Inspection on 21/02/09 for Cliftonville

This inspection was carried out on 21st February 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

Cliftonville 05/03/07

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cliftonville 2 Essex Street Rushden Northants NN10 0LG     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: Carol Mitchell     Date: 2 1 0 2 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. that people have said are important to them: They reflect the things 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 Older People 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 Older People Page 2 of 25 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 Older People Page 3 of 25 Information about the care home Name of care home: Address: Cliftonville 2 Essex Street Rushden Northants NN10 0LG 01933353028 F/P01933353028 greyladiesltd@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Grey Ladies Ltd care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Cliftonville is a care home providing personal care and accommodation for up to a total of 20 people over the age of 65 years. (The homes registration means that up to 20 people may have a diagnosis of dementia.) There are eight single bedrooms, and six shared bedrooms. Bedrooms are located on the ground and first floor with access to the first floor being via the stairwell or passenger lift. Communal areas are located on the ground floor, and consist of two lounge/dining areas and a separate lounge. Cliftonville has a large garden with a decked area to the rear of the property. The following information about fees was obtained on 21st February 2009: Weekly fees fall in the range of £359.01 to £400.00; Additional charges are made for chiropody, Care Homes for Older People Page 4 of 25 Over 65 20 20 0 0 Brief description of the care home hairdressing, and toiletries. Further information about this service can be obtained by contacting the home direct by phone or email. The website is being updated at the time of writing. A copy of our most recent report is included in written information given out by the home. Care Homes for Older People Page 5 of 25 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report takes account of information received since the last key inspection in March 2007 and considers information we summarised an an annual service review on 16th January 2008. For this key, or main, inspection we sent surveys to ask the opinions of residents and professionals living in or using the home, and the manager completed detailed written information about the home which we received before our visit. We visited the home on Saturday 21st February 2009 for about five hours. During this unannounced visit we spoke with residents and considered the care and support given to four residents in particular. We also spoke with family members who were visiting the home, members of staff on duty, and the manager. We checked some records, and looked around some parts of the home. We would like to take this opportunity to thank everyone involved with the inspection visit. Care Homes for Older People Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: The manager will be discussing with the owner her plan to introduce twilight shifts to help residents and staff during the busy evening period. Care Homes for Older People Page 7 of 25 Menus are going to be given to those residents who would like to see one. The bathroom with the damaged floor (following installation of a new hoist) is scheduled for redecoration soon. During our visit we suggested that for some residents, using a method to measure the dependency of people with dementia might be sensible. The manager is going to look into this. The manager is also going to discuss as needed prescriptions with family doctors and the homes pharmacist to make sure that their use is minimal (and clearly explained if unavoidable). On the day of our visit the manager checked that risk assessments are done for anyone using their own inhalers. The considerable work done in the area of quality assurance needs to continue. This includes formal publishing of results from surveys, the inclusion in surveys of visiting professional people, the further development of monitoring methods used to check that things in the home are done right, and optimising the usefulness of the monthly visits and reports done by the owner. 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 Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. The manager makes sure that she knows how residents need to be supported and cared for before they move in. Therefore people living at the home can be sure that their needs will be met. Evidence: We spoke to a family member of a resident who had been admitted during the last year. The resident had settled in very well and the relative was pleased that she had been able to visit the home and been given good written information. Before admission the manager visits people and assesses their needs and the homes ability to meet them. We looked at the records of a resident who had been admitted during the week prior to our visit. A detailed assessment had been completed, a care plan was in place, and a contract had been issued. This home does not offer intermediate care. Care Homes for Older People Page 10 of 25 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 manager makes sure that each resident has a carefully written care plan and that staff know about the information in it. Residents see professionals like family doctors when they need to. Therefore people living at the home can be sure that their health care needs will be met. Evidence: Relatives told us that the staff take great care to make sure that residents are cared for well. One said I am very pleased with his care. A resident told us that when she was ill she was very well looked after indeed. A relative told us that staff were quick to call for the family doctor and paramedics in an emergency, and that they had contacted her straight away. We looked at the care plans for four residents and found well organised and useful documents. The care plans had been written in an individual way with care, and staff were familiar with the contents. A relative and a resident had been involved with writing the care plans and had signed some records. Risk assessments have been completed and care plans are reviewed regularly. Care plans include reference to how people like to occupy their time, and information about life histories is recorded. Staff receive training about dementia care. The manager already Care Homes for Older People Page 11 of 25 Evidence: assesses how dependent people are, and she is going to consider whether she can improve how this is done especially for residents with dementia. Relatives confirmed that family doctors and other professionals are called in or visit when necessary, and we saw that treatments are recorded using a clear and organised method. The home has had recent difficulty finding dentists but is trying to resolve this. Two relatives have recently written to thank the home for the quality of the care given to their relatives at the end of their lives. Staff receive training in the administration of medicines, and the providing pharmacist inspects the medicines. The most recent inspection was done