specific details about service users’ health needs and how these needs are met. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 10 The majority of service users are frail elderly. In addition, the home provides a specialist dementia service. Dementia care is provided in consultation with clinical professionals and community – based professionals. The home also works in partnership with external organisations including relevant charitable organisations who specialise in dementia care. One service user was in hospital at the time of this inspection. District Nurses visit the home twice weekly. Any treatments carried out are recorded in a dedicated diary. The Registered Manager confirmed that all service users were registered with a local GP. Service users had access to primary health care treatments such as: • Chiropody. • Opticians. • Dental treatment. Three staff are trained in foot care. Referrals are made for service users to be seen a qualified Chiropodist if there are concerns with the condition of their feet. All staff had a valid First Aid qualification. The four senior staff had attended the four-day First Aid - Appointed Person training. The Registered Manager confirmed that none of the current service user group was receiving alternate health remedies or treatments. Specialist equipment and treatments are provided in accordance with service users assessed needs. These include specialist mattresses for the prevention of pressure sores, continence aids, and nutritional screening. Where possible, palliative care treatment is provided at the home with advice and assistance from community health services and specialist nursing staff. Service users are moved on to more appropriate placements if the home is unable to meet their health needs. All service users are accommodated in single bedrooms. Service users have the choice of spending time alone or with others. This was observed at the time of the inspection. Policies and procedures were in place for promoting services users’ privacy and dignity. The Registered Manager confirmed that service users are given their mail unopened. Staff assist service users to open their mail if requested. When necessary, service users mail is given to relatives. This is mainly done for service users who have dementia. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 11 Name tags are used to avoid service users clothes being mixed up. Individual baskets are also provided for returning service users clothing to their rooms from the laundry. The Registered Manager confirmed that service users are assisted with personal care tasks in total privacy. Staff are also required to knock on service users doors before entering. Service users have easy access to a telephone. Personal telephones can be installed in service users bedrooms on request. Service users are issued with keys to their bedrooms and a lockable cabinet in their bedrooms in accordance with their preferences and ability to manage keys safely. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 Good systems were in place for promoting service users’ capacity to exercise personal autonomy and choice. EVIDENCE: The home has established positive links with the local branch of a charitable organisation who would advocate on behalf of service users and/or their relatives if requested. The Registered Manager explained that relatives/significant others currently advocate on behalf of service users. The London Borough of Hounslow hosts a monthly meeting for carers to which relatives are invited to attend. A small team of volunteers visit service users on a regular basis. The London Borough of Hounslow has approved the volunteers. Service users are entitled to bring their personal possessions including items of furniture when admitted to the home. The Registered Manager confirmed that procedures were in place for service users to access their personal records. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 Service users are fully supported to participate in civic processes and any matters concerning the running of the home. EVIDENCE: As stated in the section headed “Daily Life and Social Activities” of this report, the home has established positive links with the local branch of a charitable organisation who would advocate on behalf of service users and/or their relatives if requested. The Registered Manager confirmed that service users are accompanied to Polling Stations to vote at local and Parliamentary elections. Service users are also encouraged and supported to express their views and opinions on legal and political issues. At the time of this inspection, the home was in the process of consulting with service users on the proposed plans to build an extension to the home. Architectural plans were on display in the home. This was judged to be good practice for maximising the consultation process. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 & 22 The detail of work carried out to the environment is outstanding. The environment is judged to be stimulating, relaxing and homely. Adaptations have been carefully selected to meet the needs of service users with mobility needs and for those who have dementia. EVIDENCE: The premises were very well maintained and clean throughout. Grab rails are positioned throughout the home. The colour of the grab rails is in contrast to the walls. Sufficient toilets and bathing facilities are provided on both floors. Toilets are within close proximity to service users bedrooms. Some of the toilets on both floors are clearly marked for ladies and gentlemen. Separate toilets were decided by service users. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 15 The home features a range of suitably adapted facilities to meet service users needs. The bathroom on the ground floor is fitted with a tilt – parker bath and sensory equipment. This includes a bubble tube, colour projector and relaxation music. A new shower has been installed on the first floor. This is a walk in shower, with a non – slip mobile ramp and a shower chair. The bath on the first floor has an adapted bath chair. Grab rails, ramps and paved areas are situated around the exterior of the home. Small allotments, raised flower and herb beds and a green house are provided for service users who wish to participate in gardening activities. An information board is provided in one of the units on the ground floor. The board shows the date and activities for the day. An adapted mouse and keyboard is also provided for service users who use the computer. The kitchen units on the ground floor are labelled with the contents to maximise service users’ independence. Pressure pads are used when required for monitoring service users movements. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 The home has made good progress in training staff to NVQ Level 2 in care. EVIDENCE: The staff team consists of the following: • The Registered Manager. • One Deputy Manager. • Four Senior Residential Support Workers. • Twenty-four Residential Support Workers. • One Activities Coordinator. • One Business Support Manager. • One part time Administrator. • Five Domestic staff. • One cook. • One Assistant cook. • One part time Link Worker. • One Handy Person. The home had vacancies for five Residential Support Workers and two Domestic Staff at the time of this inspection. Vacant shifts were being covered by external agency staff. The Registered Manager confirmed that the agency staff worked regular shift patterns. They are familiar with service users needs and do not cause any disruption to the quality of care provided. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 17 The Deputy Manager has achieved the NVQ Level 4 in management and care. Thirteen staff have achieved the NVQ Level 2 in care. Two staff were registered to commence the NVQ Level 2 training in February 2006. One senior Residential Support Worker was working towards the NVQ Level 3 in care. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Robust systems were in place for the management of service users finances. EVIDENCE: The Business Support Manager is responsible for managing all records relating to service users finances. At the time of this inspection, service users finances were being managed as follows: Relatives – twenty service users. London Borough of Hounslow Customer Financial Affairs – eight service users. Appointee (other) – one service user. The Registered Manager confirmed that he is not an appointed agent for any of the service users finances. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 19 Service users finances are kept at the home. Service users expenditures are processed via the home’s petty cash system. Services users finances are kept in a bank account held by the London Borough of Hounslow. This account is known as the Residents Property Account. Individual records are kept of service users finances. A statement of service users finances is issued to relatives on a quarterly basis. Copies of these statements are also available to service users on request. Services users finances were audited in December 2005. This report was available for inspection purposes. The outcomes were very positive, indicating that service users finances were well managed. Secure facilities are provided for the safe-keeping of valuables on behalf of service users. Records are kept of possessions handed over for safe-keeping. Where possible, service users are required to sign the record when possessions are handed over and given back to service user. This is judged to be good practice. Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 3 18 x x x 3 4 x x x x STAFFING Standard No Score 27 x 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x x Clifton Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 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 Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST 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 Gardens, 59 DS0000032624.V274203.R01.S.doc Version 5.1 Page 23 - 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!