Inspection on 13/10/05 for Clifton House Residential Care Home

This inspection was carried out on 13th October 2005.

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 House Residential Care... 02/04/09

Clifton House Residential Care... 07/06/07

Clifton House Residential Care... 08/06/06

Clifton House Residential Care... 06/05/05

Clifton House Residential Care... 27/10/04

Clifton House Residential Care... 11/08/04

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Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Clifton House Residential Care Home Clifton House 94/96 Clifton Avenue Hartlepool TS26 9QP Lead Inspector Mr Paul Emmerson Announced Inspection 9:45 13 October 2005 th 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 House Residential Care Home DS0000058542.V253861.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 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 Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Clifton House Residential Care Home Address Clifton House 94/96 Clifton Avenue Hartlepool TS26 9QP 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) 01429 223399 01429 223399 Finest Care Limited Mrs Andrena Piggins Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. All unguarded radiators must be covered by 1st June 2004 in order that the risk of burns to service users be reduced. 6th May 2005 Date of last inspection Brief Description of the Service: Clifton House is a care home for older people and is registered under the Care Standards Act 2000 to provide accommodation and care for up to 30 older people. The home is located in a quiet road, close to local amenities and the town centre. Most residents select to personalise their rooms with their own furniture and personal belongings. The home has a number of communal areas that are well used by residents. There are quieter areas should privacy be required. Although the home is situated over three floors, a lift gives access to all levels. Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. By law we have to inspect all care homes at least twice a year. This announced inspection was carried out in accordance with this obligation. The inspection took place over 7 hours, on the morning and afternoon of Thursday 13th October 2005. In line with current CSCI policy on ‘Proportionality’, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion were assessed during the last inspection of the home. The inspector looked around the building and a number of records were examined. 9 service users, 3 visitors, the home’s owner, the acting manager, 5 members of staff and a visiting pharmacist were spoken to. What the service does well: What has improved since the last inspection? Since the last inspection an activities co-ordinator has been appointed and catering arrangements have been reviewed. A new carpet has been laid in the sun lounge and furniture in this room has been re-upholstered. Service users spoken to said how nice this room looks now. A non-slip floor covering has been laid to the second floor bathroom. Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 6 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 Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 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 House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 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): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. EVIDENCE: NA Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 9 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. Personal and healthcare needs are adequately met. Appropriate care plans are prepared. Any medicines required are dealt with correctly. EVIDENCE: The inspector spent time in the company of service users and saw that they are well cared for and comfortable in their home. Management and staff within the home ensure that service users’ health care needs are met. Where specialist intervention is required it is sought. Records confirm that contact with GPs and other health professionals is maintained. For example, one person spoken to said she was: “Going for an appointment to get a walking frame”. In a CSCI inspection comment card, one relative wrote that they: “Have had a great deal of pressure and worry taken from them now that our Mam is living at Clifton House. We know that at the end of each day and throughout each day, our Mam is safe and well cared for. The staff are very helpful and understand about our Mam’s problems and are trying to encourage her to be more independent. When we thought our Mam might be going into Clifton House, everyone we told – Doctors etc. – said that she was fortunate to be accepted into such a good home, one of the best”. Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 10 A relative spoken to on the day of the inspection said: “It’s very caring, the environment and the food is very good”. The inspector looked at 4 care plans, which were all generated from comprehensive assessments. The plans are clear about people’s physical needs and describe the care required and being provided to meet their needs. However, care planning arrangements would benefit from some further exploration of the mental health needs of older people and also those needs relating to nutrition. Service users and/or their relatives are involved in formulating the care plan and they sign to agree it. Within the care notes there are specific documents for other health care professionals to enter their findings and record treatments that have been given. On the day of the inspection a pharmacist from the local ‘Older Persons Integrated Needs Team’ visited Clifton House. The home’s systems relating to medication were checked with the pharmacist, who also carried out medication reviews for individual service users. The home uses a monitored dosage system. There are adequate policies, procedures and systems in place relating to the receipt, recording, storage, handling, administration and disposal of medicines. However, medicines that need keeping below a certain temperature should be stored in a refrigerator suitable for this purpose – as opposed to a kitchen fridge. Further, to reduce the risk of drugs being administered to the wrong person, it recommended that medication administration records should have service users’ photographs attached to them. The inspector observed, through the actions and responses of staff, that staff respect service users’ privacy and dignity. Service users spoken to expressed their satisfaction with the manner and attitude of the staff. A telephone is available to the residents for private conversations and staff do not open mail unless otherwise instructed. Medical staff attend to service users in their rooms with a staff member for support. Residents wear their own clothes at all times and these clothes are well laundered. There are currently no shared rooms in the home. Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 11 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): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. However, it is acknowledged that since the last inspection an activities co-ordinator has been appointed and catering arrangements have been reviewed. EVIDENCE: NA Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 12 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 & 18. The home has systems in place to respond to complaints. Service users are safeguarded from abuse. However, the home’s policies and procedures in this area require further development. EVIDENCE: Information about complaints, how and who to make them to, is made available to service users and their families through information displayed on the home’s notice boards and in the home’s ‘Service Users Guide’. Service users’ and families’ views are obtained through regular contact and an ‘open door policy’. Residents Meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. The home has a copy of the local authority’s ‘No Secrets’ guidance on abuse and the protection of vulnerable adults. Some staff have also received ‘No Secrets’ training. However, although the home has its own policies and procedures about abuse, they require further development and need to be amended to reflect local protocols, contact arrangements and the initial action to be taken (things to do and things not to do) if an allegation of abuse arises. Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 13 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): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. However, an updated action plan showing redecoration works intended and timescales for completion should be forwarded to CSCI. Further, as highlighted in the previous inspection report, to ensure that Clifton House can meet the future needs of service users coming into the home, bathroom upgrade costs should be considered within any future business plans for the home. Hot water should be available throughout the day, in particular to the kitchen and bathrooms. It is acknowledged that since the last inspection a new carpet has been laid in the sun lounge and furniture in this room has been re-upholstered. A non-slip floor covering has been laid to the second floor bathroom. EVIDENCE: NA Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 14 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 & 30. Sufficient staff are generally employed. The home has a settled, well-trained and well lead staff team. EVIDENCE: From discussions with management and staff, and from an examination of duty rosters, generally sufficient staff are employed within the home. There is a settled staff team. Most of the staff spoken to have worked at Clifton House for many years and they know the service users well. Agreed staffing levels for Clifton House are, in addition to the manager and ancillary staff: a senior care assistant and 2 care assistants throughout the day and 2 staff at night. An additional member of staff is required and is generally rostered on a morning to assist with personal care. However, due to internal staff promotions and some changes in responsibility for staff posts in the home, the additional morning shift is not being covered. Although it is acknowledged that recruitment is underway, this post should be filled as soon as possible. It is also recommended that staffing arrangements at lunch and tea-time be reviewed to ensure: service users do not have to wait around too long for their meals; more staff support is available if required; and staff are less hurried arranging and serving meals. Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 15 Recruitment procedures within the home are safe. CRB (Criminal Records Bureau) disclosure checks are carried out for all staff. A copy of each person’s birth certificate and a photograph is kept in their personnel file; these documents are copied when completing the Criminal Records Bureau disclosure. Applicants for employment complete an application form and 2 references are obtained. A reference from the last employer is requested, plus another; any gaps in employment are explored. Each member of staff receives a contract of employment and a job description. Staff training is given a high priority. 80 of care staff have an NVQ (National Vocational Qualification) at level 2 or above. Core training such as in First Aid and Moving and Handling is arranged, along with other courses such as dementia care and risk assessment. Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 16 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, 33, 35 & 38. Although the manager has recently left, Clifton House continues to be a wellrun care home. Appropriate quality assurance systems are in place to identify and rectify any concerns. EVIDENCE: The home’s registered manager left in September. However, a senior member of staff, who has worked at Clifton House for some 14 years, has been appointed manager and will be applying for registration with CSCI. Service users spoke highly of this person and although sad to see the previous manager leave, said the home was still running well. The Statement of Purpose for Clifton House describes the aim of the home’s care, which is to provide a high standard of care to the service users. Questionnaires are sent to families and residents asking their views on the standard of care in the home. CSCI inspection reports are available in the hall area for service users and visitors to read. Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 17 Service users’ and families’ views are also obtained through regular contact and an ‘open door policy’. Residents Meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. The home’s owner visits regularly and reports required under Regulation 26 of the Care Homes Regulations 2001 are completed and forwarded to CSCI. The home has a range of appropriate policies and procedures. However, it is recommended that these be reviewed to ensure that they are up to date and current. For example, as highlighted above, the home’s adult protection policies and procedures require updating. Appropriate systems are in place to ensure service users’ health and safety is protected. For example, risk assessments are completed; staff training relating to risk assessment is being arranged. However, it was noted that a number of staff call leads were missing. Call systems with an accessible alarm facility must be provided in every room. Clifton House Residential Care Home DS0000058542.V253861.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 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 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X X X X X X X X 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 X 3 X 3 X X 3 Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 19 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. Standard OP18 Regulation 13 Requirement Policy and procedure documents relating to adult protection must be amended to reflect local protocols, contact arrangements and the initial action to be taken (things to do and not to do) if an allegation of abuse arises. A call system with an accessible alarm facility must be provided in every room. Timescale for action 01/12/05 2. OP38OP22 12 & 13 01/12/05 Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 20 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. 2. Refer to Standard OP7 OP9 Good Practice Recommendations Care planning arrangements would benefit from some further exploration of mental health needs and those relating to nutrition. Medicines that need keeping below a certain temperature should be stored in a refrigerator suitable for this purpose – as opposed to a kitchen fridge. Further, to reduce the risk of drugs being administered to the wrong person, it recommended that medication administration records should have service users’ photographs attached to them. An updated action plan showing redecoration works intended and timescales for completion should be forwarded to CSCI. As highlighted in the previous inspection report, to ensure that Clifton House can meet the future needs of service users coming into the home, bathroom upgrade costs should be considered within any future business plans for the home. As highlighted in the previous inspection report, hot water should be available throughout the day, in particular to the kitchen and bathrooms. Staff vacancies should be filled as soon as possible. It is also recommended that staffing arrangements at lunch and tea-time be reviewed. The home has a range of appropriate policies and procedures. However, it is recommended that these be reviewed to ensure that they are up to date and current. 3. OP19 4. OP27 5. OP37 Clifton House Residential Care Home DS0000058542.V253861.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. 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