Inspection on 19/04/07 for The Clockhouse

This inspection was carried out on 19th April 2007.

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

The Clockhouse 04/12/08

The Clockhouse 28/10/05

The Clockhouse 17/05/05

The Clockhouse 01/11/04

The Clockhouse 23/09/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Sutton Lodge Nursing Home

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Shrewsbury Road (12) The Clockhouse 12 Shrewsbury Road Redhill Surrey RH1 6BH Lead Inspector Mary Williamson Unannounced Inspection 19th April 2007 11:00 Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 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 Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 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. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shrewsbury Road (12) Address The Clockhouse 12 Shrewsbury Road Redhill Surrey RH1 6BH 01737 773851 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) RNIB Position Vacant Care Home 6 Category(ies) of Learning disability (6), Physical disability (3), registration, with number Sensory impairment (6) of places Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th October 2005 Brief Description of the Service: 12 Shrewsbury Road is a Residential Home that is served by The Royal Institute for the Blind, and caters for the individual needs of six residents with sensory impairment, physical disability, and learning disability. The home is a detached, three story building situated within the community of Redhill. The unit offers accommodation for up to six residents. All the bedrooms are en-suite. Two of the bedrooms are situated on the ground floor level and are fully adapted for residents who have a physical disability. There is a large kitchen, utility room, and a living room. All these rooms are adapted to meet the needs of the residents. To the rear of the home is a small patio sensory garden that is accessible by both steps and a ramp. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first site visit of a key inspection and was unannounced. The inspection took place over three and a half hours. Mary Williamson who is a Regulation Inspector carried out the inspection. The acting deputy manager represented the service for part of the inspection. The people living at 12 Shrewsbury Road like to be called residence and are therefore referred to as residence throughout this report. A considerable part of the inspection was spent talking with the residents in the garden who were very enthusiastic about sharing their experience of living in the home. A tour of the premises was undertaken and records relating to the care of the residents and the management of the home were examined. An acting manager and an acting deputy manager currently manage the home. The acting manager was on leave and the acting deputy manager was off duty but came in for part of the inspection. The RNIB is currently undergoing restructure with the closure of the college as an educational establishment and the deregistration of three of the homes on the campus site. This will result in staff being redeployed in some the organisation’s residential settings. The CSCI have attended several senior management meetings in the college over the past eighteen months to provide support and input regarding the closure of the college and registered homes. It was also agreed to support the organisation until staff have been redeployed. It is anticipated that a permanent manage and deputy manager will be in post following this restructure. The Commission for Social Care Inspection would like to thank the residents and staff for their help and hospitality during this inspection. What the service does well: The whole staff team are committed to providing good quality care and support for the residents who live in the home. Residents are encouraged to participate in the daily running of the home and their views are sought and acted upon to promote independence. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 6 The home offers a good standard of accommodation, which is well maintained and homely. Resident’s bedrooms promote privacy and individuality. The staff have training specific to the job they do including visual awareness and sighted guide. All staff undertake induction and foundation training. 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. The summary of this inspection report can be made available in other formats on request. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 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 Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have sufficient information available to help them make an informed choice about where they live. Needs assessments and contracts of occupancy are in place. EVIDENCE: There is a statement of purpose and service user guide in place and all the residents have a copy of this, which is available in symbol format. This can be made available in Braille format if requested. The group of residents living at Shrewsbury Road have been there for several years. There has only been one admission since the last inspection. Needs assessments were sampled and these are informative and well maintained. Terms and conditions of occupancy are in place and outline in detail the breakdown of fees charged, which include care provided, accommodation offered and the various activities offered on the college campus. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individual care plans outline the level on care and support required. Staff encourage residents to make decisions regarding every day life and assess the risks involved. EVIDENCE: Three care plans were randomly sampled and are well maintained. These care plans are well written with input from residents in a format they can understand. For example these can be made into CD or tape format if required. Two residents stated that they were aware of their care plans and the content. Residents have a copy of their care plan in their bedrooms. These are reviewed every month in house and six monthly by the multidisciplinary team. One resident was looking forward to his review the following day, and was going to make biscuits for all those attending. Residents make decisions and choice in all aspects of their daily life. They choose individual activities to include a daily menu plan, and when and where they will shop for food to implement that. They also have input in choosing their college activities. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 10 House meetings take place every Friday when residents can decide their activities and routines for the coming week, for example cooking arrangements, cleaning arrangements, shopping rotas, laundry days, and evening activities. A member of staff was observed helping a service user plan a shopping list for a shopping trip that afternoon. Risk assessments in place do not restrict residents from participation and aiming to achieve their personal goals. One resident stated that he plans his trips to town so he can walk there and get a taxi home. