Inspection on 13/10/08 for Clifton Manor

This inspection was carried out on 13th October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clifton Manor 15/10/07

Clifton Manor 19/02/07

Clifton Manor 01/08/05

Clifton Manor 20/05/05

Clifton Manor 21/02/05

Clifton Manor 02/09/04

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Clifton Manor 67 Manor Road Wallington Surrey SM6 0DE two star good service The quality rating for this care home is: 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: Barry Khabbazi Date: 1 3 1 0 2 0 0 8 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. They reflect the things that people have said are important to them: 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. 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Clifton Manor 67 Manor Road Wallington Surrey SM6 0DE 02086695305 02086693060 jackie.lehane@cliftonmanor.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Clifton Manor Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 8 Date of last inspection A bit about the care home Clifton Manor is a double fronted, detached property that is registered to provide care to a maximum of eight people with learning disabilities. Mr and Mrs Mohamedally are the registered providers, the home having a manager and staff team to run the service on their behalf. The home is situated in Wallington - between Sutton and Croydon - on a main road close to the local towns shops, pubs, churches, and public transport links - both by bus and train (Wallington railway station is nearby). The home provides care for eight adults with severe to moderate learning disabilities; some of the residents may also have moderate / medium levels of challenging behaviour. Each resident has a single bedroom, with bathrooms - including a whirlpool bath - showers and toilets sited throughout the ground and first floors. There is a staff / conference / meeting room and another shower room / toilet on the second floor. As well as the lounge, dining room and office room. There is a garden to the rear of the premises, which has a patio area and also a sturdy wooden framed garden chair swing. 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 How we did our inspection: This is what the inspector did when they were at the care home The overall quality rating of the service is 2 star. This means the people who use this service generally experience Good outcomes. As the people who use this service go out early in the day the inspection started early to allow the people who use this service to be met and so involved in the inspection. The manager was interviewed and records policies care plans and the building were examined The home has a new manager and so the managers self assessment AQAA was not yet available to support findings in this inspection All previous requirements were assessed as met at this inspection and only one new requirement was needed Please see the requirement section for details. All previous requirements were assessed as met at this inspection and only one new requirement was needed Please see the requirement section for details . What the care home does well This home has just had a change in manager. The home was well managed throughout the absence of a manager by senior staff acting up to the post and the area manager having regular and close involvement. There was no drop in standards during this period and in fact a slight improvement. All bedrooms exceed the minimum 10 sq m required This gives people more space. The service has exceeded the 50 of staff who are required to have a NVQ2 qualification. This provides a wellqualified staff group who have a better understanding of the needs of those who use the service. In addition to working care plans person centred plans are also being developed This records peoples needs from their perspective, which personalises care to ensure that it is carried out in a way they prefer What has got better from the last inspection The home now has a manager that is qualified to NVQ Level 4 in Management and Care. This provides an appropriately qualified manager with suitable knowledge and skills. The number of staff who are qualified to NVQ Level 2 has now risen to the 50 of care staff This provides a better-trained workforce and therefore a better quality of care provision. Risk assessments have been produced to ascertain the safety of the water outlets in relation to the risk of scalding, and any action required to maintain its safety This will better protect people from scalding. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Barry Khabbazi 33 Greycoat Street London SW1P 2QF 02079792000 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 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 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 . People who want to live at this home can be confident that their needs and aspirations will be assessed and recorded ,so that they can be met by the home. Evidence: People who live at this home receve good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service 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 . The needs and changing needs of people who use this service are assessed and recorded so that staff know and can therefore meet these needs. However the information is recorded over a number of documents and could be difficult for new staff to find People who use this service are supported to make decisions about their lives to maximise their independence and choices Risk assessments contain all the information required as including this information could reduce the risk for people who use this service and remove unnecessary restrictions of liberty Evidence: People who use this service experience good quality outcomes in these areasThis judgement has been made using available evidence including a visit to this service 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 . People who use this service receive sufficient access to activities to maintain a stimulating life. People who use this service are regularly participating in the local community with the aim of maximum integration and challenging discrimination. People who use this service are supported in maintaining appropriate relationships so that their social lives are maximised within chosen boundaries . The daily routines and house rules do generally promote the rights of people who use this service, to ensure equality and that all rights are enjoyed by all . Dietary needs are catered for and a balanced diet is provided, to ensure good health and enjoyment of food. Evidence: Evidence was provided of people being supported to attend college to continue education and training Independent living training occurs at the home and day centre, and is supported by staff and key workers. The home provides its own day centre in Thornton Heath which people who use this service attend. The activities at the home s day centre were previously inspected and included adult education and independent living skills Some people told us about recent activities and outings they had attended Evidence: and visits to friends and family Trips out occur during the