Inspection on 05/01/09 for Clifton House

This inspection was carried out on 5th January 2009.

CSCI found this care home to be providing an Good service.

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 House 19/10/09

Clifton House 14/12/07

Clifton House 08/09/06

Clifton House 01/11/05

Clifton House 05/07/05

Clifton House 15/12/04

Clifton House 01/06/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Clifton House 1 Grantley Road Boscombe Bournemouth Dorset BH5 1HW     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gloria Ashwell     Date: 0 5 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 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 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Together Working for Wellbeing care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: 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 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 the staff team undertake the day-to-day running of the home. Fees are charged weekly; the fee range quoted by the service at the time of Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 23 Brief description of the care home 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 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. This inspection was carried out by one inspector, but throughout the report the term we is used, to show that the report is the view of the Commission for Social Care Inspection. This inspection was unannounced; the inspector arrived at 11:00 on 5 January 2009, Care Homes for Adults (18-65 years) Page 6 of 26 toured the premises and spoke to residents, staff, observed staff interaction with residents and the carrying out of routine tasks and together with a senior care worker discussed and examined documents regarding care provision and management of the home. The duration of the inspection was 3 hours. During the inspection, particular residents were case tracked; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same residents were examined and the residents spoken with. In advance of the inspection an Annual Quality Assurance Questionnaire was completed by the registered manager and returned to the Commission; the information it contained has been used to inform the findings of this inspection. During this inspection compliance with all key standards of the National Minimum Standards was assessed. What the care home does well: What has improved since the last inspection? What they could do better: 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Care Homes for Adults (18-65 years) Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them, and the home provides prospective residents with plenty of time to consider their options and the suitability of the placement. Evidence: Since the previous inspection no new residents have been admitted to the home so it was not possible to fully assess compliance for this standard. However, from discussion with staff and our knowledge of established practices within the service, there was evidence that the admission process is based on relevant and thorough assessment, it includes opportunities for prospective residents to visit the home in advance of admission, and review takes place 6 weeks after admission to check on progress and identify any unmet needs. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged and supported to exercise personal choice in their daily lives in order that they may lead as fulfilling a life as they are able and wish to. Evidence: Care is planned on a continuous basis in accordance with the changing needs of residents and the findings of regular reviews. Records are kept of assessments, reviews and care plans and residents are involved in the care planning process. Records are stored securely to protect and promote confidentiality and privacy. Regular meetings of the residents forum take place and provide opportunities for people living at the home to voice their opinions and become directly involved in planning daily routines and the ongoing development of the service. Residents are encouraged to make decisions about their lifestyles, with support and advice available within the service or through the other agencies involved with the Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: residents. The home manages the personal allowances of four residents; there are records of expenditure and income with receipts and signatures for all transactions. The amounts of money kept in the home for these people matched the recorded balances of their accounts. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides opportunities for personal development and encourages integration into the community at the home, and the wider community outside the home. The daily routines of the home promote wellbeing and independence. Staff respect the individuality and dignity of residents. Evidence: Since the last inspection, some residents have been away for weekend breaks and holidays and one person has spent a week in Majorca accompanied by two staff. Residents pay a monthly contribution to a social fund for the costs of social activities. The home is close to the centre of Boscombe enabling residents who wish to and are able to visit shops and community centres.Residents spoken with said they have good levels of freedom and are supported to achieve more independent living. Some people regularly attend local day centres. People living at the home have routine household Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: tasks including assisting with cleaning (the home employs a cleaner), washing up and making their teatime meal with staff supervision; this encourages greater choice as well as helping people to gain the necessary skills for more independent living. Among other subjects, residents discuss the standard of food offered at their monthly meetings. Feedback from the meeting is used to plan the service the home provides, including menu planning. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and social care needs of residents are met by suitably trained staff and residents receive the medicines they have been prescribed. Evidence: The care records of three people who live at the home were examined and found to be clear and comprehensive with risk assessments forming the basis for care plans and daily records describing the care and circumstances of each person. There was evidence that individual residents and involved health and social care professionals had been involved in the development and review of planned care provision. Medicine handling is carried out by staff trained in this work. Residents are encouraged to manage their own medicines in accordance with a risk assessment process and a number of the currently accommodated residents do manage their own medicines. Medication records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts. To promote good practice some recommendations to improve particular aspects of medicine handling are contained in this report. Care Homes for Adults (18-65 years) Page 16 of 26 Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure and other methods allow people to raise concerns. Staff understand and adhere to established policies for the safeguarding of vulnerable people. Evidence: Residents are relaxed in the presence of staff and believe they are listened to and that staff are approachable. Weekly residents meetings provide a forum for concerns to be raised. There have been no recorded complaints since the last inspection. Staff spoken with during the inspection demonstrated good understanding of the principles of safeguarding vulnerable people and have received associated training. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable and well maintained and meets the needs of the accommodated residents. Evidence: Residents have full use of the premises and are able to spend time in their private rooms or in the communal areas, according to their preference. There is a continuous programme of repair, renewal and refurbishment to ensure the premises and furnishings remain comfortable, well maintained and safe. The building complies with the requirements of the local fire service and environmental health department. All areas of the home were clean and there were no unpleasant odours. There are bathrooms equipped for the use of persons requiring assistance. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are well trained and experienced and residents are confident they are in safe hands. Evidence: At all times there are sufficient staff to properly care for and meet the needs of residents. The records of 2 recently employed staff members were examined and found to contain all essential information including written references and evidence of identity. Criminal Records Bureau (CRB) disclosures are obtained for all staff in advance of employment. The home has developed and implemented a comprehensive induction process for all staff, designed to ensure their familiarity with all aspects of the home and a clear understanding of their responsibilities. There is an enthusiastic approach to staff training and all staff undertake and as necessary update training in core subjects including fire safety, food hygiene and Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: emergency aid. All staff spoken with during the inspection felt that they provided a good standard of care to residents and are properly supported by the management and training provision. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is properly managed and maintained in the best interests of service users. Evidence: Mr Low holds the Registered Managers Award and the National Vocational Qualification at level 4 in care. He his supported by a team of suitably experienced and trained staff. Prior to this inspection the home completed an annual quality assurance assessment (AQAA), which they submitted to the Commission for Social Care Inspection. This identifies what the home considers they do well and sets out any plans for improvement over the next twelve months. The home routinely obtains the opinions of residents on the standard of meal provision and other essential aspects. With the exception of safekeeping small amounts of money for some residents, the Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: home does not manage the finances of residents. Residents who are unable to undertake this responsibility personally have nominated relatives, friends or other representatives to do this on their behalf. There are good processes for staff recruitment, induction and formal supervision. Accidents to residents are investigated and analysed to identify any possible trends eg time, place, person, activity, to ensure that future risks are minimised. Records indicated that fire safety equipment is routinely checked and tested at the required frequencies and during the inspection a sample of records regarding equipment servicing and maintenance were examined and found to be in good order. Care Homes for Adults (18-65 years) Page 23 of 26 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, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 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, Care Homes 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 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 1 20 When an existing prescription is changed, the medication administration record instruction should be crossed through, dated and signed to show it has been closed, and a new instruction written, dated and signed by the writer and a competent person who has checked the entry for accuracy. A maximum/minimum thermometer should be obtained and the temperature of areas where medicines are stored should be checked on a daily basis and records kept, to ensure their effectiveness has not been altered by incorrect storage. Paper should not be overstuck on medication administration records, nor corrective fluid used; a supply of blank copies should be kept for use when a new chart is needed. 2 20 3 20 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!