Inspection on 17/01/06 for 39 Townend

This inspection was carried out on 17th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

39 Townend 08/02/07

39 Townend 12/07/05

39 Townend 07/10/04

39 Townend 16/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Townend Townend 39 Townend Caterham Surrey CR3 5UJ Lead Inspector Kenneth Dunn Unannounced Inspection 17th January 2006 10:00 Townend DS0000013814.V276064.R01.S.doc Version 5.1 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 Townend DS0000013814.V276064.R01.S.doc Version 5.1 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 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. Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Townend Address Townend 39 Townend Caterham Surrey CR3 5UJ 01883 383827 01999 999999 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) Surrey Oaklands NHS Trust Mrs Tracy Tonczynski Care Home 11 Category(ies) of Learning disability (10), Learning disability over registration, with number 65 years of age (4), Physical disability (1) of places Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Of the 10 (ten) residents within the category Learning Disability (LD), 1 (one) may also be in the category Physical Disability (PD). The age/age range of the category LD must be between 30-65 years. Of the 10 (ten) registered 4 (four) may be in the category Learning Disability over 65 years of age LD(E). 12th July 2005 Date of last inspection Brief Description of the Service: Towend is a care home for younger adults located in Caterham within reach of the amenities in the high street. It is a detached property owned by Surrey and Borders Partnership. The home offers ten single rooms and communal spaces. The service users are supported to live as independently as possible with the help of staff and the wider network of community health care professionals. Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was the home’s second inspection for the year 2005/2006. This was an unannounced visit, which meant that staff and residents were unaware that it was due to happen. The home had a comprehensive statement of purpose, which accurately depicted the services provided by the home. The service plans in place were comprehensive and are reviewed on a regular basis to ensure that they accurately depict service users’ needs. The home provided a high level of individualised support to service users. This was a commendable part of the home’s operation. Links with service users friends and family were well developed and maintained by the operation of the home. Service users’ health needs were well met. The home has a robust complaints procedure. There have been no complaints received either by the service or by the CSCI in relation to this service. The home is relatively well maintained but is furnished to good standard. What the service does well: What has improved since the last inspection? What they could do better: The manager must ensure that the staff are aware of and adhere to the homes statement of purpose, paying specific attention to the rights of the service users to receive care with privacy dignity and respect. In addition all outstanding and current requirements must be fully actioned. Townend DS0000013814.V276064.R01.S.doc Version 5.1 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. Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 8 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 the following standard(s): The service continues to meet the core standard please refer to the previous inspection report dated 12th of July 2005. EVIDENCE: Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7&9 Staff demonstrated a good understanding of the service users support needs. This is evident from the positive relationships, which have been formed between the staff, service users and their family/representatives. EVIDENCE: Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 10 The manager stated that the service users are all encouraged and supported to the best of their individual abilities to make decisions regarding their daily and long-term life plans. This occurs in varying ways, in one instance the staff team was able to assist one service user to select and buy the materials needed to redecorate his bedroom. There is strong documented evidence of key workers working closely with the service users to ensure that they are allowed to focus on areas of specific interest to them. To ensure that this information is accessible the home has developed person centred planning (PCP’s). The PCP’s reviewed were clear and concise and fully focussed on the individual. Daily diary notes and discussion with service users and staff provided evidence that the residents were encouraged to be as independent and in control of their lives as possible. It was evident that risk assessments were produced in consultation with the individual, as far as possible, and any restrictions were only applied where the level of risk was considered unacceptable. Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 15, 16 & 17 The philosophy of the home is to promote the independence and opportunities for the service users and to become part of the wider community in which they live. EVIDENCE: Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 12 The relationship between residents and staff was observed to be relaxed and friendly, creating a warm and homely feel. Residents were encouraged and supported to be as independent as they were able and they all appeared to lead busy and interesting lives, which include attending, day care, leisure activities, shopping, home time. Evidence indicated that residents rights were only limited where risks were assessed as being unacceptable. Service users notes and files confirmed that staff helped them to keep in contact with relatives and friends. Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 13 Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 18 The service should be adhering to the procedures to ensure that personal support and care is offered to promote the privacy, dignity and the independence of service users, however on the day of this inspection this was not demonstrated. EVIDENCE: The service has a fully operational set of policies and procedures in place that have been designed to guarantee that the service users privacy and dignity is up held at all time. It was however disappointing to witness the opposite happening when a community nurse called to monitor the blood pressure of service users. The community nurse was taken into the dining room to undertake her tasks instead of the service users being asked to go to their own private bedrooms. In addition the service has a set of electronic clinical weighting scales to allow them to monitor the weight of the service users however these are stored and used in the bedroom of one of the residents, again diminishing the privacy of the person being weighed and the occupant of the bedroom. The manager must ensure that the rights of the service users are maintained above that of the ease of the task. Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 15 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 the following standard(s): 23 The staff and manager were able to demonstrate that residents were being appropriately protected and that residents’ views were important and acted upon. EVIDENCE: All staff were said by the registered manager to have completed vulnerable adults protection procedures training and were thereby aware of the action to take should they have a concern or if an allegation of abuse was made. The CSCI has not received any complaint in respect of this service. Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 16 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 the following standard(s): 24, 25, 28 & 30 The standard of décor and equipment in this home is of a relatively good standard there was satisfactory evidence of improvement through maintenance and refurbishment. EVIDENCE: The inspector raised concerns over the viability and suitability of one of the bedrooms on the first floor. The bedroom was partially built into the eaves of the house and as a result had greatly reduce floor and height space and it could pose potential risk to future residents or staff working in the room. The manager must revaluate this room, and must consider the possibly of deregistering it. The other bedrooms reviewed during the inspection were on the whole very individual and clearly represented the service user resident in the room, with proud displays of family snap shots and important items to the person. The lighting within the building continues to be problematic the manager has made repeated efforts to remedy this but in areas the light is very poor and could pose potential hazard for service users and staff. The main areas for concern were the stairs and both the hallways on the ground and first floors. On the day of the inspection all 3 areas were dark and received no natural daylight they were totally dependent upon artificial light to illuminate them and even then the light provided was poor. Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 17 The home was on the whole clean and hygienic, however there was a very strong and unpleasant odour in the area around the stairs. The manager stated that one of the service users was in the habit of sitting on the stairs and he has a tendency to drop things on the carpet and as a result of the poor lighting it has not always been possible to clean the area as thoroughly as they would like and as a result the odour has built up. Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 18 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The service continues to meet the core standard please refer to the previous inspection report dated 12th of July 2005. EVIDENCE: Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 19 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 & 42 The manager is supported by senior staff in providing clear and consistent leadership in the home with staff on duty demonstrating an awareness of their roles and responsibilities. EVIDENCE: The manager operates an open and inclusive style of management approach in the home. Records required for the protection of service users and sampled were well maintained, accurate, and up to date. The staff-training programme includes training in first aid, manual handling, infection control, fire safety, health and safety and basic food hygiene. Systems were in place to safeguard the health and safety and welfare of the service users. Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 20 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. 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 2 25 1 26 X 27 X 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 1 X X X X 3 X X X 3 X Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 21 NO 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 YA18 Regulation 12, 18 Schedule 3.3 16 & 23 16 & 23 Requirement Timescale for action 17/01/06 2 3 YA24 YA25 4 YA30 13, 16 & 23 The manager must ensure that the privacy and dignity of the service users ids upheld at all times and should not be impeded for ease or lack of facilities. The manager must review the 17/02/06 lighting in all communal areas. The manager must review the 17/02/06 viability of the empty bedroom (the end of the first floor corridor) to ensure that it can safely meet the needs of any potential new service user. The manager must ensure that 17/02/06 all areas of the home are kept clean and hygienic. 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 Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Townend DS0000013814.V276064.R01.S.doc Version 5.1 Page 23 - 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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