in March 2008 and another is due soon. The manager organises the medicines and makes weekly checks. We saw medicine being administered safely, and looked at four medicine record sheets. We found that these were in good order. We noticed that an as needed prescription required further explanation for staff, and a risk assessment is needed for a resident who is able to use her own inhalers. The manager started to address these two issues at the time of our visit. We saw that staff dealt with residents in private and in a sensitive manner. The way residents wish to be addressed is recorded in care plans and residents were approached politely and professionally. Staff develop a friendly and warm rapport with residents. A relative confirmed that the sharing of a room had been well managed. Privacy screens are provided, and toiletries were separate and labelled in a shared room we visited. Care Homes for Older People Page 12 of 25 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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 manager and staff know the residents well, and they find out as much as possible about what residents enjoy doing and about their likes and dislikes. The manager and staff think that personal choice and making residents feel at home are very important. Therefore people at the home can be sure that their expectations of living there will be met. Evidence: During our visit some residents were enjoying listening to music, a resident was occupied sorting out books and folding napkins, two residents were looking at/reading the newspapers, others were sitting quietly or chatting with each other and members of staff. A resident told us that she enjoys the quizzes which are held regularly. Also that when her friend visits they like to go into the garden. A family member told us that her relative joins in organised activities when she can, especially the singing. On the morning of our visit at least one resident had chosen to stay in bed late. Another resident was heard to ask What time is bed? The staff member replied Its up to you..... A family member said He is wearing his white hat which he always chooses to wear. A member of staff found particular biscuits for a resident knowing they were her favourites. Care Homes for Older People Page 13 of 25 Evidence: A resident was able to tell us that a residents meeting had been held, and the home produces a newsletter. We noticed that at least two residents lock their doors, and a resident who expressed a wish for a lockable box in her room was given one during our visit. We looked at the care plans for four residents and found reference to how people want to occupy their time. Life histories are also included to help with this and staff are being encouraged by the manager to learn about how residents with dementia can benefit from being occupied in meaningful ways. Planned group entertainment takes place and themed events and church services are arranged. The home is currently trying to recruit an activities organiser for two afternoons a week. Residents and family members told us that food at the home is good, hot, and plentiful. Residents are given a choice and although there is a menu displayed in the kitchen, this is not routinely given to residents. At least two residents told us that they would like to see the menu and the manager is going to arrange this. A family member told us He likes the food. Another wrote in our survey Mum was not eating very well but that soon changed after she came to Cliftonville and she put some weight on. Although she is not a big eater she enjoys her food. Family members in surveys and during our visit told us that they are made very welcome indeed and at any time. I and all my family are always made very welcome. Care Homes for Older People Page 14 of 25 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 improvement in how staff are checked before they are employed at the home has been keenly sustained by the manager, and recruitment procedures are now well organised. New staff receive training, and all staff learn about how vulnerable adults can be harmed. The manager and staff are friendly and open and they encourage residents and family members to voice any concerns. Therefore people living at the home can be sure they will be listened to and kept safe. Evidence: Residents and family members told us that there is a friendly and open atmosphere at the home which makes speaking up about concerns easy. A family member said she would soon make her voice heard loud and clear if she were not happy. A residents wife told us It is very easy to talk to the manager and staff; and a resident said I would speak to Sandra (the manager) and the girls, they sort things out- the manager and staff are very sweet and caring. Another family member told us that she has raised issues in the past and these have been dealt with. A staff member explained that she sits down with residents to listen to minor worries as often as possible. Anything she cannot deal with she refers to the manager. Staff have received training about vulnerable adults and abuse with especial reference to people with dementia. A staff member was able to tell us what she would do if she was worried about a resident being at risk. Care Homes for Older People Page 15 of 25 Evidence: There is a complaints procedure on display and within the written information given out by the home. Very few complaints have been received by the home and we received one since the last key inspection in March 2007. The complaint was received last summer and concerned the employment of a staff member prior to proper checks being done. The person was not allowed to continue working at the home. We looked into this matter and found that at that time recruitment procedures at the home were unsafe. We told the owner what he had to do to comply with the law and we did a special inspection in October 2009. That inspection showed that proper staff checks and recruitment procedures had been put into place. During the visit for this main inspection we discussed staff recruitment with the manager. There is a robust and organised approach to this area now, and assistance is obtained from a specialist in employment law. We looked at three staff files and saw that proper checks are being done before people are employed at the home. The well ordered files, together with discussion with staff showed us that safe and methodical recruitment procedures have been maintained, and that new staff receive effective induction when they start to work at the home. Written information we received before the visit explained that arrangements are made so that residents do not lose their right to vote in elections. Care Homes for Older People Page 16 of 25 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, 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. 