CARE HOMES FOR OLDER PEOPLE
Clifton House 3 Clifton Road Heaton Moor Stockport Cheshire, SK4 4DD Lead Inspector
Kathleen Mcall Unannounced 26th May 2005 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 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 House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Clifton House Address 3 Clifton Road Heaton Moor Stockport Cheshire SK4 4DD 0161 432 8287 0161 432 8287 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) Clifton House (RCH) Limited Mrs Lynne Carol Hudson Care Home 12 Category(ies) of MD(E) Mental Disorder over 65 - 3 registration, with number OP Old Age - 9 of places Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1 Service users to include up to 9 OP and up to 3 MD (E). Date of last inspection 13th October 2004 Brief Description of the Service: Clifton House is a residential care home, situated in the Heaton Moor area of Stockport. It is registered for twelve residents whose primary care need is old age; included within this number are three residents with a diagnosis of mental illness. Clifton House is not suitable for wheelchair users. Mr and Mrs Hudson are the registered proprietors of Clifton House. Mrs Hudson is the registered manager of the home. Clifton House is a large, detached house set in its own grounds; it is clean, well presented and provides comfortable accomodation throughout. All bedrooms are single person occupancy and are spread over two floors, there are no ensuite facilities however all bedrooms have a washbasin. There are two bathrooms, one of which has a hoist to assist residents whilst bathing and a shower for those residents who prefer to shower. There is a passenger lift to assist residents to their bedrooms. The home has two lounges, a larger one on the ground floor and a smaller one on the first floor and a separate dining room. Ample car parking facilities are available to the front of the home with a plesant garden to the rear The homes operates a no smoking policy. Local shops, cinema, library and park are within walking distance of the home. Stockport town centre, motorway network and public transport are easily accessible. Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over the course of a day. The registered manager was not available at the time of the inspection. The Deputy Manager assisted the inspector throughout the inspection. Care plans, assessment documentation, medication and their storage were examined. The inspector spoke with a number of residents in the home and had a discussion with a relative who was visiting the home at the time of the inspection, and several members of staff. One relatives comment card was returned, that indicated satisfaction with the home but they were not aware of the homes complaints procedure. Two residents comment cards were returned, both indicated that they were happy with the way the home was meeting their care needs, however one resident expressed a degree of dissatisfaction with the activities that were on offer at the home and indicated that they were unsure who to speak to if they were unhappy with their care. What the service does well: What has improved since the last inspection?
Care plan documentation had improved since the last inspection. The home had introduced a new style care plan that was detailed and concise, which set out clear guidelines on how staff were to meet a residents care needs.
Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 6 The administration of residents’ medication 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 House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 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 standard(s) 1, 3 and 5. Sufficient information was available to service users to enable them to make an informed choice about residing at the home. The home met service users care needs. EVIDENCE: The inspector met a relative of a service user who had been admitted to the home the previous day; they confirmed that they had received information from the home prior to their relative’s admission. They felt that it was informative and helped them in their decision to place their relative at Clifton House. Service users were assessed prior to their admission to the home; no service user was admitted to the home without having had their care needs assessed. Assessments were obtained from social workers if they had been involved in the admission. Service users were assured that their care needs could be met by the home prior to their admission. A service user who had recently been admitted to the
Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 9 home told the inspector that they were happy and that staff had made her feel welcome. Her relative was impressed that within a short period of time the staff had arranged for his mother to have their hair styled and feet attended to. Arrangements were in place for service users to visit the home prior to their admission. Service user documents available for your record. Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 9 and 10. Service users health and personal care needs were identified and met. EVIDENCE: Since the last inspection a new system of care planning had been introduced at the home. All service users had a care plan, that had been developed using assessment documentation and from discussions held with service users, their relatives and any other significant professionals. Care plans included health needs, personal care needs, mobility, social interests, and risk assessments. Care plans seen were individualised to each service users care needs and all information was stored in one accessible document. Each service user had a diary in which staff recorded progress and development. Staff told the inspector that they felt the new system worked extremely well. Service users had access to GP support, district nursing services and chiropody services when required. Medication and the administration of medicines in the care home had improved since the last inspection. However a second member of staff needs to verify hand written recordings of medicines on medication administration records.
Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 11 Service users told the inspector that all care staff were ‘very nice and very helpful’. Another said ‘the place is great, people are lovely’. Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 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 standard(s) 2, 13 and 15. Service users were able to exercise choice and control. Mealtime arrangements were well managed and satisfied service users expectations. EVIDENCE: The day-to-day routine of the home was relaxed and flexible with some service users preferring to spend time in their rooms and others using the lounge facilities. Two service users regularly go out and visit local shops and a public house. The home did not have a formal activities programme, service users told the inspector that this suited them. However care staff felt that following a number of new admissions to the home they would like to review the homes activity arrangements as some service users may now enjoy organised activities. Residents meetings had been held and service users views with regard to menus were discussed and this proved successful. Two service users told the inspector that they would like visits from local churches. Visitors were made welcome at the home and service users kept in touch with family and friends. Service users confirmed that they could have visitors at all times. Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 13 Comments received from service users regarding food and meal arrangements at the home were very positive. One service user said the ‘food is perfect’ another said the food was very nice, plenty of it and a good variety. Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 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 standard(s) 16 . The home had a complaints policy and procedure, the majority of service users were confident that their complaints would be dealt with in a satisfactory manner. EVIDENCE: The home had a detailed complaints policy and procedure. Service users told the inspector that they knew who to complain to and felt that their complaint would be dealt with in a suitable manner. A service user comment card that was returned indicated that the service user did not know who to speak to if they had a problem. Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 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 standard(s) 19, 24 and 26. The internal living standards of the home were clean, well maintained and comfortable. The external structure of the dining room remained poor. EVIDENCE: The home was well maintained and provided comfortable accommodation throughout. When the registered providers took over the ownership of Clifton House it had been with the understanding that they would replace the existing dining room at the home. The registered providers had asked that this be deferred whilst all options including upgrading the building were considered. This issue remains unresolved and needs a satisfactory conclusion. The grounds of the home were well kept and attractive. A number of service users rooms were seen, these were also furnished and equipped to a comfortable standard, many had been personalised by the
Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 16 occupants, with many of the service users being quite self contained in their own rooms. The home was clean, tidy, bright and airy throughout and was free from any unpleasant odours. One service user said that the home was ‘spotless’ and said that it was always clean and tidy. Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, The home was sufficiently staffed to meet service users care needs. EVIDENCE: At the time of the inspection the home was adequately staffed to meet the assessed needs of service users living there. Several service users spoke highly of the staff group and staff appeared to have a positive relationship with the service users. The staff group at Clifton House was a stable one. There had been no new members of staff employed at the home since the last inspection. Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38. Staff were supported and supervised in their work. Health and safety of staff and service users was not fully safeguarded. EVIDENCE: Staff reported that they received regular supervision to support them with their work. Staff had updated their moving and handling training. The home failed to maintain records held in respect of fire safety on a regular basis. Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 2 x x x x 3 x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 3 x 2 Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 20 Yes 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 OP 9 Regulation 13(2) Requirement The registered person must ensure that handwritten recordings on MAR charts are checked and signed by a second member of staff. The registered person must ensure that the exterior of the dining room is kept in a good state of repair. (Timescale of 12.12.04 not met.). The registered person must ensure that records held in respect of fire safety are maintained on a regular basis. The registered person must ensure that all staff up date their training in moving and handling procedures. (Timescale of 13.11.04 not met) Timescale for action 26th May 2005. 2. OP 19 23(2)(b) 26th August 2005 26th May 2005. 26th July 2005. 3. OP 38 23(4) 4. OP 38 13(5) 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.
Clifton House F54 F04 s8549 Clifton House un v227980 260505 Stage 4.doc Version 1.30 Page 21 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton-under-Lyne OL7 OQD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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