Care Home: Cloverdale

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What the care home does well People are able to visit the home before they decide whether to move in. This helps people to decide whether they like it.Each person has a care plan that sets out how staff should support them. This helps to ensure people receive the right support.People are supported to take part in activities they enjoy.People receive the medication they are prescribed when they need it. The medication is stored safely and staff have been trained in administering it.There are good systems to respond to complaints.The home is clean and well decorated. Staff are well trained. This gives them the skills they need to support people.The manager has a plan of how she wants to improve the service provided. What has improved since the last inspection? We did not make any requirements or recommendations following our last inspection. The conservatory has been cleared so people can now use it. What the care home could do better: Some of the plans about how staff should support people to manage risks need to be updated.The manager needs to make sure the records of people`s money are accurate and up to date. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cloverdale 95 Anstey Lane Alton Hampshire GU34 2NJ two star good service The quality rating for this care home is: 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: Craig Willis Date: 1 7 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (20092008) 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 Information about the care home Name of care home: Address: Cloverdale 95 Anstey Lane Alton Hampshire GU34 2NJ 01420544118 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) : Iliace Ltd care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: The maximum number of service users to be accommodated is 4. The registered person may provide the following category/ies 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). Date of last inspection A bit about the care home Cloverdale was registered in May 2000 and is one of a number of Homes owned by Iliace Limited, which is part of Independent Living Group (ILG). It is situated in a rural location close to the town of Alton with its range of leisure and shopping facilities. The Home has four bedrooms, a large lounge/diner, conservatory and a kitchen and laundry area. There is a garden to the rear of the property and a large driveway with provision for both the homes and visitors cars. The manager reported during the visit that the current range of fees for a place in the home is between 1349 and 1730 pounds per week. 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 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on 17 March 2009. During the visit we spoke with two people who live in the home and observed peoples interactions with staff. We spoke with the manager and staff on duty, looked at the shared rooms in the home and looked at some of the homes records. Before we visited the home we looked at all the information we have received since our last inspection. What the care home does well People are able to visit the home before they decide whether to move in. This helps people to decide whether they like it. Each person has a care plan that sets out how staff should support them. This helps to ensure people receive the right support. People are supported to take part in activities they enjoy. People receive the medication they are prescribed when they need it. The medication is stored safely and staff have been trained in administering it. There are good systems to respond to complaints. The home is clean and well decorated. Staff are well trained. This gives them the skills they need to support people. The manager has a plan of how she wants to improve the service provided. What has got better from the last inspection What the care home could do better Some of the plans about how staff should support people to manage risks need to be updated. The manager needs to make sure the records of peoples money are accurate and up to date. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Craig Willis The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 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 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. There are good systems to assess peoples needs before they move into the home. This reassures people that the home will be able to meet their needs. Evidence: The annual quality assurance assessment (AQAA) states that there is a comprehensive assessment procedure and a thorough assessment is completed with people before they are offered a place in the home. The manager reported that one person has moved into the home since the last inspection. The records of this person were inspected during the visit. These demonstrated that the person had lived in another ILG service and their needs assessment had been reviewed before they moved into Cloverdale. The assessment includes the persons health, medication, social skills, personal relationships and sexuality, academic skills, domestic skills, community skills, environment, rights and behaviour assessment report. Each area has goals and objectives. The person was supported to visit the home before deciding whether they wanted to move in. The AQAA states each person is provided with a statement of purpose and service users guide. These documents were not inspected on this occasion. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good care planning systems that involve people in making decisions about their lives and helps staff to provide the support that people need. Further information is needed in some of the risk assessment documents to ensure there are clear instructions about managing identified risks. Evidence: The records of two people who live in the home were inspected during the visit. Both people had care plans that set out how their assessed needs should be met. The plans included details about how people communicated decisions and the support they need during periods of agitation. Both of the plans seen had been regularly reviewed and amended where necessary. Two staff members were spoken with during the visit. Both said they received good information about peoples needs and how to meet them. During the visit staff were observed supporting people to make decisions about the activities they took part in and what to have for lunch. Both of the records inspected contained a set of risk assessments. These included challenging behaviour, travelling in vehicles, fire safety and risks from medical conditions. The assessment for one person travelling in a car refers to not going in the car for long trips without support, however, it is not clear what constitutes a long trip or what support is needed. The manager reported that she is in the process of reviewing all of the risk assessments and has not yet completed the review for this person. The manager agreed that more detailed information was needed for this person and said she would ensure this is put in place. 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 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 for people to take part in a range of activities, to maintain contact with family and friends and to provide a healthy diet. Evidence: Each person has an individual programme of activities including trampolining, college courses, music, cycling, arts and crafts and using an outdoor activities centre. Two people who live in the home were spoken with during the visit and both indicated they enjoyed the activities in their programme. The home has a car that is used to transport people to their activities. People are supported to maintain contact with family and friends, with staff providing support for people to visit family where necessary. The home has a menu that is planned each week by people who live in the home with staff support to provide a balanced diet. The menus are displayed in a pictorial format to aid understanding and plan shopping. The kitchen was well stocked and alternative meals are available if people do not like what is on the menu. Mealtimes are flexible to fit round activities and snacks are available at all times. 