Inspection on 21/04/05 for Clinton Care

This inspection was carried out on 21st April 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

Clinton Care 17/12/07

Clinton Care 20/02/07

Clinton Care 10/01/06

Clinton Care 07/12/04

Clinton Care 06/05/04

Clinton Care 23/02/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOME ADULTS 18-65 Clinton Care 5 9 St Michaels Avenue Northampton NN1 4JQ Lead Inspector Judith Roan Maggie Hannelly Unannounced 21 April 2005 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Clinton Care Address 5 - 9 St Michaels Avenue Northampton NN1 4JQ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01604 632165 01604 620619 Ms Aileen Holland & Ms Una Holland Vacant Younger Adults 17 Category(ies) of MD(E) Mental disorder over 65 10 places registration, with number MD Mental disorder 17 places of places Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: To include within the total of 17, a maximum of 10 service users in need of personal care by reason of Mental Disorder, excluding learning disabilty or dementia over the age of 65. Date of last inspection 7 December 2004 Brief Description of the Service: Clinton Care is situated in a residential area close to local shops, leisure facilities and other amenities. It is also close to the main bus route into town centre. The accommodation provides a service for adults with mental health needs in both single and shared rooms. There is a range of communal areas with access to kitchen facilties to make hot/cold drinks and snacks throughout the day.Gardens are available for service users to use when weather permits. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 2 residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The inspection took place during the morning and early afternoon, over a period of 4 hours and was carried out on an unannounced basis. At the time of the inspection the manager’s position is vacant. Ms Una Holland is acting manager and intends to apply for registration as the manager. What the service does well: The service at Clinton care provides a strong care service for people with Mental Health Needs. The care staff team provide warm and friendly support in a home that is clean and brightly decorated. Service users feel valued by staff and are supported to make choices and decision about their lives. The home has a dedicated member of staff who organises activities within the home. Meals served are freshly prepared and of good quality. Service users have free access to the kitchen during the day to make drinks & snacks. Smokers and non-smokers have their own communal facilities within the home. Service users are encouraged to personalise their own rooms and can spend time in their rooms if they so wish. One service user spoken to said she liked to relax in her room and had privacy. The providers had supported her to personalise the room with items from her own home. Visitors to the home are welcomed and can call at any reasonable time that is suitable to service users. They are also encouraged to join in activities. Within the home there is good organisation and the staff work well as a team. There is a positive approach to training and the providers support and encourage all staff to progress. The home has a good quality assurance process that is produced in an assessable and graphical format. Views of service user and visitors to the home are evident. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5, The admission process undertaken for a recently admitted service user was inadequate in that it failed to provide sufficient information, to obtain a full history, risk assessment and produce an interim care plan. EVIDENCE: A newly admitted service users had the opportunity to visit the home prior to admission and discuss their needs. The statement of purpose and service users guide although available within the home, was not available as an individual copy prior to admission. The admission process for a recently admitted service user was not robust and failed to gather sufficient details about their history and needs or complete an initial assessment. There had been a reliance on the sparse information provided by the CPN and the homes assessment tools had not been used to enhance the information. The acting manager needs to ensure that full details are available to make a decision on whether the home can meet the person needs. A care plan was being drawn up with the new service user, but staff had limited details on which how to support to them in the short term. Another service users file reviewed who have lived at the home demonstrated that all relevant documentation had been gained. This information was reviewed and had been signed by the service user and provider. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 9 Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Service users are enabled to make decisions and choices about their daily lives. EVIDENCE: The home has good care plans and risk assessments for service users. Apart from the newly admitted service users file, files viewed demonstrated that a working care plan was available and that it had been reviewed. In discussion with service users and staff it was evident that service users were involved in the development of their care plan and made decisions about their lives. Daily records are kept on individual service user files. These notes evidence daily activities and are used to determine changing needs and how they can be met. Through observation and discussion with staff there was evidence to show that they were able to support service users with difficult issues in a sensitive and professional manner. The risk assessments have details that are appropriate to service user needs within the home. The risk assessments completed clearly showed how service users are supported to have an independent lifestyle and manage associated risks. Service users informed the inspectors that they were able to do what they wanted to do and that staff are available to discuss issues Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 11 Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,16 Service users are encouraged to participate in a range of activities and to maintain links with the local community. EVIDENCE: A member of staff at the home undertakes the role of activities co-ordinator who ensures that a range of options is available. Community involvement is encouraged and any activity that a service user was involved in prior to they moving into the home would be supported. One service user was very involved in various day activities and utilised community support networks. Another choose to spend most of their time in the home and rarely used community resources independently. Visitors are encouraged and involved in activities and one service user stated that ‘ I can have friend in at anytime’. The home’s open policy on visitors ensures that service users receive the emotional benefit gained from meeting with family and friends. This in part supports the outcome of Standard 19 The relationships between service users and staff was observed to be professional yet friendly. Staff spoke about their work with service user in a Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 13 respectful manner. Throughout the visit it was noted that there was a good communication and understanding between staff and service users. In discussion with service users it was noted that any restriction within the home were agreed and did not prevent choice or freedom of movement both within the home and wider community. One service user commented that their decision to move to the home was influenced by the minimum number of restrictions. Where it was necessary to restrict alcohol / cigarettes it was agreed with service users as part of their plan of care and recorded appropriately. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 There are effective systems and processes in place to ensure that service users health care needs were monitored and relevant health care professionals involvement where indicated. EVIDENCE: Care plans seen at the time of the inspection demonstrated that staff supported service user with their personal care as agreed with them in their care plan. The issues identified in the environment section in relation to privacy locks Staff confirmed that important information about changes to service user’s personal support were communicated at handover and recorded in daily records. Service user confirmed that their personal care needs are met. Daily routines are agreed with individuals and this enables service user to have maximum independence and control over their lives The provider ensures that service users can access appropriate support from health care professionals. Negotiations were underway for the support for one service user who had difficulty accessing the community, to be provided at the home. The files viewed confirm that appropriate records are kept. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 15 The health of service user is monitored and when necessary the service user is supported to attend their GP or specialist appointments. Annual health checks are available and recorded. The provider has a monitored dosage system in place that is well managed. However the inspector found that the medication for the newly admitted service user was pre-dispensed and stored in a dosette previously used by the service user. This is considered unsafe and unacceptable and the provider was asked to address this. The provider was advised that until supplies could be arranged from the pharmacist the medication should be administered using the individual tablet containers that showed clearly the dosage of each medicine. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Service users within the home were in part protected, as they knew how and where to express their concerns. Lack of staff awareness on Protection of Vulnerable Adult procedures however reduced the homes effectiveness. EVIDENCE: Service user spoken with knew that they could speak with the acting manager if they had any concern about the way they were supported or treated within the home. Staff confirmed that they were aware of the protection of vulnerable adults processes but need clearer communication lines of who they should call should the need arise. The provider may wish to consider the development of staff skills by including within the induction programme the understanding and management of physical and verbal aggression that they may encounter within their work. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27 The homes provides a warm, comfortable, homely environment that is in need of improvement. The toilet and bathroom provision within the home does not provide adequate privacy. EVIDENCE: The décor within the home is fresh and bright. Service user can have their rooms decorated as they choose. Service users who were happy to show the inspectors their rooms were pleased with the furniture supplied by the home. Service users are able to bring their own items from home. One service user said the provider was happy to supply additional items if needed. The furniture in the ground floor communal lounge is in need of refurbishment or replacement. The provider stated that they would provide arm covers in the short term to bring the chairs up to an acceptable standard. The provider recognised that replacement chairs would be needed in the near future. The floor in the lounge also requires attention. There are sufficient bathrooms/toilet facilities to meet the requirements of the service user resident at the home. In touring the building it was found that Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 18 most locks on toilet doors were missing or not working. None were privacy locks that would facilitate the access in an emergency. Bathrooms were fitted with locks that did not enable access from both sides. The provider must have these locks removed and fitted with privacy locks. Advice from the fire officer to be sought on type to use. The inspector also noticed that bedrooms did not have locks, but was satisfied that this was by choice of service users. Risk assessments and agreements from service users need to be in place to support this decision and noted on file Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 The recruitment of recent staff failed to meet the requirements set out in the Care Home regulations and National minimum standards. EVIDENCE: The inspector viewed the files of two staff. The file of a newly appointed staff member had no references, photograph, birth certificate or visa. Criminal Records Bureau clearance was gained, as was the POVA first check prior to employment. The second file had all relevant documentation except references. The provider explained that references were not available, as the person had commenced employment direct from education. The provider was advised that in these instances and reference from the school and a character reference was essential. The provider agreed that the recruitment policy must be more robust. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,41 The provider has a quality assurance system within the home that reflects the present service and enables them to make decisions on future developments. The homes records in safeguarding service user finances are inadequate to protect service monies. EVIDENCE: The findings of the quality assurance system was well presented and clearly demonstrates the views of service users and visitors. One visitor said ‘ as visitors to the home we are always made very welcome. The residents appear to be very happy and well looked after’ another said ‘ The party food we’ve seen looks very appetising.’ Generally comments were good about the overall service provided by Clinton Care. The financial records seen at this inspection did not clearly show how service users spent monies. The system needs to demonstrate the source of income, Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 21 the expenditure, (with receipts) and balances remaining. The provider agreed that the records would be changed to reflect these details. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 2 3 2 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 2 x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x x 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Clinton Care Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x 2 x x C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 20 Regulation 13(2), Sch3(3)(i) Requirement Medication must not be predispensed into a dosette All medication not in a monitored doseage system must be kept in its original packaging with the administration directions Locks to bathrooms that cannot be overridden must be removed or disabled All staff files must have proof of identity, including a recent photograph A copy of the newly appointed member of staff birth certificate must be on file The provider must gain two written references for new staff Financial records for Service user must demonstrate income, expenditure and balaances. Timescale for action 7 days 2. 3. 4. 5. 6. 27 34 34 34 41 13.4 19 Sch2(1) 19 Sch2(2) 19 Sch2(5) 17 Sch4(9) 7days 7 days 7 days 7 days 2 Weeks 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. Refer to Standard 1 Good Practice Recommendations The statement of Purpose must be available to service C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 24 Clinton Care 2. 3. 4. 5. 2 24 27 34 users prior to service user making a choice to move into the home. A service user guide is provided to all service users Service user are only admiited on the basis of a full needs assesment Remedial action is taken to armchairs in ground flloor lounge. Appropriate locks are fitted to all toilet and bathrooms. The provider should review their recruitment procedures to ensure they are robust. Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection First Floor Newland House Campbell Square Northampton NN1 3EB 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. Extracts may not be used or reproduced without the express permission of CSCI Clinton Care C51 S12748 Clinton Care C221767 210405 Stage 4.doc Version 1.30 Page 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. 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