Random inspection report
Care homes for older people
Name: Address: Tyspane Nursing Home Lower Park Road Braunton North Devon EX33 2LH two star good service 28/05/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Joanne Walsh Date: 2 5 0 1 2 0 1 0 Information about the care home
Name of care home: Address: Tyspane Nursing Home Lower Park Road Braunton North Devon EX33 2LH 01271816600 01271818302 tyspane@barchester.com www.barchester.com/oulton Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Susan Dawn Rowland Ms Martine Rosemary Tarakaniec Type of registration: Number of places registered: Conditions of registration: Category(ies) : Barchester Healthcare Homes Ltd care home 69 Number of places (if applicable): Under 65 Over 65 58 0 old age, not falling within any other category physical disability Conditions of registration: 0 11 As at the 16 October 2003 the home accommodated 58 service users with the service user category of OP which is 6 over the current maximum registered number for this category of service users. The National Care Standards Commission and future successor regulatory bodies will not seek to enforce the breach of this condition of registration subject to the registered provider using his best endeavours to achieve the transition within one year and not admitting any new service users in contravention of the conditions contained in this certificate of registration Notice of Proposal to Grant Registration for staffing/environmental conditions of registration issued 19/6/2000
Care Homes for Older People Page 2 of 9 That 11 places are provided for service users with a physical disability. That all service users who were accommodated with the service user category of PD as at 16 October 2003 who do not have a bedroom within the new designated wing will be offered a room when one becomes available before the room can be offered to any new potential service users. That all service users who were accommodated with the service user category OP as at 16 October 2003 who do not have a bedroom outside the new designated wing will be offered a similar room when one becomes available before the room can be offered to any new potential service users. That from 16 October 2003 when a room becomes available in the new designated wing it can only be occupied by a person who falls within the service user category of physical disability (PD) and when a room becomes available within the remainder of the establishment then it can only be occupied by a service user falling within the category of service users, old age, not falling within any other category (OP). The total number of service users shall not exceed 69 in total. Date of last inspection Brief description of the care home Tyspane Nursing Home is registered for 69 residents who may need nursing care, within the categories of old age (58 beds), and physical disability (11 beds for adults below retirement age i.e. Adults 18-65). The home does not offer intermediate care, and there are smoking restrictions. It is a purpose-built, two-storey home, in a residential area of Braunton. It is relatively near the town centre facilities (including shops, a library, and public houses) and coastal areas. There is a regular bus service to the larger town of Barnstaple. The home has its own transport. Most bedrooms are for single occupancy only, and all have en suite facilities. Three rooms can be used as double rooms if requested. There are two lifts giving access to all areas of the home. There is a large lawned area with some seating at the front of the home, with other paved or grassed areas and car parking areas elsewhere around the home. Barchester Healthcare Homes Limited owns the home. Weekly fees can be obtained from the home. They do not include the cost of theatre outings (a contribution is requested), taxis/transport, magazines/newspapers, toiletries, sweets, stationery (which are all charged at cost price), hairdressing for men and women, chiropody, and visitors meals. Inspection reports produced by the Commission about the home are kept at the reception, in the homes entrance hall. 2 8 0 5 2 0 0 9 Care Homes for Older People Page 3 of 9 What we found:
We completed this random inspection during the hours of 5pm until 9pm on the evening of 25th January. We wanted to check on staffing levels and that individuals needs could be met in a timely fashion during this busy tea time period. The reason we wanted to specifically look at this is because we had received information that indicated that needs may not being met in a timely fashion during this time period. We also wanted to check how well the service had responded to a complaint from the family of a person who had lived at the home. We spent time observing the tea time period and looked at the individual records of three people including the person whose family have been unhappy with the care provided at Tyspane. We also spent time talking to some individuals who live at the home and to staff on duty. The manager and deputy manager, two nurses and three care staff were spoken to during this inspection. We have also received surveys as part of our information gathering. To date we have had received 10 surveys from people who live at the home, 2 from relatives, 7 from staff and 2 from health and social care professionals who know the service. Overall their comments are extremely positive and helped us to make a judgment about the quality outcomes for people who live at Tyspane. In answer to the question do you receive the care and support you need? nine people ticked usually and one always. In answer to the question are staff available when you need them? eight ticked usually and two said always. No one had answered sometimes, never or dont know. Comments to the question what does the home do well included meals and mealtimes, everything as far as I am concerned. The home is well run, clean and the facilities varied and stimulating Physio, keeping us occupied, no time to brood, I am well happy here. Looked after well, couldnt do better. There were no negative comments although one person did say they would like to be enabled to get up earlier than they are. Relative surveys were also complimentary, one commented They keep my relative safe, comfortable and happy. Because they know him well they spot any changes very quickly and prevent small problems becoming serious. One relative did say they would welcome a cup of tea when they visit. The surveys from health and social care professionals included the following comments The home gives individualised care, promotes a homely environment. Since the new manager has started the atmosphere in the home has improved significantly, her motivation and determination are astounding and this has such a positive impact on the staff and residents. We found that plans of care generally gave good information about peoples needs and how these should be met. We saw examples of where staff had listened to families concerns and made referrals to speech and language therapist, given further
Care Homes for Older People Page 4 of 9 physiotherapist input and sought advice from the clinical lead in continence. We saw that risks had been identified, but that the homes own risk proforma was not always completed. One person for example had clear risks in respect of choking but this was not included in the risk assessment form. We saw that one persons plan identified that they had a sacral pressure area and the plan included what staff should do in the care of this. When we spoke to staff we found that in fact the sacral area was now heeled. The plan of care had not been updated to reflect this. In another plan of care we found that there was some slightly confusing information about their fluid intake. In speaking to staff who care for the person, they were aware of what regime was in place and could describe the persons needs and what should be done for them well. The plan of care needs to be updated to reflect this. We saw that there were sufficient staff available throughout the teatime period. Individuals who needed support to eat their meals were given this in a kind and respectful way. The tea time meal was relaxed and unhurried and we did not encounter call bells not being answered within a reasonable time frame. Individuals we spoke to said that staff were kind and helpful and the surveys returned would also support this view. One person said You can always do with more staff but they are very good. Staff that we spoke to said that in the past there has been times when they thought they were short staffed especially when people phone in sick at the weekends, but that overall staffing levels were currently good. We looked at the staffing rotas for January and saw that sufficient staff were rostered to be on duty to meet the needs of the current people at the home. The manager and deputy discussed with us the fact that they have listened to individuals and staff and have now included twilight shifts to cover the more busy periods and this appeared to be working well. They have also tried hard to address absenteeism with staff, and they believe this has worked to good effect. We have asked the home to make further inquiries concerning their own complaint investigations and we will be writing to them separately about this issue. What the care home does well: What they could do better:
Care Homes for Older People Page 5 of 9 Plans of care need to be constantly updated to reflect the changing needs of the individuals. Where plans are reviewed the reviewer needs to ensure they comment on any changes made, so that staff can refer to these changes quickly. 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 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, 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 7 Plans of care should be updated and reviewed as necessary to reflect the changing needs of individuals. Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 9 of 9 - 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!