day, and at evenings and weekends. Staff have information and health training to support people in making appropriate and informed decisions where they wish to develop close relationships, and they would ensure that this was mutually welcomed. Evidence was provided to confirm that where this is not welcomed or appropriatestaff do take appropriate action to protect people Although people who use this service do receive holidays they do not receive all the paid holidays they are entitled to. The home has approached the placing authorities for this but the placing authorities have not provided this funding yet. Although the following recommendation is technically is still needed it is recognised that it refers more to the placing authority than the home. Each resident should be offered a sevenday holiday paid for by the placing authority as a part of the contracted price. The daily routines and house rules do generally promote independence and choice Meals for example, can be taken where and when people want, and people go to bed and get up when they want This is done within the context of enabling people to attend appointments and other commitments The menu has been put into a pictorial format suitable for the people living at the home Previous service user surveys state that many people like the food at this home At this inspection one person also reconfirmed this Dieticians are used well where concern about nutrition arises and an assessment was occurring during the week of this inspection. 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 . Personal care is now carried out in a way that people prefer so that dignity and choice are maintained. The physical health needs of people are met by this home This ensures that the physical health is well maintained and therefore the quality of life experienced is also maximised. Medication is well managed and staff have had approved and accredited medication administration training to promote safer medication administration. Evidence: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. 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 . Complaints are well so that people feel their concerns are listened to and the complaints procedure is now more accessible. The protection policies and procedures promote protecting people from abuse. Evidence: People who use this service experience good quality outcomes in these areas.This judgement has been made using available evidence including a visit to this service. 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 building rooms and furniture generally meet peoples needs and provide a comfortable environment that promotes independence. Bedrooms are suitable and all exceeded the minimum 10 sq m required. This gives people more space. The home is generally hygienic and clean homely and comfortable This environment therefore facilitates peopleshealth and emotional wellbeing. The building rooms and furniture generally meet peoples needs and provide a comfortable environment that promotes independence. Bedrooms are suitable and all exceeded the minimum 10 sq m required This gives people more space. The home is generally hygienic and clean homely and comfortable This environment therefore facilitates peopleshealth and emotional wellbeing. The building rooms and furniture generally meet peoples needs and provide a comfortable environment that promotes independence. Bedrooms are suitable and all exceeded the minimum 10 sq m required This gives people more space. The home is generally hygienic and clean homely and comfortable This environment therefore facilitates peopleshealth and emotional wellbeing. Judgement: Evidence: People who use this service experience good quality outcomes in these areas.This judgement has been made using available evidence including a visit to this service. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use this service are supported by appropriately qualified staff which raises the quality of staff and their practises. The home has exceeded the 50 of staff who are required to have an NVQ2 qualification. This provides a well qualified staff group. The homes recruitment procedures have protected the people who use this service through vigorous staff vetting in the past. However the fact that these documents were not accessible at the time of this inspection could put people who use this service at risk. Staff receive induction training to national training sector specifications This ensures a better inducted staff team. Evidence: People who use this service experience adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. 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 managed by an experienced and well-qualified new manager who can ensure a quality service There is a quality assurance system, which involves the people who use this service and provides a way for them to measure improvements in quality for themselves The home generally promotes the health and safety of the people who use this service so that practices and the environment do not generally place their health and safety at risk Evidence: People who use this service experience good quality outcomes in these areasThis judgement has been made using available evidence including a visit to this service Are there any outstanding requirements from the last inspection? Yes  No  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 1 32 38 Any absence of a manager for more than 28 days must be reported to the Commission in writing. 20/06/2008 2 32 181 At least 50 of care staff should be qualified at NVQ Level 2 01/08/2008 3 37 8 A manager must be recruited 01/08/2008 for Clifton Manor and apply to be registered as the registered manager with the Commission. 4 42 12 Doors must only be held 20/06/2008 open by fire responsive door closing devises. {Old requirement that needed to be re-set.} 5 42 12 Risk assessments must be produced to ascertain the safety of the water outlets 01/08/2008 with regards to the risk of scalding and any action required to maintain its safety. 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 Description 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 Description Timescale for action 1 33 17 All elements of schedule 11/05/2009 4staff files must be kept at the home and be available to the Commission at all times This is needed to ensure the protection of the people who use the service and this information may also be immediately required by other protection agencies and authorities In requirement and home does not want to hold records centrally 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 14 Each resident should be offered a seven-day holiday paid for by the placing authority as a part of the contracted price. This would facilitate more funding and additional holidays for residents that they do not have to pay for. 2 42 Alternative storage for the wheelchairs that were blocking the kitchen fire exit should be explored. This is needed to ensure that staff do not put them in front of the kitchen door again out of habit. 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). 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