Inspection on 10/04/06 for Clock Tower Mews

This inspection was carried out on 10th April 2006.

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

Clock Tower Mews 27/07/05

Clock Tower Mews 01/02/05

Clock Tower Mews 14/10/04

Clock Tower Mews 03/06/04

Clock Tower Mews 04/03/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Clock Tower Mews Morven Park The Causeway Potters Bar Hertfordshire EN6 5HA Lead Inspector Hazel Wynn Key Unannounced Inspection 10th April 2006 10:00 Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 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 Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 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 Adults 18-65. 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. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Clock Tower Mews Address Morven Park The Causeway Potters Bar Hertfordshire EN6 5HA 01707 662253 01707 652419 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) Caretech Community Services Limited Ms Marlene Morris Care Home 11 Category(ies) of Learning disability (11), Physical disability (11) registration, with number of places Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th July 2005 Brief Description of the Service: Clock Tower Mews was originally the stable block for Morvan House and was converted into a care home in 1995. It stands in Morvan Park adjacent to Morvan House (also a registered care home). The buildings and park are owned by the National Trust and leased to Caretech Community Services Ltd. They are located on the outskirts of Potters Bar and are easily accessible to local shops and are close to public transport. The home provides full care services in a safe environment for its service users who all have learning and physical disabilities. The home comprises of three units, The Mews House which is fully wheelchair accessible, caters for 8 residents and The Lodge for 1 resident, who all have higher needs whilst The Flat accommodates two services users who have moderate needs. The building is surrounded by beautiful parkland, which provides a peaceful living environment. The fee range is from £208.49 (for one gentleman) through to £1,273 with an in between variance depending on assessed needs. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been drawn up following an inspection carried out by one regulation inspector representing CSCI on 10th April 2006 using available evidence gathered during the inspection including observation, discussion with service users, care staff and the registered manager and examinedof records maintained in the home. The overall quality of this service is good. What the service does well: What has improved since the last inspection? What they could do better: The registered manager is proactive in identifying areas for improvement and carries out regular audits and where deficits exist takes action, for example she had identified that the bathroom (ladies) was becoming in need of Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 6 replacement flooring and was including this as part of this years annual budget refurbishment needs – hence a requirement did not need to be made. 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. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 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 the following standard(s): 1, 2, 3, 4 and 5 Quality in the outcome of this inspection visit is good; this judgement has been made using all available evidence including a visit to this service. Information is provided to prospective service users about the home to enable and support them to make a choice. The home will only admit service users whose needs and aspirations can be met. A trial visit to the home prior to admission is supported. An individual written and signed contract/terms and conditions is provided to service users. EVIDENCE: The service users guide was seen at this inspection to have been updated in January 2006 and a copy maintained in each service users individual file. Service users are supported by various advocates (including professionals and family members) who contribute appropriately to the individual’s assessment and review and evidence of this was seen in individual files. The evidence examined in the files provided assurance that service users know that the home can meet their needs; observation of the meeting of needs during this inspection provided further evidence. The registered manager explained how transitional visits and stays are co-ordinated appropriately to suit the needs of a service user being admitted to the service. A user-friendly copy of the contract was maintained on the individual records examined at this inspection. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 6, 7, 8, 9 and 10 Quality in the outcome of this inspection visit is good; this judgement has been made using all available evidence including a visit to this service. Service users know their care plans contain their assessed and changing needs as well as their personal goals (or their advocates do on their behalf). Assistance is given where needed to support service users to make decisions about their lives and to have input into the running of the home. Service users are safely supported to take risks as part of an independent lifestyle. Service users can feel confident that information about them is handled appropriately and that their confidences are kept. EVIDENCE: The records showed that monthly auditing of the service users care plan, which contains their individual assessed, and changing needs and personal goals is well documented with progress recorded. The registered manager demonstrated how various methods of communication (such as objects of reference) are used to support service users to make decisions about their lives and how the home is run. Individual talk time is built in to ensure all service users are supported to make decisions and be heard. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 10 Individual risk assessments are carried out to support service users to take risks as part of an individual life style and these were observed (during this inspection) to be regularly reviewed on the individual service users’ files examined at this inspection. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in the outcome of this inspection visit is good; this judgement has been made using all available evidence including a visit to this service. Opportunities for personal development are provided, as are age, peer and culturally appropriate activities. Service users enjoy leisure activities and ongoing personal relationships. The rights and responsibilities of service users are recognised in their daily lives. The service users enjoy a healthy diet with choice in amenable surroundings and support where required. EVIDENCE: A sample of service users care plans and records were examined at this inspection and these contained evidence that opportunities for personal development are provided and enjoyed and that appropriate leisure activities are provided. The range of activities enjoyed were seen to be age, peer and culturally appropriate and the records showed that many of the activities take place in the local community thereby supporting service users to be part of their local community. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 12 Relationships with family members were seen to be well maintained by telephone communication and visits. A number of families who live nearby make regular visits and two residents are able to make visits (both day and staying visits) to their families with support from staff where appropriate for transport. Families and friends are invited to the home for parties and seasonal activities and are also regularly consulted by means of quality questionnaires for their views about the running of the home. Policies and procedures are in place to support service users to benefit from all relationships they have with their families and friends. The registered manager explained the staff induction programme and how staff training from this point on supports the ethos that the rights and responsibilities of service users is of the utmost importance. There were policies and procedures in place to further support this principle. The service user guide is regularly updated to aid service users to know their rights and responsibilities. The dietician visits regularly to supervise the menu planning and to monitor the service users’ weights. Service users are encouraged to assist staff with the weekly shopping for the home and to build on to these domestic skills were appropriate,. Fresh meat is purchased several times a week and vegetables similarly come from a local farm shop. Organic produce is purchased where possible and daily home cooking is a feature of the home. During the inspection service users were observed to be taking part with staff in food preparation. The registered manager explained that as service users try out any new dishes, notes are made of individual likes and dislikes and photographs are used to choose menus by those who need this support. Staff ate with the service users and the meal was taken at a leisurely pace and enjoyable atmosphere. Service users requiring assistance with eating their meal were assisted in a dignified and relaxed manner. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 18, 19 ,20 and 21 Quality in the outcome of this inspection visit is good; this judgement has been made using all available evidence including a visit to this service. Personal support is provided to service users according to their wished. The physical and emotional health needs of service users are met. Services users who are able are supported to retain and administer their own medication and protected to do so through the homes policies and procedures. EVIDENCE: Staff were observed to be providing personal support with dignity and respect and in accordance with the care plan for the individual. Emotional and physical needs are assessed and included in the care plans examined at this inspection; there was clear guidance for staff and planned in ‘talk time’, which provides for service users to be at the centre of their service. Specialist equipment to assist in the meeting of physical needs was in place and records showed regular servicing of the same. Service users who are able to manage their own medication are supported to do so with protocols in place to manage risks. Policies and procedures were in place and seen to be observed. Service users who need full support with medication are safeguarded by the policies and procedures in place and by staff training in medication. There were no gaps on the Medication Administration Records and medication was stored and rotated according to Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 14 guidelines. Medication that had been opened had been dated on the day of opening. Satisfactory policies and procedures are in place to guide staff in the ageing process of service users and in the event of a service users illness or death. Loss and bereavement training forms part of the staff training schedule. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 22 and 23 Quality in the outcome of this inspection visit is good; this judgement has been made using all available evidence including a visit to this service. Service users views are actively sought, listened to and acted upon. Services users are protected from abuse, self-harm or neglect. EVIDENCE: No complaints or concerns have been received by the CSCI or the home since the last inspection. Adult Protection training had been planned to take place in the week post inspection and was seen on the planner. A sample of service users finances was checked during this inspection and found to be accurate and records transparent. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in the outcome of this inspection visit is good; this judgement has been made using all available evidence including a visit to this service. The environment is homely, comfortable and safe and bedrooms promote independence and are personalised. Bathrooms and toilets provide privacy and meet individual needs. Specialist equipment is in place as appropriate to maximise independence. The home is clean and hygienic. EVIDENCE: The home was observed to be clean, hygienic and comfortable and the manager explained that the bathroom floor (ladies bathroom) will be refurbished during the next round of refurbishments as this is showing as ‘tired’. The home is bright with a very attractive entrance. The carpenter was busy making a low temperature fascia for a radiator which had been unguarded previously; this was the meeting of a requirement made at the last inspection. Specialist equipment was in place for service users requiring this, and the records showed that this was kept serviced. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 17 Service users rooms were personalised, promoting independence; they were seen to be well furnished clean and comfortable and the communal areas were in keeping with a normal domestic home in as far as possible. Risk assessments are carried out in respect of the environment and guidance is provided for staff. Fire safety measures were in place, including regular safety checks servicing, staff training and drills; these had been clearly recorded. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 18 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 32, 34 and 35 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, 32, 33, 34, 35 & 36 Quality in the outcome of this inspection visit is good; this judgement has been made using all available evidence including a visit to this service. The care staff team have the skills and competence to effectively support service users individually and jointly. The job description and induction training provide clarity of role, and recruitment is robust. The care staff team are supported and supervised. EVIDENCE: Clear Job descriptions are provided to staff in their handbook given at the commencement of employment; these provide clarity of staff roles and responsibilities; a copy is maintained in the office. All staff receive an adequate induction programme and there is a staff training programme for ongoing training. The staff were observed to be knowledgeable and were carrying out tasks in a responsible and effective manner and were happy to assist in the inspection process. Progress is being maintained with National Vocational Qualification programme for various staff members at varying levels from NVQ 2 - 4. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 19 A sample of staff files (newly recruited staff files were inspected) and these showed that recruitment practices are robust. The registered manager is provided with the outcome of CRB checks including the date and CRB number as these are obtained centrally. The registered manager provided evidence of how meticulously she conducts recruitment. Supervision is conducted monthly and staff stated that they feel supported and motivated by the one to one time set aside for them for this purpose. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 and 43 Quality in the outcome of this inspection visit is good; this judgement has been made using all available evidence including a visit to this service. The home is well-run and service users benefit from the homes ethos, leadership and management approach. Service users views underpin self-monitoring audits and developments made by the home. The service users rights and best interests are safeguarded through the homes policies and procedures. The health, safety and welfare of service users EVIDENCE: From examining various records in the home, some of which have been highlighted earlier in this report and from discussion with the staff and registered manager, the inspector was able to ascertain that the home is well run and that there is good leadership and a healthy ethos. The service users were obviously benefiting from the manner in which the home is run. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 21 Service users views (and those who advocate on their behalf, where appropriate) underpin self-monitoring and developments by the home; influencing the manner in which the home is managed and of outcomes. In various sections of this report evidence that adequate policies and procedures, with guidance for staff and staff supervision and training has been provided. There was ample evidence that policies and procedures are adhered to throughout this inspection. Adequate measures are taken by the management to ensure that service user and staff welfare and safety is promoted and protected. Service users were benefiting from competent and accountable management of the home and the evidence for this was gathered through discussions with service users and staff and through records and observation. Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 3 3 3 3 Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 23 33 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Clock Tower Mews DS0000019324.V288838.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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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