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. Cleaning staff work during the week, and a maintenance man is employed. The manager makes sure that safety checks are made, and that improvements to the decor are planned. Therefore people living at the home know that they are in a safe and maintained environment. Evidence: Residents and family members told us that the home is kept clean: Everywhere is kept spotlessly clean; I am happy with the cleanliness. Cleaning staff are employed during weekdays only. We visited on a Saturday and the parts of the home we saw were clean and there were no odours. During our conversations residents, family members and staff told us that the cleaning and laundry are run in a most satisfactory way. A family member volunteered that her husband always looks presentable. The manager is in charge of the laundry, and care staff do the ironing at night. No laundry assistant is employed. The manager confirmed that the system works well. We looked around some parts of the home. Rooms are redecorated before being occupied, and the quiet lounge has just been redecorated. Work on the lounge/dining room was due to start during the week following our visit. We saw a bathroom with floor damage following the installation of a new hoist, and a patch of wall damage due to a previous flood. The bathroom is on the list of works to be done and the manager is aware that it is a priority for prompt attention. Care Homes for Older People Page 17 of 25 Evidence: Residents and family members we spoke to were happy with the bedrooms and shared facilities. In the bedrooms we saw that residents had displayed some personal possessions. The Environmental Health Officer visited eight months ago and gave the home a good (four star) rating. A maintenance man is employed and his role includes the checking of the hot water in the home, and we saw the records he keeps. Care Homes for Older People Page 18 of 25 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. 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. The manager makes sure that people who work at the home are checked out properly first. She is very willing to think about ways of improving staffing at the home, and is planning to introduce an extra evening shift. Staff are trained and very happy in their work. People living at the home can therefore know that there is a good staff group there, and that every effort is made to make sure they are in safe hands at all times. Evidence: Residents and family members told us that they are pleased with the staff at the home. A family member said The staff are very sweet and familiar with all the residents little habits. Staff know the residents well and during our visit we saw them interacting often with residents in a polite, friendly and professional manner. Staff like working at the home. All the staff are happy. Its a friendly environment, like a big family. Staff told us they receive essential and other training, and new staff are given induction training and a period of shadowing before starting to work unsupervised. Most staff have undertaken National Vocational Qualification training. Staff meetings are held and staff told us they now receive supervision sessions. The manager keeps records of these. A resident, a family member, staff and the manager told us that the home operates well without cleaners at the weekend and with care staff undertaking laundry duties. Care Homes for Older People Page 19 of 25 Evidence: (Please also see the section on the environment.) On the day of our visit there were 16 residents present, with two care staff and a cook on duty. The staff and residents/family members we spoke to thought that this was sufficient to meet residents needs. The manager showed us documents which confirmed that she has reviewed staffing together with resident dependency regularly since the last key inspection. We suggested that for some residents it might be better to use a dependency tool concentrating more on the needs of people with dementia, and the manager is going to do this. We asked a resident and staff about the situation during late evenings when two care staff are on duty. (During peak activity periods in the day one or more of the manager, cook, cleaner, maintenance man will usually be present.) The resident and staff explained that some residents do require help from two staff when going to bed and this can leave others needing help downstairs. Someone may be ill or need help downstairs and (if they are upstairs with someone) they are too busy. The manager agreed that the evening period of peak activity needs consideration, and she is going to discuss with the owner the introduction of a twilight shift. We looked at a sample of staff files and found that the proper checks are done before people are employed, and robust recruitment procedures are now in place. Care Homes for Older People Page 20 of 25 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 manager and owner try very hard to listen to residents and their families. The manager is an open and committed person who works with us and others to make improvements. Therefore people living at the home can be sure that it is run with their best interests at heart. Evidence: The manager is supported by the owner and another manager and administrative staff from a sister home. The manager and owner are keen to work with us and have used the services of a specialist in employment law since we required an improvement in recruitment procedures at the home. We spoke to staff, residents, and family members about the management of the home. A family member said that the manager is very friendly and open; a care assistant said she is a very good manager, and a resident told us that the manager is very caring and sweet. Since the last key inspection, improvements have been made in the area of quality assurance. The owner now leaves written reports after monthly visits, and Care Homes for Older People Page 21 of 25 Evidence: questionnaires have been distributed to residents. The manager is happy to share comments received and is currently considering the best way to publish this information. The manager is also going to ask for views about the home from family doctors and others. A residents meeting has been held and the manager and owner hold surgeries where residents and family members are invited to discuss any issues. The manager makes checks to establish that the home is being well run. For example she monitors the medicines every week and records regular checks on bedrooms, the appearance of residents, and the food. The manager also systematically tracks staff training and monitors any trends noticeable from accidents happening at the home. Records we saw in the home were well ordered and up to date. we looked at the fire log book and hot water checks, and the information sent to us before our visit gave details of other health and safety checks, and the servicing of equipment. During our visit we confirmed that advocacy arrangements are made for individual residents needing this. Residents told us they can choose to lock their doors. We checked the money and record for one resident whose money is held by the home, and found that this is done with due care and accuracy. Staff told us that they receive supervision sessions now, and the manager keeps records of these. Care Homes for Older People Page 22 of 25 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 Older People Page 23 of 25 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 Care Homes for Older People Page 24 of 25 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 Older People Page 25 of 25 - 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. 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