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. An individual activities and development programme is in place for each resident meets their assessed needs. Community links are accessed and family links are maintained. The catering arrangements in the home suit resident’s needs and lifestyle. EVIDENCE: The residents attend the local RNIB College to further their personal development. This is planned on an individual assessment of needs and provided on a sessional basis. Two residents returned to the home at midday having had work experience in the local law courts, helping in the coffee shop. Four residents sat in the garden with the inspector and gave a good account of their experience about how they spend their leisure time. Trips to the pub are very popular and there is a pup club organised every Friday for lunch. One resident said they liked swimming and had a preference for the pool with the wave machine as he can walk into this as opposed to using steps or jumping into the water. Other activities include shopping for music and clothes, going to the leisure complex, eating out, and going on organised trips when the staff Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 12 book one of the cars provided by the college. Two residents had been to see Southampton play football on Easter Monday and stated that they regularly go to football matches, and like to watch major sports on television. Holidays are arranged and service users stated that they have started to talk about ideas for this year’s choice and location. Meals are planned individually. Staff support residents to plan a weekly menu and money is allocated individually to budget for this. The menu plan is flexible to allow residents to either cook a main meal at lunch- time on their days off or in the evening to accommodate their time- table of activity. Varying degrees of staff input is available and the kitchen is also equipped with a talking microwave, liquid level indicator, talking scales, and wide knives to aid spreading. Risk assessments are in place to encourage all kitchen activities. There is nutritional advice and assessment available if required. Residents stated that they plan a communal Sunday lunch during their weekly house meetings, which can include choices from a roast dinner to a BBQ. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides appropriate support to residents to ensure that all their health and personal care needs are met. The medication procedure in place protects residents. EVIDENCE: The deputy manager explained that flexible and sensitive support is offered to residents in a manner that promotes their independence, privacy and dignity. This is carefully outlined in individual care plans. All the residents are registered with a local GP. One service user stated that he liked going to see his doctor. Yearly medical health checks take place but residents see their GP whenever necessary. Dental care is provided by a dental practice in Reigate and the chiropodist visits the home regularly. There is also a nurse on campus who will provide support on request. Arrangements are in place to access specialist care for example one resident attends Moorefield’s Eye Hospital and another has regular appointments with the eye specialist. The home has a policy in place for the administration of medication. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 14 All staff who are responsible for the administration of medication receive training in safe medication practices. The medication recording charts are well maintained and there is an audit of all medication entering and leaving the home. There is are risk assessments in place for residents that self medicates. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure and the abuse awareness procedures in the home protect the residents living there. EVIDENCE: The home has a complaints procedure in place and this is available to all the residents in their information packs, which is part of their care plans. Residents stated that they were aware of this procedure and would be able to make a complaint if they had to. There have been no complaints since the last inspection. There is an abuse awareness policy in place and all staff receive training in this policy during their induction training. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28, and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing residents with comfortable, clean and homely accommodation to live in. EVIDENCE: The home is clean and comfortable and accessible to all residents. Individual bedrooms are single and en-suite. They have been decorated and furnished to a high standard. Staff support residents to personalise their bedrooms. The communal areas of the home include a large well-furnished lounge where residents sit to watch television. There is also a dining area, which forms part of a large well- equipped kitchen. There is ramp access to a well-maintained courtyard type garden, well furnished with garden furniture. The utility/laundry is suitable to meet the home’s requirements. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 34, and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A competent staff team, in sufficient numbers to meet individual needs, supports residents. EVIDENCE: On the day of the inspection residents were being supported by one permanent member of care staff, one bank staff and one agency staff member both of whom work regular shifts. The home was functioning well and there was positive and confident interaction between staff and residents. The recruitment procedure in place is part of the corporate recruitment procedure for the RNIB. It is robust and protects residents living in the home. Staff employment files were randomly sampled. These are well maintained and include written references, employment history and a CRB (Criminal Records Bureau) disclosure number. All the staff undertake induction training in line with best practice. Foundation training follows this. Currently there are two staff undertaking NVQ level 3 due to complete this in July 2007. One staff member has completed NVQ level 2 and another has NVQ level 3. The RNIB is very committed to the training and development of staff. Individual training and development plans are in place Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 18 for all staff. It was noted that all staff undertake visual awareness and sighted guide training, specific to resident’s needs. Bank staff and agency staff are also inducted in mandatory training for example manual handling, fire safety, food hygiene, and COSHH. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well run home. The health welfare, and safety of service users is promoted and protected. EVIDENCE: The home is currently without a registered manager due to the promotion within the organisation of the previous manager. On the day of the inspection the acting manager was on leave and the acting deputy manager was off duty but came into the home for part of the inspection. This home has always been well managed and the current management arrangements continue to create an open and inclusive atmosphere. The residents spoke of the management support within the home with confidence although feel very unsettled about the future plans for the RNIB College and staff that support them there. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 20 Quality assurance is measured during house meetings where residents have to opportunity to air their views, and by Regulation 26 visits. There is regular contact with relatives who also provide feedback on the care provided in the home. The RNIB are currently working on a quality assurance questionnaire for distribution soon. Health and safety policies and procedures are in place, some of which were seen throughout the inspection. Risk assessments are in place for all identified risks and promote safe working practice. The acting deputy manager stated that all staff undertake health and safety training as part of their induction training. All COSHH procedures are observed and chemicals are also identified in Braille. Fire safety policies and procedures are followed, records well maintained, and fire-fighting equipment maintained regularly. Accidents and incidents records were observed to be satisfactory. Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 21 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 X 4 X 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 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 3 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 22 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 Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House, 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU National Enquiry Line: 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 © 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 Shrewsbury Road (12) DS0000052005.V333192.R01.S.doc Version 5.2 Page 24 - 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. 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