Inspection on 04/12/08 for The Clockhouse

This inspection was carried out on 4th December 2008.

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

The Clockhouse 19/04/07

The Clockhouse 28/10/05

The Clockhouse 17/05/05

The Clockhouse 01/11/04

The Clockhouse 23/09/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Clockhouse 12 Shrewsbury Road Redhill Surrey RH1 6BH     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: Mary Williamson     Date: 0 4 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 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 Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: The Clockhouse 12 Shrewsbury Road Redhill Surrey RH1 6BH 01737773851 N/A mwaitling@rnib-redhill.ac.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : RNIB care home 6 Number of places (if applicable): Under 65 Over 65 0 0 0 learning disability physical disability sensory impairment Additional conditions: 6 6 6 The maximum number of service users to be accommodated is 6. The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Physical Disability (PD) Sensory impairment (SI) Date of last inspection Brief description of the care home 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 Care Homes for Adults (18-65 years) Page 4 of 26 Brief description of the care home garden that is accessible by both steps and a ramp. The fees charged range from £60,634 to £78,245 per year. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was the first site visit of a key inspection and was unannounced. The inspection was undertaken by Mary Williamson Regulation Inspector over a period of three and a half hours. The home was represented by the staff on duty, and the integrated service manager who was present for part of the inspection. It was possible to meet five of the six residnets living in the home and to gain some feedback and comments about their experiences of living in the home. The athmosphere was relaxed, and individual and group discussions were able to take place. Four of the residents are new to the home since the last inspection and it was good to note their positive experiences since living there. Care Homes for Adults (18-65 years) Page 6 of 26 A tour of the premises was undertaken and records relating to the care of the residents and the management of the home were seen. There was also the opportunity to sit with residnets during lunch and hear how they are supported to plan their own menus, do their food shopping and prepare their meals. Discussion took place with senior management regarding the management arrangements in the home. The Commission for Social Care Inspection would like to thank the residents and staff for their help and hospitality during this inspection. What the care home does well: What has improved since the last inspection? What they could do better: 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 Adults (18-65 years) Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have access to sufficient information in order that they can make an informed choice about living in the home. Pre admission needs assessmnets are undertaken to determine if assessed needs can be met. Contracts of occupancy are in place. Evidence: The home has a statement of purpose and residents information guide in place which is available to all the residents in the home. This is explained to residents so they are aware of what the home has got to offer. This document is also available in symbol format, audio format and Braille if required. Four of the six residents living in the home since the last inspection have progressed to supported living, and there have been four new admissions to the home since then. It was possible to discuss the admission procedure with residents. Each prospective residentet has a full needs assessmnet undertaken with contribution from the multidisciplinary team to establish if the home can meet individual specific needs. It was good to observe a review of care needs taking place during the Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: afternoon of the inspection. Trial visits are offered to enable residents to get to know eachother and the layout of the house. Contracts of occupancy are in place between the RNIB and the resident, and outline the type of accommodation offered, the level of support, and the activity available at the hub which was formally the RNIB College. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Well maintained care plans outline in detail the level and type of suppore residents require to meet their daily needs. Staff encourage residents to make decisions regarding their daily lives, and assess the associated risks. Evidence: Care plans were seen for the new residents admitted to the home since the last inspection. These are well wriitten with full input from residents, and all the information gathered from the needs assessment. Care plans are reviewed regularly and one resident was looking forward to her review which was taking place on the afternoon of the inspection. Residents have access to their care plans. Risk assessments are in place for all identified risks and do not restrict independence in any way. These include assessments for accessing the community, using public transport, self medication, and undertaking various activities within the home and when attending the hub. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Residents have a choice and make decisions regarding all aspects of their daily lives. Some of these decisions are incorporated into their care plans regarding personal needs. House meetings are facilitated when residents decide on a menu plan, and when they will shop for food. They also discuss routines and arrangements for the week for example thire laundry days, cleaning arrangements, evening activities, and their communal meal on Sundays. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activity arrangements meet the individual and collective needs of the residents. Family links are maintained and community participation is encouraged. The nutritional needs of the residents are met. Evidence: Individual activity programmes are included in care plans. These have been agreed with individual residents and meet their needs. Structured activities are offered in the hub, which was formally the RNIB college. These include music, drama, book club, yoga, life skills, horse riding, cooking and swimming. Home staff support residents to access community facilities and residents stated that they like to go shopping, go to the cinema, bowling, swimming, and trips out. Residents are encouraged to use public transport and a local taxi company is used to transport residents from home to the hub. Staff and residents stated that they would like the home to have its own Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: transport for convenience. One resident attends a local church on Sunday mornings. The residents informed the inspector that they had a lovely holiday in Blackpool earlier this year. Family links are maintained and relatives and friends are welcome in the home at any reasonable time. Relatives are allso encouraged to attend reviews of care and to attend home and hub events. All the residents are going home for Christmas and the New Year when the home will close. Staff support residnets to follow a healthy eating plan while promoting their insependence. Residents meet weekly to discuss their menu for the week and arrange when they will go shopping for food. All residents are encourage to prepare their own food. The kitchen has been adapted to met their needs for example there is a talking microwave provided. When residents attend activities they make their own packed lunch. Two residents stated that they look forward to eating a Sunday lunch together every week. Food hygiene is observed and all the staff have a food hygiene certificate. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides good support to residents to ensure that all their personal, and health care needs are met. The medication policy in place protects the residents living in the home. Evidence: Personal care is undertaken as outlined in agreed care plans. This is undertaken in a way residents prefer, maintaining privacy and dignity. Whenever possible residents have some choice regarding the staff who work with them promoting independence and diversity. Appropriate arrangements are in place to meet the health care needs of residents. They are all registered with a local GP and can visit the surgery when necessary. A resident had been to see his doctor the morning of the inspection and stated that he liked visiting him. Dental care is provided by an NHS dentist in Reigate. Chiropody is provided by a domiciliary practicioner and eye care is provided by specialists according to individual needs. Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: The home has a medication policy in place and all staff who administer medication undertake medication safety training. There are audits of medication undetaken monthly and when residnets go home or on holiday. The medication charts(MAR charts) are well maintained. Risk assessmnets are in place for residents who self medicate. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure and safeguarding awareness procedure in place protect residents living in the home. Evidence: The home has a complaints procedure in place. This forms part of the residents information pack and is kept in individual bedrooms. It can be provided in symbol, audio, or Braille format according to residents choice. There have been no complaints since the last inspection. Staff explained that views and concerns are discussed at weekly meetings and a resident confirmed that he was aware of how to make a complaint. The home has a safeguarding vulnerable adults procedure in place. The training coordinator ensures that all staff undertake this training on commencement of employment and that this is updated at regular intervals. There is a copy of Surreys Multi Agencies Policies and Procedures on Safeguarding Vulnerable Adults in place and help line numbers available to residents. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The 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 en-suite arranged over two floors. Two bedrooms on the ground floor have been adapted to meet assessed mobility needs. Staff support residents to personalise their bedrooms, including electronic games, and CD players. Keys are provided on request. The communal areas of the home include a large well furnished lounge and dining area which is part of an open plan well equipped kitchen. This is homely and meets the needs of the residents. There is a ramp access to a courtyard style garden, which is well furnished with garden furniture during the summner months. The utility/laundry room is suitable to meet the homes requiremnets. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are supported by a competent and well trained team of staff in sufficient numbers to meet their assessed needs. Residents are protected by the corporate recruitment procedure in place. Evidence: On the day of the inspection the residents were being supported by two permanent staff members who had a very good understanding of the residents needs. There was also an agency staff on duty who was familar with the home having worked there on a regular basis. The home was functioning very well and there was positive and confident interaction between staff and residents. The home follows the corporate recruitment policy. The service manager explained that there is always a resident on the interview panal, and that all the required checks for example written references, CRB disclosures, and employment history are in place prior to employment. It was not possible to sample staff files on this occasion as the keys to the filling cabinet were not available. These were seen at the last inspection and were satisfactory. The training coordinator for the organisation oversees staff training. All staff undertake Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: induction training and are assessed as competent prior to being awarded with a certificate. The carer in charge had achieved her NVQ level 3. Currently there are two staff undertaking NVQ level 2, and more staff enrolling for this course in the new year. The intiegrated service manager also undertakes the formal supervision of staff in the home as an interim measure and retaines recorde for information. This is undertaken monthly to support staff in the abscence of the home manager. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home. The health, safety, and welfare of residents and staff are observed, promoted, and protected. Evidence: On the day of the inspection the home was being managerd efficiently by a senior support carer. She participated in the inspection in a professional and helpful manner. Currently the registered manager is on indefinate sick leave and the deputy manager was also off sick. The Integrated Service Manager was present for part of the inspection and explained that the organisation was interviewing a relief manager the following day recruited from an agency to manage the home in the interim. CSCI have now been informed in writing that this appointment has taken place, and thet there is also sufficient senior management input to ensure the smooth and safe running of the home. Systems are in place to monitor quality assurance. Monthly regulation 26 visits are undertaken and reports retained in the home for information. It was advised that the Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: last three reports shoule be retained in print copy for inspection. Bi-monthly development visits are undertaken by the Integrated Service Manager and action plans formulated when necessary. Questionnaires are sent to residents, relatives, and other health care professionals for comment and feedback presented on parents day. Health, safety, and welfare of the residents and satff are promoted for best practice and a safe working environment. There is a wide range of health and safety policies and procedures in place and staff are made aware of these during induction training. Risk assessmnets are in place for all identified risks. These are reviewed frequently and updated when required. All COSHH procedures are observed and chemicles are identified in Braille. Fire safety is observed and a risk assessmnet in place. Accident and incidents are reported and recorded satisfactory. Care Homes for Adults (18-65 years) Page 23 of 26 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 Adults (18-65 years) Page 24 of 26 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 1 37 It is recommended that the integrated service manager informs CSCI monthly of the management arrangements in the home. This may follow the regulation 26 viist. Care Homes for Adults (18-65 years) Page 25 of 26 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 Adults (18-65 years) Page 26 of 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!