Inspection on 29/06/05 for 10 Tanners Walk

This inspection was carried out on 29th June 2005.

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

10 Tanners Walk 08/05/06

10 Tanners Walk 25/11/05

10 Tanners Walk 27/01/05

10 Tanners Walk 10/06/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 10 Tanners Walk Off Newton Road Twerton Bath BA2 1RG Lead Inspector Angela Smith Announced 29th and 30th June 2005 10.00am 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service 10 Tanners Walk Address Off Newton Road Twerton Bath BA2 1RG 01225 331192 01225 331192 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) New Era Housing Association Limited Mr Robin Carr PC Care Home 5 Category(ies) of Learning Disability LD registration, with number Physical Disability PD of places (5) 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 5 persons aged 18 years and over with physical and learning disabilities for respite care. Date of last inspection Announced 27th January 2005 Brief Description of the Service: Tanners Walk is a care home operated by New Era, an independent voluntary organisation, to provide respite care for up to five people who have a learning and physical disability. The home is a purpose built split-level bungalow, built in 1998. It is located in the Twerton area of Bath approximately two miles from the city centre. The home is fully accessible to people who use wheelchairs. The main entrance door opens both ways for ease of access and there is a through floor lift. Accommodation is offered on two floors – an upper entrance level and a lower ground floor. The upper floor offers three single bedrooms, one of which has ensuite facilities with overhead hoisting and a fully assisted bath with toilet and wash hand basin. The other two bedrooms are equipped with wash hand basins and one has overhead hoisting facilities for assisting with moving and transferring residents. There are two bedrooms on the lower ground floor, also equipped with wash hand basins. There are communal toilet and bathroom facilities on both floors. The upper level floor has an aqua nova bath with an overhead ceiling track hoist, toilet and wash hand basin, and there is an assisted shower room with toilet etc on this floor. There is a communal lounge area, a kitchen/dining room and a laundry area located on the upper level floor, and a communal lounge/activity room with kitchenette on the lower ground floor. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that was carried out over two days. Evidence was gathered for this report through the examination of relevant records, from consultation with staff, and from direct and indirect observation of practice and interactions between staff and the people who were using the service. Seeking the views of the people who were using the service at the time of this inspection through discussion was restricted due to their communication difficulties. However, the Inspector did spend time in the company of the people using the service and as stated above their interaction with staff was directly observed. What the service does well: Tanners Walk offers a much needed respite care service to adults with a learning/physical disability in pleasant accommodation. The individuality of the people who use the service is respected and the staff team respect their rights and make every effort to enable them to make choices about things that directly affect them during their stay in the home despite any communication difficulties. This results in the people using the service being relaxed and happy in the company of the staff. Much information is collected about each person who uses the service in order to ensure that individual needs can be met. Professional expertise is actively sought whenever a need is identified in order to support and maintain peoples’ health and well being. The staff make every effort to support people who use the service to enjoy activities that they would normally enjoy if they were at home. The staff team are supportive of each other and there is a good team spirit apparent in the home. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 6 What has improved since the last inspection? What they could do better: Requirements and recommendations made at previous inspection should be met within the timescales set. There are still some requirements and recommendations outstanding, which have had to be repeated after this inspection. The service users guide needs to be updated and a personal copy provided to all people who use the service. The information collected on each person who uses the service must be put into an accessible care plan format. This has been actioned for some, but not all of the people who use the service. There needs to be evidence of the training which has been provided to staff if they take responsibility for drawing up a person’s insulin. This should be maintained on the person’s care file and also in the individual staff training records. All staff need to be provided with fire safety training from a suitably qualified person. Plugs need to be provided for sinks to facilitate people washing in their bedrooms. The showers need to be repaired or replaced so that the water temperatures can be adequately regulated and the potential risk of a person scalding themselves removed completely. The addition of pictures, plants and ornaments will help create a more homely environment. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 7 Consideration should be given to replacing the kitchen work surfaces and kitchen units, purchasing some new sofas and curtains for the lounge on the entrance level floor. Staff should be provided with challenging behaviour training and consideration should be given to the staff members request for Makaton training. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 People who use the service are not being provided with their own personal copy of the home’s service users guide. The home’s comprehensive referral and admission procedure means that people who use the service can be assured that their individual needs will have been identified before they have a period of respite in the home. People who wish to use the service and their relatives/main carers are able to check out whether or not they will be happy using the service by being able to spend some introductory time in the home. EVIDENCE: Tanners Walk was providing respite care to approximately 28 adults who all had a range of learning and physical disabilities. The manager said that the people who were regularly using the service had not been provided with their own personal copy of the home’s service users guide. The guide needs to be reviewed and updated to reflect current charges and then provided to all people who use the service so that they have written information about the services the home can offer. The five beds available at Tanners Walk had all been block contracted by Bath and North East Somerset Council. This means that the Local Authority Community Learning Disability Team makes all referrals to the home. The home was operating its own booking service, which was the responsibility of 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 10 the deputy manager. The home manager said that when arranging bookings for people consideration is given to the individual needs of the people who will be using the service at any one time, and any specific requests from the people being supported or their families/main carers. Information about bookings offered and confirmed by families/main carers was seen within the care records of the people who were using the service at the time of this inspection. There was evidence that respite care dates had been negotiated and altered as appropriate to fit in with any personal requests. The home had a detailed referral document in operation, which allowed for the collection of background information before a person commenced using the service. Several completed referral documents were seen which relatives/main carers had completed. These documents provided personal details about the person who would using the service, a brief life history and other information such as strengths and needs, likes and dislikes, information relating to any medication and any night time support needs. This information was then being used to determine a persons support needs and whether the home would be able to meet the person’s needs. All the people who had been referred to the home since the last inspection had been able to visit the home for a meal on more than one occasion if necessary and to have an overnight stay before they actually received a period of planned respite. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 & 9 The range of information the home collects about each person who uses the service enables the staff team to provide sensitive support. This information has been used to compile an accessible care plan for some, but not all people who use the service. This needs to happen in order to ensure consistency of service delivery. EVIDENCE: 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 12 Care files were being maintained in respect of each person who was using the service. Eight people’s individual files were examined and found to include a personal profile; a photograph of the person; copies of social worker assessments; information collated on daily routines and some had guidelines for working with the person, which had been collected from a wide range of sources e.g., parents/main carers and any previous service providers; risk assessments; and any relevant correspondence from professionals involved in the care of the person. Three of the care files seen set out the action that needed to be taken by staff in order to meet the persons individual needs in an easy to follow format. The support needs of the other people had not been pulled together into one easy to follow format within their care file. This meant that a significant amount of documentation needed to be read in order to determine what action was being needed by staff in order to meet the person’s needs during their stay at the home. All the information needed was contained within the files, but does need to be consistently set out in an agreed easily accessible care plan format. People who use the service do continue to attend any day care services they would normally attend during the week. Two of the four people who were using the service at the time of this inspection were seen to return to the home after being at their day care placement. They were welcomed and made to feel at home by the staff on duty. A monitoring tool was being used when a physical intervention (a stair gate), was used with one particular person. The length of time the intervention had been used was clearly recorded, as was the reason for the intervention. One person had been admitted to the home as an emergency due to their main carer being taken ill. This person’s stay in the home had been extended as a long-term residential placement was being sought. There was evidence with the person’s records to show that the staff team from Tanners Walk had accompanied this person during visits they had made to proposed residential placements and the staff team were helping to support the person to understand where they would be moving on to from Tanners Walk with the aid of photographs. This demonstrates that the service is responsive to the needs of the people who use it. Members of the home’s staff team were seen to actively involve the people who were using the service to choose what they would like to eat for their evening meal and activities they pursued in the house. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 & 17 The home’s staff team respect the lifestyles of the people who use the service. Day care services continue as normal and staff respect people’s rights to spend their free time as they wish whilst staying in the home. The food preferences of people are respected. People are able to choose what they would like to eat and drink. EVIDENCE: During a person’s period of respite the home’s staff team endeavour to maintain the person’s social, emotional, communication and life skill abilities. This was evident from the interactions witnessed that took place between staff and the people using the service. The manager stated that most of the people who regularly use the service have a care management package in place, which includes attendance at day care services. Attendance at day care services always continues during a person stays at Tanners Walk. Two people were attending their day care 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 14 services on both days this inspection and they were witnessed returning to the home late afternoon on the first day. For those people who do not attend day care services staff members do offer activities in the home or will take people out. One person was taken out for lunch by staff on the first day of this inspection and a staff member was witnessed enjoying doing a puzzle with this person later the same day. There is a television, video and stereo system available in the home’s communal lounge and some of the bedrooms are equipped with portable televisions. The Inspector was introduced by a staff member to a person who was enjoying watching the news on the portable television in his room. The Inspector was told that this person also likes reading the newspaper and the staff member had bought a newspaper for this person on his way into work, which was given to him. Staff were seen to interact with each of the people who were using the service in a respectful manner. Documentation seen in the individual people’s files showed that staff had been able to develop positive relationships with each of people’s family members/main carers and there was evidence that regular communication took place. Staff described the home’s routines as being generally flexible and only dependent upon day care arrangements for the individual people using the service. The Inspector was told that people can choose when they wish to get up and go to bed and whether they want to spend time in their own rooms or in the communal lounge. This was evident as one person was enjoying watching television in his room. The evening meal witnessed on the first day of this inspection was prepared and served by a staff member. The people who were using the service were given a choice of what they would like to eat, which was done sensitively by the staff member, who took the time to enable each person to make their selection, and the staff member sought to clarify that they had clearly understood the person’s selection. The Inspector was told that the staff team are working on compiling a selection of pictures of different meals, which will be used to assist people who have a communication difficulty with their meal selection in the future. The evening meal that was prepared and served was nicely presented and looked appetising. One person was assisted to enjoy a cup of tea on his arrival at the home from his day service. This was done respectfully and was unhurried. The people using the service seemed relaxed and happy in the company of staff and general conversation took place with staff actively including the people using the service despite their limited verbal communication skills. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, & 20 The health and personal care needs of the people who use the service are met by the home. Medication administration records were in date and in good order. However, evidence of staff being trained to draw up a person’s insulin is needed. EVIDENCE: 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 16 All of the four people who were using the service at the time of this inspection were dependent to some degree on staff to meet their care needs. Guidelines for working with each person were seen within the various pieces of documentation maintained in their care files. Where a person is independent with regards to aspects of their daily living, for example – taking a shower, this was being promoted and the person was being supported to continue doing this during their stay. It was evident from talking to staff that they were aware of the individual needs of each of the four people who were using the service at the time of the inspection. The Inspector was told that people do bring with them any adaptations or equipment they may need during their stay, which they use regularly at home. There was evidence within the eight care files examined to show that professional health care support would be sought for someone if a need were identified. For example, a speech therapist had been involved with supporting the staff team with the eating support needs of the one of the people who uses the service. Members of the staff team had been provided with suction instruction from a lifetime nurse in relation to this person. Staff had been issued with certificates from the nurse and protocols for using suction were in place within the person’s care file. All people who use the service are registered with their own General Practitioner. The manager stated that GPs would be requested to visit the home if required, although staff would more than likely make arrangements with family members/main carers to take service users to the surgery if they needed to see their GP during their stay. People bring any prescribed medication with them on admission, which is booked on and off the premises. A medication profile is requested by the home from the G.P. of any person who is prescribed medication. Not all of the people who receive a service from Tanners Walk are prescribed regular medication. People do self administer their medication if they are able. Records relating to the administration of medication retained on those people who were taking prescribed medication and who were using the service at the time of this inspection and required support from staff were found to be up to date and accurately maintained. Medication administration charts had been signed by two members of staff and stock balances had been checked on each occasion that medication had been administered. The home manager told the Inspector that refresher training was being organised for staff with regards to the support of a person who has insulin controlled diabetes and for whom staff draw up their insulin. Evidence of this training was required following the last inspection. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 Complaints, whistleblowing and protection of vulnerable adult procedures are relevant and known by staff who in many instances have to act as advocates for people using the service. EVIDENCE: New Era has a complaints and compliments procedure dated 5 July 2004. This complaints and compliments procedure includes a flowchart, which sets out the various stages and timescales for dealing with and responding to any complaint. The procedure on its own would not meet the requirements of legislation, as it does not include the name, address and contact number of the Commission for Social Care Inspection. The home did, however, have a complaints leaflet and a pictorial complaints pamphlet both of which did include the contact details for the Commission for Social Care Inspection and these documents are included in the service users guide. There have been no complaints received by CSCI regarding Tanners Walk. Members of staff spoken with said they had received training on protecting vulnerable adults and the home had a vulnerable adults policy and procedure and a whistle blowing policy and procedure. The vulnerable adult policy and procedure was clear and included a flow chart for staff to follow. The policy and procedure clearly set out the role that social services play in convening a strategy meeting/discussion to determine who will lead any vulnerable adult investigation. There were policies and procedures in place relating to residents financial affairs and dealing with service users’ money. The home was not holding any monies on behalf of people using the service at the time of this inspection. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29 & 30 The house offers pleasant accommodation, which has the potential to offer a homely environment to the people who use the service if some pictures, plants ornaments and new furniture/curtains were purchased. In order to keep the house in good order some maintenance work is needed in the kitchen and shower fittings need to be repaired or replaced to ensure the safety of the people using these facilities. EVIDENCE: 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 19 The home is predominantly domestic in its layout and is inconspicuous in its location within the local community. The house offers pleasant accommodation over two floors – an upper entrance level and a lower ground floor. The upper entrance level floor offers three single bedrooms one of which had ensuite facilities with overhead ceiling track hoisting and a fully assisted bath with toilet and wash hand basin. The other two bedrooms on this floor were equipped with wash hand basins and one had overhead ceiling track hoisting facilities for assisting with moving and transferring people who occupied this room. There were two single bedrooms on the lower ground floor, which were equipped with wash hand basins. None of the wash hand basins had a plug, which must making washing at these sinks difficult for the people occupying the rooms. One of the lower ground floor rooms would benefit from some tiling around the sink, particularly at the side of the wardrobe. The home was experiencing problems with shower fittings. Water temperatures were too hot at these outlet points and it did not seem that they could be regulated as records showed that they were running consistently high. Shower fittings therefore need to be repaired for replaced. Some underpinning work had been carried out on the premises during 2004. Cracks in internal plasterwork had been repaired and some internal painting carried out. A damp area was seen on the wall of the activity room, which has probably been caused by the flat roof at the rear of the property. This will need to be repaired. The walls of the home were generally bare and would benefit from some pictures. Other homely touches such as plants and ornaments would also make the house seem more homely and inviting. The home’s lounge on the entrance level floor had two sofas, both of which were showing signs of wear and would benefit from being replaced. This room would also benefit from some new curtains. The kitchen work surfaces and some of the units were showing signs of wear and would benefit from being replaced. The home’s laundry area was generally well equipped and of a domestic nature. The home was clean and tidy on both days of this inspection. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 & 36 People who were using this respite service were being supported by a team of staff who were responsive to their individual needs, which resulted in them being relaxed and happy in the company of staff. EVIDENCE: Staff members spoken with and seen interacting with the four people using the service did have the skills to adequately meet their individual care needs. Staff members demonstrated a good understanding and knowledge of the difficulties and needs presented by each of the individual people and were able to respond sensitively to each person’s needs. The home’s staffing establishment consisted of the manager, a full-time deputy, four full-time support workers and six part-time support workers, providing a total of 385.5 staff hours including the manager’s hours per week. Five members of the staff team were working towards their National Vocational Qualification Level 3 award. No member of the staff team had completed all of the units and successfully achieved the full award. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 21 A training matrix was provided to the Inspector with the pre-inspection questionnaire. Individual staff training records were also seen during the inspection. These records showed that all members of the homes staff team needed to be provided with fire safety training. Staff members spoken with said that they would like to be provided with challenging behaviour training and one person said that they would like to do Makaton training as some people who use the service use this form of communication. The manager stated that he and the deputy manager plan one to one staff supervision sessions four to six weekly. This was confirmed by the staff members who were spoken with who stated that they are provided with a copy of their supervision record, which they are asked to sign to acknowledge receipt of. Recruitment documentation was seen for two members of the staff team. Documentation included application forms, references and criminal record bureau clearances. The need to ask for further references if a questionable reference is received was discussed with the home manager. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, & 42 The home is being generally well run, which means that people who use the service can be assured they will receive a good standard of service. However, in order to ensure consistency of service a care plan format needs to agreed and implemented. Some environmental maintenance work is needed in order to adequately ensure the health and safety of the people using the service. EVIDENCE: 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 23 The home manager, Mr Carr, has been working in the home since 1991, and took over as manager of the home in 2000. He has a RNMH qualification, a City and Guilds 325.3 Advanced Management in Care award, a NEBS Supervisory Management qualification and is working towards his Registered Managers award and the NVQ Assessors award. Prior to commencing his employment at Tanners Walk the manager worked for Bath Health Authority. Staff members spoken with during this inspection stated that they felt the home was well managed and said that they felt supported and listened to by their manager. It was evident from interactions witnessed that the staff team were supportive of each other. An agreed care plan format needs to be implemented in order to drive the consistency of service delivery. Recording systems were in place to show that regular in-house checks had been carried out on such things as the home’s fire alarm system, fire fighting equipment, window restrictors, water temperatures and fridge and freezer temperatures. Shower temperatures were noted to be running consistently high and a risk assessment had been put in place. Showers, however, need to be repaired or replaced. New Era (South West Region) has adopted what it defines as “an ongoing, region/organisation wide framework in which people are committed to and involved in monitoring and evaluating all aspects of the activities (inputs, process and outcomes) in order to continuously improve them”. Mechanisms used to evaluate service delivery and create a service improvement plan are such things as service user assessments, service user reviews, financial audits, manager’s monitoring visits, health and safety audits, staff supervision and appraisal, team and managers meetings. A structured survey had been sent out to relatives/main carers. The home manager was in the process of compiling the results of this survey, which he agreed to share with CSCI. Appropriate insurance arrangements were in place and an insurance certificate was seen to be in date and on display in the office of the home. Copies of reports following visits carried out by a New Era Area Manager responsible for overseeing the running of the home on behalf of New Era are forwarded to the CSCI as required by Regulation 26. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 2 3 3 3 Standard No 11 12 13 14 15 10 Tanners Walk x 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 3 2 3 Version 1.20 Page 25 D56_08194_TannersWalk_221615_290605_Stage4.doc 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 2 x 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 26 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. 1. Standard 6 Regulation 15 Requirement Timescale for action 30/10/05 2. 20 18(c ) (i), 13(6) 3. 4. 5. 6. 35 & 42 24 24 & 27 1 23(4)(d) 23 23, & 13(4)(b) 5 Use information collected on each person who uses the service to compile an accessible care plan. Provide training to staff who take 30/10/05 responsibility for drawing up insulin for person who uses the service. Keep evidence of this training available for inspection on the persons file. Provide all staff with fire safety 30/09/05 training by a suitably qualified person. Provide plugs for sinks. 30/08/05 Repair or replace showers so that water temperatures can be regulated adequately. The service users guide needs to be updated and a personal copy provided to all people who use the service. 30/08/05 30/09/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Version 1.20 Page 27 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc 1. 2. 3. 4. 24 24 24 Provide pictures, plants and ornaments to create a more homely environment. Replace kitchen work surfaces and units. Purchase new sofas and curtains for the lounge on the entrance level floor. Provide challenging behaviour training to staff and consider providing Makaton training as requested by staff member. 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 28 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire BS32 4RG 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 10 Tanners Walk D56_08194_TannersWalk_221615_290605_Stage4.doc Version 1.20 Page 29 - 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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