Inspection on 28/06/06 for Clifton Gardens, 59

This inspection was carried out on 28th June 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 25/01/06

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 Ms Jean Bovell Key Unannounced Inspection 28th June 2006 11:55 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.V300763.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V300763.R01.S.doc Version 5.2 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.V300763.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 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.V300763.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Inspection was carried out between 11:55 am and 5:15 pm on Wednesday 28th June 2006. The Business Support Manager, a Senior Carer, six care workers and 32 service users were present. The Inspector was informed that the Registered Manager was on leave. During the course of the inspection, a tour of the building was conducted, the home’s records, policies, procedures and documents were viewed and observations were made. The Inspector spoke to three members of the care support staff team, four service users and a friend of a service user who visited the home at the time of the inspection. No requirements were made at the last inspection, but all outstanding Standards were examined. The Inspector received appropriate co-operation and assistance from the Business Support Manager, a Senior Carer and subsequently from the Deputy Manager who had been undertaking staff interviews, outside of the home, during the initial stages of the inspection. What the service does well: The service users appeared appropriately dressed and well cared for and comfortable within their environment. Those who spoke to the Inspector expressed satisfaction with the standard of care they received at the home. There were also positive reports from a visitor to the home at the time of the inspection. All records viewed were satisfactory and indicated that the best interests of the service users were being safeguarded. Regular staff supervision and training ensured that care workers were supported and competent in meeting the needs of the service users. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 6 The home was found to be essentially clean and interior areas were well maintained. The overall atmosphere was calm and homely but the units on the ground floor were also lively and jolly. What has improved since the last inspection? 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.V300763.R01.S.doc Version 5.2 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.V300763.R01.S.doc Version 5.2 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): 2,3,4,5 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Appropriate needs led assessments which includes visits to the home by prospective service users and their relatives/friends, are undertaken prior to admission. The home’s contract/statement of terms and conditions is satisfactorily detailed. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 9 EVIDENCE: The Inspector was informed by the Deputy Manager that prospective service users were referred to the home by care managers based within hospitals or locality teams and that background information was submitted. The home initiated their own assessment by visiting prospective service users in their own homes or in hospitals. Care managers, medical professionals and relatives participated in an assessment process which included visits to the home by prospective service users and/or their relatives. New service users were placed on a trial period of six weeks after which a review would be held to determine the suitability of the home in meeting specific assessed needs. It was evidenced on service users files examined at random that initial written needs led assessments had been undertaken in relation to prospective service users. Contracts/statement of terms and conditions detailing how separate assessed needs would be met, were appropriately signed. Two beds are currently allocated to respite care but the home does not provide short-term intensive rehabilitation/intermediate care. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate care plans are being drawn up and the health care needs of service users are being fully met. The home’s policies and procedures for dealing with medicines are satisfactory. Service users right to privacy are respected and individual wishes/requests in the event of death are being satisfactorily upheld. EVIDENCE: The care plans of four service users were inspected at random and were found to be satisfactorily undertaken. Separate personal, social, health care and dietary needs were identified. Action plans and set goals were put into place and appropriate risk assessments had been carried out. Care plans and risk assessments were reviewed on a monthly basis. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 11 The Deputy Manager confirmed that all service users were registered with a General Practitioner. There were regular dental, optical and chiropody checks and district nurses visited the home each week. Access to occupational or physiotherapists were arranged as required and the home ensured that where appropriate, service users were accompanied during medical appointments. A policy on medication was in place and the records indicated that medication training had been delivered to all members of the care team. Storage, disposal and administration of medicines were satisfactory. The Inspector was informed by a senior care worker that none of the service users were self-administering their medication at the time of the inspection. Service users appeared to be wearing their own clothes and hairstyles and make-up were suggestive of individual choices and preferences. The Business Support Manager confirmed that service users made their own decisions regarding clothing and that a hairdresser visited the home each week. Service users were able to make private telephone calls, receive personal mail and see visitors in their bedrooms. Care staff were observed knocking on bedroom doors prior to entering and the Inspector was advised that personal care tasks were carried out in privacy within bedrooms or bathrooms. The home’s policy and procedures relating to death and dying were in place and individual wishes and/or requests were appropriately recorded. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 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): 12,13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged to be independent and are able to participate in various interesting indoor and outdoor activities. Contact with family and friends are encouraged. Nutritional meals are being provided. EVIDENCE: The home employs an activities co-ordinator and the social interests of the service users were identified within care plans viewed. Daily activities were posted on the notice board and regular outdoor activities such as various day trips and bowling were organised. In-door activities included baking, exercise classes, art and a monthly church service was held at the home. Photographs depicting service users participating in different outdoor activities and being involved in a project at the home, with local school children, were on Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 13 display. Paintings and drawings that had been undertaken by individual service users were also displayed. There is an open visiting policy in place and contact with relatives and friends are encouraged and facilitated. One regular visitor to the home reported being always welcomed by care staff and that drinks, snacks or meals were offered. Service users are given choice in relation to meals, activities, what they wear, when they get up in the morning or retire at night and personal purchases. The home employs a cook and it was reflected on the menus that varied, wholesome and appealing meals were being provided. Service users who spoke to the Inspector indicated that the meals were enjoyable and that snacks and drinks were readily available. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 14 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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are satisfactorily investigated and service users are being protected from abuse. EVIDENCE: The complaints procedure is clear, concise and accessible to service users and their relatives. Two complaints were made to the home following the last inspection and both were satisfactorily investigated and resolved. The home’s policy and procedures relating to the protection of vulnerable adults were in place and the records indicated that staff training on adult protection had been delivered to the care workers. The Inspector was informed by the Business Support Manager that relatives or local authorities held financial responsibility for the service users. However, personal allowances were handled at the home. The financial records relating to several service users were examined at random and no discrepancies were identified. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 15 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): 19,20,23,24,25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The communal areas within the home are suitable for individual and shared activity and service users bedrooms are personalised. Although the overall environment within the home was safe and adequately maintained, the garden and specific areas within the kitchen were not satisfactorily kept. EVIDENCE: The home comprises of four units and there are two on each floor. All units are comfortably furnished, spacious and appropriate for individual and shared activities. The large surrounding gardens are accessible to wheelchair users and the overall environment of the home is safe and adequately maintained. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 16 The service users occupy separate bedrooms. Each contain individual locks and are suitably fitted and furnished and are reflective of personal choices and interests. All rooms were well ventilated and the lighting and hot water temperature met the required Standards. Although the home was essentially clean and adequately maintained, the grass in the garden required cutting and specific areas within the kitchen, such as windows/sills, the hob and wall tiles needed attention. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 17 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): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment policy and practices are satisfactory and care workers receive appropriate training for meeting the needs of the service users. It was, however, not evidenced that additional staff were on duty during peak periods. EVIDENCE: The Inspector was informed by the Business Support Manager that there was a total of twenty seven employees at the home and included the Registered and Deputy Managers, senior care staff, care workers, an activities co-ordinator, an administrator and domestic staff. The Registered Manager confirmed that interviews had been held on the day of the inspection for the recruitment of additional domestic and care staff, and also a link/liaison worker for respite care placements. It was indicated on the staff rota that the Registered Manager and/or Deputy Manager, a senior carer and six care workers were on duty during waking hours and that three waking staff covered duty at night. Care workers who were on duty at the time of the inspection were observed being attentive and competent in meeting the needs of the service users. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 18 A number of personnel files were examined and all contained the required documents such as application forms, references, photo identification, signed contracts and CRB clearance certificates. It was reflected on records viewed that new staff members received induction training and that subsequent ongoing training for meeting the needs of the service users included, moving and handling, dementia, medication, adult protection, challenging behaviour, fire safety, first aid and food and hygiene. Care workers who spoke to the Inspector reported being satisfied with the training, supervision and support they received at the home. However, concerns were expressed that high demands during morning and evening periods, resulted in service users being late for breakfast and/or impacted on the administering of medication. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 19 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): 31,32,33,34,35,36,37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager is suitably qualified and the home’s ethos suggests that the best interests of the service users are being upheld. Care staff members are adequately supervised and the health, safety and welfare of the service users and their financial interests are being safeguarded. EVIDENCE: The Registered Manager has been in post for three years and has obtained the Managers Award/NVQ level 4. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 20 The Deputy Manager has occupied her position for four years and is also suitably qualified. She explained that a person centred approach was in operation and that the home aimed to improve the wellbeing of the service users and enhance their quality of life. The records were indicative of systems being in place for undertaking quality assurance exercises. Questionnaires for assessing the views of service users, relatives and stake-holders had been completed and outcomes/summaries dated 2003/4 were documented. It was evidenced that quality assurance exercises covering periods 2005/6 had been initiated. The Business Support Manager confirmed that relatives or local authorities held responsibility for the financial affairs of the service users but that personal allowances were managed at the home. The financial records relating to the personal allowances of several service users were examined at random and all were found to be satisfactory. The home’s financial and business plan was available for inspection and were satisfactory. A valid employers’ liability insurance certificate was in place. The Deputy Manager confirmed that at least eight annual sessions of supervision were delivered all care staff. This was evidenced on records viewed. All records inspected were found to be satisfactory and secure. The Deputy Manager reported that service users and/or their next of kin would be given access to personal records, on request. Policies and procedures relating to health and safety were in place and a poster on health and safety was on display. Health and safety checks such as tests for legionella, fire safety, portable appliances and gas maintenance were up-to-date and environmental risk assessments had been undertaken. It was indicated on training certificates that all members of the care staff team had received training in moving and handling, health and safety and food hygiene. Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 21 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 X 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 X 3 3 3 Clifton Gardens, 59 DS0000032624.V300763.R01.S.doc Version 5.2 Page 22 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. 1 2 3 Standard OP26 OP26 OP27 Regulation 23(2)(d) 23(2)(o) 18(1)(a) Requirement The Registered Person must ensure that all areas within the main kitchen are kept clean. The Registered Person must ensure that the garden is adequately maintained. The Registered Person must ensure that additional staff are on duty during peak periods. Timescale for action 30/07/06 30/08/06 30/07/06 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.V300763.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection 11th Floor West Wing 26-28 Hammersmith Grove Hammersmith London W6 7SE 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.V300763.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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