CARE HOME ADULTS 18-65
Clifton House 1 Grantley Road Boscombe Bournemouth Dorset BH5 1HW Lead Inspector
Sally Wernick Unannounced Inspection 10:00 1 November 2005
st DS0000003930.V256863.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 DS0000003930.V256863.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. DS0000003930.V256863.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Clifton House Address 1 Grantley Road Boscombe Bournemouth Dorset BH5 1HW 01202 393385 01202 303620 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) Together Working for Wellbeing Mr Douglas Low Care Home 23 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (23) of places DS0000003930.V256863.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Five named adults (names known to CSCI) over the age of 65 years may be accommodated until such time as their assessed needs cannot be met by the home 5th July 2005 Date of last inspection Brief Description of the Service: Clifton House is situated in a quiet residential area of Boscombe and is close to all local amenities. It is a corner property with a pleasant rear garden and an outside laundry area. It is registered under the category mental disorder (MD excluding learning disability or dementia) for up to 23 male and female service users. The home has 21 single bedrooms and 1 double none has en-suite facilities. There is a self-contained flat within the building, which can accommodate two service users assessed as suitable for more independent living. Clifton House is operated by Together an independent organisation that accommodates and supports individuals with enduring mental health problems. Residents receive 24-hour emotional and practical support from a team of experienced residential care workers. The registered manager Mr Low and a very experienced staff team undertake the day-to-day running of the home. DS0000003930.V256863.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 10:00am on 1st November 2005. It was conducted as part of the normal routine of inspecting twice during a twelve-month period. The registered manager-Mr Low, and two service users all assisted during the inspection. Methodology used included a tour of the premises, review of records and discussions with service users. The inspector also reviewed the contact sheet for Clifton House and comment cards received since the last inspection. Not all of the National Minimum Standards were assessed on this visit. Please note where a National Minimum Standard was not assessed the score is shown as X. What the service does well:
Clifton house has a comprehensive statement of purpose and service user guide. It details clearly how the organisation aims to meet the needs of service users and provides information on the home’s policies and procedures. Care plans were well formulated and well maintained and there was evidence that service users participated in there formulation and review. A number of residents have lived at Clifton House for many years and are now over the age of 65. Staff at the home are very experienced in the field of mental health and continue to assess and meet the needs of these older persons. However, the home also accommodates younger people who are aiming towards independent living, which allows for a greater mix socially. Two residents spoken to described the home as “lovely” with “help available when needed”. Staff were described as very supportive and life at the home as “very happy”. The atmosphere throughout the home was very relaxed some residents were out or at day centre others were sitting to-gether communally. The previous evening residents had enjoyed a Halloween party with music and food alcohol is encouraged moderately. Records evidence a good understanding of service user’s needs with an individual approach to all. Care plans indicate that personal support is offered in the way that residents prefer and in a way, which maximises dignity and independence. Service users enjoy a wide-range of leisure activities and have strong links with family and friends. DS0000003930.V256863.R01.S.doc Version 5.0 Page 6 The home is well run by experienced staff and the atmosphere is a positive one. Comprehensive health and Safety systems are in place to offer quality care to service users and this is reflected in good quality assurance as well as wide-ranging policies and practice. 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. DS0000003930.V256863.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 DS0000003930.V256863.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): Not assessed on this occasion. EVIDENCE: DS0000003930.V256863.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): Not assessed on this occasion. EVIDENCE: DS0000003930.V256863.R01.S.doc Version 5.0 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 the following standard(s): Not assessed on this occasion. EVIDENCE: DS0000003930.V256863.R01.S.doc Version 5.0 Page 11 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 Personal support is offered in a way that promotes service users privacy dignity and independence. EVIDENCE: Three care plans were examined during the course of the inspection and all were maintained to a good standard. The degree of personal and practical support required was detailed clearly and the emphasis throughout was on maintaining independence and dignity. Likes and dislikes were charted, as were areas where some service users may encounter difficulties. Access to healthcare i.e chiropody or personal care (hairdressing) was arranged for those who preferred to receive that service at home and advice given to those who wished to access services externally. Service users at Clifton House vary in age enormously from early 20’s to late 70’s. Individual rights are respected and this was evidenced in the degree of sensitivity and support offered to a young man with different social aspirations. Key workers are allocated according to gender and service users spoken to dressed comfortably and in the way they preferred. Care plans evidenced good liaison with healthcare providers and assessment of need was reviewed in key work sessions, which were signed and dated accordingly. DS0000003930.V256863.R01.S.doc Version 5.0 Page 12 Overall, care plans evidenced consistency and continuity of support for service users. Key workers are skilled in identifying individual aspirations and needs and there is a good balance between promoting individuality and independence, whilst providing appropriate levels of care and guidance. DS0000003930.V256863.R01.S.doc Version 5.0 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 the following standard(s): Not assessed on this occasion. EVIDENCE: DS0000003930.V256863.R01.S.doc Version 5.0 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 the following standard(s): 30 Communal areas are generally clean, hygienic and free from odours and the home promotes safe working practices in these areas to ensure that service users are not at risk of infection. EVIDENCE: A tour of the home revealed well-maintained accommodation, which is clean, light, airy throughout and well decorated. Communal areas are comfortable with good furnishings and bathroom areas are clean and well maintained. The semi-independent accommodation currently houses two service users who each share a bathroom and kitchen. It is their responsibility to clean these areas and maintain a good standard of hygiene. Inspection of these premises indicated that service users would benefit from more support in this area as the accommodation was not clean and presented a very real risk of infection. DS0000003930.V256863.R01.S.doc Version 5.0 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 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): Not assessed on this occasion. EVIDENCE: DS0000003930.V256863.R01.S.doc Version 5.0 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 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): 42 The health safety and welfare of service users and staff are generally protected by suitable policies, procedures and practice at the home. EVIDENCE: Not all aspects of the Homes health and safety policies were inspected on this occasion. A recent incident however, has indicated that there is a potential risk to resident’s safety, which has led to a change in the provision of tea and coffee making facilities. The unsupervised use of a kettle during the night has led to the need for the registered persons to source an alternative option for drink making facilities. Following inspection the registered persons were asked to forward to the Commission For Social Care a copy of their fire risk assessments specifically in relation to their smoking policy within bedrooms. These demonstrated that checks and balances were in place and that some potential hazards may be adequately controlled. DS0000003930.V256863.R01.S.doc Version 5.0 Page 17 However, Service users should be reminded during key work sessions of their responsibilities to maintain safe behaviour within the home. Risk assessments should be reviewed regularly to include risks specific to the individual. DS0000003930.V256863.R01.S.doc Version 5.0 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 x x x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x x x Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x 2 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x DS0000003930.V256863.R01.S.doc Version 5.0 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. Standard Regulation Requirement The registered persons must ensure that tea and coffee making facilities do not present a hazard to residents and that current provision is replaced by a safe method. Timescale for action 1 YA42 13 (4)(b) 01/12/05 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 YA30 Good Practice Recommendations The registered persons should ensure that the premises are kept clean and hygienic. This should include all semiindependent accommodation. The registered persons should demonstrate that there fire Risk assessments are maintained and implemented regularly. They should contain risks specific to the individual and detail how those risks are to be controlled. 2 YA42 DS0000003930.V256863.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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