Random inspection report
Care homes for adults (18-65 years)
Name: Address: Clifton House 1 Grantley Road Boscombe Bournemouth Dorset BH5 1HW two star good service 05/01/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Joanne Pasker Date: 1 9 1 0 2 0 0 9 Information about the care home
Name of care home: Address: Clifton House 1 Grantley Road Boscombe Bournemouth Dorset BH5 1HW 01202393385 01202303620 cliftonhouse@together-uk.org www.together-uk.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Together Working for Wellbeing care home 23 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Conditions of registration: 23 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 Date of last inspection Brief description of the care home 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, none have en-suite facilities. There are two bed-sits with a shared kitchen and bathroom on the ground floor which, can accommodate two service users assessed as suitable for more independent living. Clifton House is operated by Together an independent not for profit organisation that accommodates and supports
Care Homes for Adults (18-65 years) Page 2 of 11 0 5 0 1 2 0 0 9 Brief description of the care home individuals with enduring mental health problems. Residents receive 24-hour emotional and practical support from a team of experienced residential care workers. The home is currently without a registered manager however, the day to day running is managed by Sheila Shutler, service manager. Fees are charged weekly; the fee range quoted by the service at the time of inspection was per person from £450; fees are adjusted in accordance with the assessed needs of each resident. Up to date information on fees can be obtained from the service. Care Homes for Adults (18-65 years) Page 3 of 11 What we found:
We looked at care files, daily entries and food records for four people who lived at the home. Records showed that all files contained a care plan and a generic risk assessment of food handling and management but lacked specific individual information regarding the ability and monitoring of self catering. The first file looked at contained a care plan which was gave non specific and vague details about that persons food provision i.e. did not state if staff would accompany that person food shopping, how often food should be bought, who would assist/supervise the person with food preparation and how often this should be reviewed. It did not contain a specific risk assessment of that persons kitchen, food shopping or self catering ability nor any nutritional assessment. Although the most recent Care Plan Approach assessment clearly recorded that the person would require on going assistance and prompting with all areas of independent living and had a history of erratic eating. A weight chart showed frequent weighing and a small gain since admission to the home. Food records showed a haphazard intake and frequent occasions when nothing was recorded as being eaten at lunch and/or teatime. In the second file there was no evidence of any pre admission assessment and in the funding authoritys most recent care assessment, it stated that the person was unable to budget, shop or safely prepare food and had been assessed as being unsafe in a kitchen. Again there was no individual risk assessment and the care plan did not reflect any of these points. There was no nutritional assessment or weight chart. Food records showed a reliance on eating cereals and often no record of anything having been eaten again at either lunch and/or teatime. The third file showed that the most recent Care Plan Approach review stated that this person had a physical health condition which required support and education, for them to safely manage it. This was not reflected in the care plan or any specific risk assessment. There was no nutritional assessment however weight charts showed that weight had been monitored monthly. Daily entries showed that managing self catering and cooking in the kitchen often triggered arguments and sometimes aggressive behaviour towards other people. There was also an entry which recorded that the person had become unwell after possibly eating out of date food. The fourth file again had no specific risk assessment, care plan or nutritional assessment relating to that individuals ability to self cater. Daily entries showed that there had been concerns with food being inappropriately reheated and food records again showed a high reliance on eating cereal at lunch and/or
Care Homes for Adults (18-65 years) Page 4 of 11 teatime meals. The meal records kept since an agency cook had been reinstated the previous week, were not completed with several people having blank spaces next to what they had eaten for lunch and/or tea. Other people were recorded as having been out frequently but there were no records to show what food they may have eaten whilst out. Regulation 26 visit reports seen failed to refer to the introduction of self catering at Clifton House. There appeared to be no monitoring of its implementation and how well it was working, except some occasional recording of discussion with people living at the home. The statement of purpose was undated and did not state that Clifton House was a self catering home. We could find no evidence to show that the introduction of self catering at Clifton House had been discussed with the contracting authorities or other healthcare professionals involved in the care of people living or placed there. There was no evidence of supplementary staff training or increased staffing levels to support people with self catering for themselves either. What the care home does well: What they could do better:
The statement of purpose should be updated and reflect what facilities the home offers and what needs of prospective residents they can meet. Pre admission assessments should be completed and available for every person who moves into the home. Individual specific and person centred risk assessments should be undertaken for all people based upon their initial admission assessment and Care Plan Approach and reviewed as necessary thereafter. The risk assessment tools should give clear information to staff on what to do with the results of the assessment to make sure appropriate measures are put in place. The care plans should be person centred and individual to each person, with enough detail to give staff clear information and guidance on what residents needs are and how they are to be met. These should show that they have been discussed and completed with the person and be regularly reviewed and updated. Nutritious and varied meals should be provided by the home to meet the dietary needs and requirements of all people living there. Individuals who are assessed as being more independent should be appropriately supported and monitored by staff and reviewed regularly. There should be regular and on going monitoring of the homes running by the provider organisation, to show that Clifton House is being run in the best interests of the people living there.
Care Homes for Adults (18-65 years) Page 5 of 11 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 11 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 1 4 The registered person shall 27/11/2009 ensure that the statement of purpose is updated and current to accurately reflect what the aims and objectives of the home are and what facilities and services are provided by the home for residents. This is to ensure that prospective residents and the people involved in helping choose their home, can make an informed decision on whether Clifton House is the best place for them. 2 2 14 The registered person must 27/11/2009 ensure that the needs of any prospective resident are appropriately assessed prior to moving in and a record of this kept. This is to make sure that Clifton House only offer places to people whose needs can be met by the home.
Care Homes for Adults (18-65 years) Page 8 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 3 6 15 The registered person must 27/11/2009 ensure that all people have an individual plan of care which has drawn up with the involvement of the person, is based upon their Care Programme Approach assessment and is regularly reviewed. This is to make sure that peoples needs are correctly identified and personal care plans involve the individual resident and reflect their chosen goals and needs. 4 9 13 The registered person shall 27/11/2009 ensure that unecessary risk to the health or welfare of residents are identified and so far as possible, eliminated. This refers to risk assessments for nutrition and kitchen safety. This is to ensure that risks are identified so measures can be put in place to reduce the risk. 5 17 16 The registered person must 27/11/2009 ensure that adequate and safe facilities are provided for people to prepare their own food if needed and that suitable and nutritious meals are provided by the home. This is to make sure that the dietary requirements and choices of all people living at Clifton House are adequately Care Homes for Adults (18-65 years) Page 9 of 11 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action met. 6 39 26 The registered person shall provide an accurate and current reflection of the running of the home in their monthly visit reports. This is to ensure that any changes to the running of the home are adequately monitored and seen to be in the best interests of residents. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 27/11/2009 Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 11 of 11 - 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!
