Inspection on 10/01/06 for 1 & 2 Turnbull Place

This inspection was carried out on 10th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

1 & 2 Turnbull Place 10/08/07

1 & 2 Turnbull Place 20/06/06

1 & 2 Turnbull Place 01/10/04

1 & 2 Turnbull Place 23/04/04

1 & 2 Turnbull Place 11/03/03

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Thorndene

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33 St John`s Church Road

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE 1 & 2 Turnbull Place Riding Lane Hildenborough Tonbridge Kent TN11 9LN Lead Inspector Paul Stibbons Announced Inspection 10th January 2006 10:00 X10029.doc Version 1.40 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 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 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 Older People and 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. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 1 & 2 Turnbull Place Address Riding Lane Hildenborough Tonbridge Kent TN11 9LN 01732 838876 01732 838876 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) The Avenues Trust Limited Mrs Bridie Patricia Chapman Care Home 5 Category(ies) of Learning disability over 65 years of age (5) registration, with number of places 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users from the minium age of 60 years may be accepted for the existing category of registration 24th June 2005 Date of last inspection Brief Description of the Service: 1 and 2 Turnbull Place is a care home providing personal care and accommodation for 5 Adults with learning disabilities over the age of 60 years. The home is owned by The Avenues Trust Ltd who have a number of care homes in the south east. The home is located in a country lane approx 1 mile from the village of Hildenborough where there are shops, a church and bus services to Tonbridge and Sevenoaks towns. The home consists of two bungalows on the same site and the Registered manager is responsible for both units. The home has access to their own vehicle and there is room for several cars to park off road. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Regulatory inspector Paul Stibbons conducted this announced inspection from 1000 hrs until 1300 hrs on the 10th January 2006. Six comment cards from relatives and the pre-inspection questionnaire were received by the CSCI prior to the visit. A tour of the buildings and grounds were carried out and a variety of documents and records were examined. The home manager was present and four service users and three members of staff were spoken with. What the service does well: What has improved since the last inspection? What they could do better: There is an outstanding requirement from previous inspections to make outside areas safe for use by service users’. The patio slabs between bungalows is very uneven and dangerous to people with mobility problems. Risk assessments in place restrict service users from using patio areas unsupervised. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 6 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. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 6 Service users are provided with sufficient information to be able to make an informed choice on whether the home will meet their needs and acceptance of the contract detailing terms and conditions. EVIDENCE: Individual plans viewed evidenced comprehensive assessments of service user needs. Prospective service users are provided with a summary of the homes Statement of purpose and a Service users’ guide details routines and facilities. Service user guides viewed contained individual contracts stating terms and conditions. The home does not accept referrals solely for intermediate care. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service Users, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards to be inspected at least once during a 12 month period JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 There is a clear and consistent care planning system in place that provides staff with the information they need to meet the needs of service users. They are unable to administer their own medication and are supported by staff who have undergone competence based training. They are treated with respect and their right to confidentiality is upheld. EVIDENCE: Care plans viewed were comprehensive and easy to follow and showed referral to other professional healthcare workers where required. The health of service users’ is monitored and they are supported in attending healthcare 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 10 appointments. Medication records were examined and were seen to be up to date. The storage and disposal of medication complies with The Royal Pharmaceutical Society of Great Britain guidelines, it is recommended that the home obtains written “Consent to medication” signed by service users’ to keep on file. The home manager states that the home has sought information from service users in respect of death and recorded their wishes in individual care plans. All confidential information is securely stored in the office when not in use to uphold service users’ right to confidentiality. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service Users have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14,15 Service users are encouraged and supported in making choices and their social, religious and recreational needs are met. They also benefit from a healthy and balanced diet according to their choices. EVIDENCE: The home has a weekly activity programme where service users’ are offered the opportunity to participate in a range of activities both within the home and the community. Group activities include visits to local public houses, cinema, garden centres and the Riverside day centre. One service user attends Adult Education classes and another is involved with church services and groups. Each service user is allocated 2 x ½ days per week on a one to one basis to 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 12 follow their interests. The home has booked to go to an Ice show at Brighton later this week. Social services provides a people to people visit to the home for internal activity. Service users are involved in drawing up shopping lists and food shopping for the home and make choices for meals. Menus viewed indicate a healthy and balanced diet for service users’. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service Users feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 The home has clear complaints procedures and service users are supported in raising concerns. They are also protected by staff who have undergone training in Adult protection issues. EVIDENCE: Service users’ benefit from clear complaints policies and procedures and support from their keyworkers in raising concerns. One relative has complained to Kelsey Housing about the unsafe patio area. All staff have received training in respect of adult protection issues and the manager states that refresher training takes place every two years. All of the service users are on the electoral roll but the manager states that only one service user chooses to vote. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20, 22, 23, 26 Service users’ benefit from living in a homely and comfortable home with adequate personal and communal space. However, the external grounds still remain potentially dangerous for service users. EVIDENCE: Furnishing and fittings in the home are of a satisfactory standard and on the day of the inspection the home was clean and tidy and free of offensive odours. Service users’ bedrooms are decorated to the individuals wishes and personal possessions seen reflected the persons interests and lifestyles. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 15 Service users’ spoken to state they are happy with their environment. All rooms are lockable and staff hold an emergency access key. The home has bath hoists’, mobile hoist and a raising cushion to assist service users to maintain their independence. Each home has a lounge, dining area and kitchen that are accessible to service users, one of the kitchens has recently been refurbished with new units. The home does not have a separate laundry facility and washing machines are located in the kitchen area. The manager states that the home uses red sacks for soiled linen and the Environmental Health Officer has approved procedures in use. The external patio area between the two bungalows remains in an unsafe condition for use by service users’ with mobility difficulties. This is an outstanding requirement and action must be taken to enable outside access for service users’. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Service users’ individual and joint needs are met by an experienced and effective staff team and are protected by the homes robust recruitment practices. EVIDENCE: Staff files examined demonstrate that appropriate checks are undertaken before employing staff. All staff undergo the homes induction programme and are supervised during a 6 month induction period. Job descriptions clarify the roles and responsibilities of staff and are reinforced through policies and procedures in place. A supervision rota was seen that indicated formal supervision of staff takes place six weekly. Training logs show that staff have continuous relevant training courses to remain competent and effective within their roles. One member of staff has NVQ 2 in care, two have started NVQ 3 and one has nearly finished NVQ 4 and the Registered Managers Award. The manager states that all staff are subject to an annual appraisal. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 37, 38 Service users’ benefit from living in a home that is run by an experience manager and where their rights and best interests are safeguarded by the homes policies, procedures and competent staff team. EVIDENCE: 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 18 The homes manager has many years of experience with this service user group and has completed the NVQ 4 in Management. Staff spoken with state that the manager is approachable and communicates a clear sense of leadership and direction. Observation of service user interaction with the manager showed they hold her in high regard. Comment cards received back from relatives and other professionals were positive about the service provided. The views of service users’, are sought through quality assurance questionnaires, and more frequently, by meetings held in the home. Documentation viewed indicated that health and safety is monitored and promoted. Care plans and other confidential information is securely stored in the managers office. The manager states that service users’ have access to information held about them if requested. Lines of accountability within the home and with external management are clearly understood. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 X 6 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 ENVIRONMENT Standard No Score 19 x 20 1 21 X 22 3 23 3 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 3 33 3 34 3 35 X 36 X 37 3 38 3 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 20 YES 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 01/05/06 1 OP20 23(2) b.o. External grounds which are suitable for, and safe for use by, service users are provided and appropriately maintained. This requirement has been unmet from two previous inspections. Action plan with timescale to CSCI by 01/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Good Practice Recommendations Standard OP9/YA20.2 Service users’ “consent to medication” is obtained and recorded in the individual plan. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI. 1 & 2 Turnbull Place DS0000023804.V266794.R01.S.doc Version 5.0 Page 22 - 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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