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. Peoples personal and health care is well met by staff who know their needs and there are good systems to safely store and administer peoples medication. Evidence: Care plans contain details of the personal care people need and how it should be provided. Both of the people who live in the home that were spoken with during the visit indicated that staff treat them well. Staff spoken with demonstrated a good understanding of peoples needs and how support should be provided. People are supported to attend a range of health services, including GP, community nurse, psychiatrist and podiatrist. Concern was expressed at a safeguarding meeting that one person had not been supported to attend a hydrotherapy session. The manager reported that this had been due to a shortage of staff who were able to drive, which has now been addressed. Medication is stored in a locked cabinet in the office and most tablets are supplied in blister packs to make them easier to administer. A record is kept of medication coming into the home, administered to people and returned to the pharmacist for disposal. The medication administration record for the current month was inspected during the visit and had been fully completed. Where people have been prescribed medication to be taken as required there are guidelines in place stating under what circumstances the medication should be administered. The manager reported that none of the people living in the home are currently able to administer their own medication. 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 home has systems to deal with complaints and respond to allegations of abuse and has taken good action where these systems were not being followed by all staff. This will give people confidence that any complaints will be taken seriously and responded to. Evidence: The home has a complaints procedure that is provided to all people living in the home in symbol format. The manager reported that she plans to produce the procedure in Makaton symbols as well as this is a preferred format for some people who live in the home. The home has received two complaints in the last year. One was from a staff member concerned about the actions of a bank staff member. The manager investigated this and as a result the bank staff member is no longer used by the home. The other complaint was from a family member concerned about clothes becoming discoloured in the laundry. The manager has taken action to prevent a recurrence of the issue and informed the family member. Records were available of both of these complaints, however they were not recorded in a complaints log. The manager reported that the company has recently introduced an electronic complaints log that will track the response to all complaints. There have been two incidents dealt with by adult services under the safeguarding procedures. One incident concerned the failure of staff to provide adequate supervision and support in the home in September 2008 that resulted in a possible assault of one service user by another. As a result of these concerns action was taken against staff under the companys disciplinary procedures and additional staffing was provided. Adult services closed this safeguarding case in November 2008. The second safeguarding case concerns assaults between service users that happened in November and December 2008. Concerns were raised in the safeguarding meetings that there had been a delay in reporting incidents to adult services. The manager reported that the incident had occurred at a time she was off work and staff had waited until her return to report the incident rather than use the on-call manager within the company. This safeguarding case is still being dealt with by adult services. Staff have received further instruction about their responsibility to report incidents of Evidence: possible abuse immediately and the procedures to follow if the manager is not available. Two staff were spoken with during the visit. Both demonstrated a good understanding of the safeguarding procedures and action to take if abuse is reported, witnessed or suspected. Seven of the eight permanent and regular bank staff have completed the safeguarding training and one new member of staff is booked to complete the training in April 2009. The money of two people that the home holds for safekeeping was checked during the visit. Records were available of expenditure and receipt had been kept. The money held was correct for one person but there was approximately eight pounds missing for the other person. The manager reported on the day following the visit that this missing money was due to an administrative error which had been corrected. The manager reported that the company was about to introduce a new accounting procedure for peoples money which should reduce such errors. 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 home is well maintained and provides a clean, comfortable and safe environment for people. Evidence: All of the homes communal areas were viewed during the visit. The home is well maintained, with good quality domestic furniture and fittings. People living in the home have access to a lounge, kitchen and conservatory. Since the last inspection the conservatory has been cleared so people can use it. Staff spoken with reported that maintenance is completed quickly. The home has a utility area off the kitchen that has a washing machine capable of washing soiled clothing. There are infection control procedures in place, with soiled clothing being carried to the machines in soluble bags that go straight into the machine and procedures that no washing is taken through the kitchen whilst food is being prepared or eaten. Hand washing sinks are suitably situated in the kitchen, utility, toilets and bathrooms. 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. Staff are well trained and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs. Evidence: The manager reported that four of the eight permanent and regular bank staff have achieved the National Vocational Qualification at level 3. During the visit staff were observed interacting with people in a friendly and respectful manner and responding to requests for support. As a result of the concerns raised in the safeguarding cases the manager has provided and additional 12 hours staffing each day. This means there are now two staff between 7.30am and 3pm, one between 8am and 3pm, two between 2.30pm and 10pm, one between 3pm and 8pm and one between 9.30pm and 8am. Staff spoken with said they felt this staffing level was sufficient to meet peoples needs. The manager reported in the annual quality assurance assessment that all staff who have worked in the home over the last year have has satisfactory pre-employment checks. We inspected the files of two members of staff recruited in the last year. Both had written references, confirmation that an enhanced Criminal Records Bureau disclosure had been obtained and confirmation that the person was not on the protection of vulnerable adults list as unsuitable to work in a care home. The home has an on-going training programme and staff reported they receive good training that helps them meet peoples needs. Staff training records indicated people had completed an induction and courses including medication administration, first aid, safeguarding, food hygiene, crisis prevention and intervention, moving and handling, fire safety and Makaton sign language. 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. The home has good management systems and action has been taken to resolve shortfalls in the service and plan further improvements. Evidence: The manager has been in post for approximately four months. Prior to this there have been a number of acting managers since the previous manager took a period of extended leave and subsequently resigned. The manager has completed the Registered Managers Award and the National Vocational Qualification in care at level 4. The manager has worked in services for people with mental health needs and older people and reported that she has submitted an application for registration to us. Staff spoken with said they felt well supported by the manager. The company has a compliance department, whose staff visit the home each month to asses the quality of the service being provided. Reports of these visits are made and contain actions that are required to improve the service provided. Regular surveys of people who live in the home, family members and staff are completed to gain feedback about how the service is operating. The results of feedback are used to develop an annual development plan, however the current one for the home is out of date. The manager reported that she had prioritised completing a new plan from the feedback she has received. This was also seen to be one of the actions from the most recent report from the compliance team. Records of the servicing and testing of the fire alarm, fire fighting equipment, gas and electrical systems were inspected. All were up to date except the gas system testing, which was approximately a month out of date. The company has a contract for this work to be completed and the manager showed us records of her contact with this company to chase up the late test. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description 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 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. 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