Inspection on 22/11/05 for Mrs Anita Gungaram

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mrs Anita Gungaram 24/02/07

Mrs Anita Gungaram 14/07/05

Mrs Anita Gungaram 25/01/05

Mrs Anita Gungaram 27/04/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

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Polesworth Group 70 Long Street

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Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Mrs Anita Gungaram Tenby Lodge 180 Hobs Moat Road Solihull Birmingham West Midlands B92 8JZ Lead Inspector Brenda O’Neill Unannounced Inspection 22nd November 2005 4:00pm Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 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 Mrs Anita Gungaram DS0000004542.V263742.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 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. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mrs Anita Gungaram Address 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) Tenby Lodge 180 Hobs Moat Road Solihull Birmingham West Midlands B92 8JZ 0121 247 1501 Mrs Anita Gungaram Mr Veer Gungaram Mrs Anita Gungaram Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection July 14th 2005. Brief Description of the Service: Tenby Lodge is a privately owned small residential home, owned and run by Mr. and Mrs. Gungaram, providing accommodation for up to 3 persons with a learning disability. The home is situated in a semi-detached house in a residential area, just off a main road into Solihull. There are a number of shops nearby and the town centre is a short bus/car ride away, making it readily accessible to amenities such as shops, places of worship and public transport. The home has a lounge, dining room and domestic style kitchen. There are three large upstairs bedrooms for the residents, a smaller staff sleep in room that is also used as an office. There is a bathroom upstairs with a shower over the bath, toilet and wash hand basin. There is an additional toilet downstairs. There are gardens to the rear and front of the property with parking space available for two vehicles at the front. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over an early evening in November 2005. This was the second of the two statutory visits for this home for 2005/2006. To get a full overview of all the standards assessed during this inspection year this report should be read in conjunction with the report written following the inspection on July 14th 2005. During this inspection a partial tour of the premises was made, two resident files were inspected as well as other care and health and safety records. The inspector spoke with the assistant manager who is also one of the proprietors, one staff member and two of the three residents. What the service does well: What has improved since the last inspection? The safety of the residents had improved with the fitting of new carpets to the hall, stairs and one bedroom as these were fraying at the last inspection. Also a new lock had been fitted to the bathroom that allowed staff easy access in case of emergency. Care plans and risk assessments had been reviewed in consultation with the residents. The manager was notifying the CSCI of any events that affected the well being of the residents. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 6 What they could do better: 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. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 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 Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 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): 2 and 3. The home was meeting the needs of the residents whilst taking into account their likes, dislikes and preferences. EVIDENCE: As at the last inspection there had been no admissions to the home since the last inspection and the existing residents had lived in the home for a number of years. One of the residents was visiting family at the time of the inspection, however the inspector spoke to the other two residents and they were able to confirm that their needs, as identified on their care plans, were being met and they were very happy with their lifestyles. There was documented evidence at the home of how the resident’s health and social care needs were to be met and evidence that this had been followed. There was an assessment tool on site that could be used should the home have the need to admit any further residents. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 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): 6, 7 and 9. There was a good system in place for care planning and assessing risks that involved consultation with the residents and ensured staff knew the needs of the residents and how to manage risks. The manager needed to ensure that the care plans only reflected the current needs and activities of the residents. EVIDENCE: Two of the residents’ files were sampled and they included detailed care plans that included all aspects of care and support that were to be offered to the residents. There were risk assessments for all activities detailed as necessary. The care plans had been reviewed and this had included consultation with the residents. It was noted that the care plans had not been updated as necessary and included activities that the residents no longer took part in, for example, one stated that a cookery course was being done and this had been completed a considerable amount of time ago, another stated the resident went to church which he no longer did. The manager needed to ensure that the care plans reflected the current needs and activities of the residents. The files included details of the resident’s likes, dislikes and preferences. Residents were encouraged to make decisions about their lives where possible, for example, handling their own money on a daily basis. Any limitations as to Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 10 residents making their own decisions were only set with the resident’s agreement, for example, a contract had been drawn up between the home and one of the residents about the amount of time spent out of the home for varying activities. None of the residents had advocates but all had links with families and two attended day centres which gave them another avenue to raise issues that may arise. As at previous inspections the manager of the home was the appointee for all the residents and although not an ideal situation this had been a long standing arrangement. All the residents had individual bank accounts. Written evidence was kept of their incoming benefits and of their fees and personal allowances being debited. Two of the residents received their personal allowance on a daily basis and signed to acknowledge receipt. There was also documented evidence of small award payments being made to two of the residents from their day placements and of them receiving these back in cash on a regular basis. There were records for the other resident who did not handle his own finances and receipts were kept for expenditure. There were risk assessments in place on the residents’ files for all their activities where any risks had been identified. These included details of how the risks were to be minimised and how any presenting challenging behaviours were to be managed. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 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): 13. Residents were supported and encouraged to be part of the local community and use the available facilities. EVIDENCE: There was documented evidence that residents were supported to access and participate in the local community activities. These included such things as shopping, attending a local gateway club, going to church and eating out. One resident was able to access the local community independently within the parameters of his risk assessments that had been drawn up in agreement with him. The other two residents were supported by staff to participate in activities. One of the residents accessed the local community on a daily basis with the support of staff and informed the inspector he had been out in the car that day, had a meal out and went shopping. Another of the residents spoke to the inspector of how he was looking forward to going out to see the Christmas lights in the local shops as he particularly enjoyed Christmas. He had already set up his own Christmas decorations in his bedroom. All of the residents were supported to attend local health care appointments including the doctors, chiropodists and dentists. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 12 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 and 19. The resident’s personal and health care needs were being met whilst maximising the resident’s independence and control over their lives. EVIDENCE: As at the last inspection residents’ needs in relation to personal care were clearly detailed in their care plans. The care plans included what the residents were able to do for themselves, what staff needed to do for them and also what staff needed to check to ensure it had been done. The assistant manager confirmed that all the residents were in good health with only minor ongoing ailments, for example, dry skin. All residents were registered with a local G.P., chiropodist, dentist and optician. When speaking to the inspector they confirmed they had recently had their flu vaccinations at the doctors. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 13 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. There was an extensive policy and procedure on site in relation to adult protection. To ensure staff are able to report any issues appropriately there needed to be a concise, accessible procedure for them to follow. EVIDENCE: There was an extensive policy and procedure on site in relation to the protection of vulnerable adults. Although this was accessible to staff it was very long and would not have been easy to refer to in any emergency situation. The manager needed to ensure there was a concise adult protection procedure for staff to follow in the event or suspicion of abuse. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 14 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, 27 and 30. The home provided residents with a comfortable, well maintained environment in which to live. EVIDENCE: There had been no changes to the layout of the home or the needs of the residents since the last inspection. The home was well maintained and safe. The issues raised at the last inspection in relation to fraying carpets had been addressed and the hallway, stairs and one bedroom had had new carpet fitted. As at the last inspection all residents had a large single bedroom and these were appropriately personalised and adequately decorated and furnished. Bedrooms did not have locks or lockable facilities however this had been discussed with the residents and they did not want these facilities. Bedrooms did not have wash hand basins but all were in very close proximity to the bathroom where there was a wash hand basin. The bathroom appeared to meet the needs of the residents and there was an additional toilet downstairs. Since the last inspection the lock on the bathroom door had been changed for one that could be opened from the outside by staff in cases of emergency. The home was clean and hygienic with no issues raised in relation to infection control. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 15 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): 32, 33, 34 and 35. Staffing levels met with the needs of the current resident group. Staff needed to undertake the appropriate training to ensure they were equipped with all the necessary skills and knowledge to fulfil their roles. EVIDENCE: The home had had no changes to the staff team since the last inspection. The owners of the home were also the manager and assistant manager and there were two care assistants. There was always one member of staff on duty and one person sleeping in. As two of the service users were out all day Monday to Friday these levels appeared appropriate. If additional staff were required due to illness of one of the residents or for an individual leisure pursuit at weekends the inspector was informed that this would be arranged. The inspector met one of the staff employed at the home who appeared to be aware of the residents needs and the residents at home at the time were comfortable in her presence. Staff in post at the home had completed application forms, references and CRB checks. One of the staff members had completed her LDAF award this year and had evidence of first aid, manual handling and food hygiene training. The other staff member had evidence of a training and development award for care Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 16 workers which covered a variety of areas but nothing specifically linked to learning disability. Neither of the staff employed had undertaken NVQ level 2. There was evidence on the staff files that received supervision, albeit brief, from the managers on a regular basis. Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 17 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): 37, 39, 41 and 42. The manager ensured the smooth running of the home in a competent manner with health and safety of the residents and staff well maintained. There needed some formal ways of monitoring the quality of the service in the home based on seeking the views of the residents and any other stakeholders. EVIDENCE: There had been no changes in the management of the home since the last inspection. The owners of the home were also the registered manager and the assistant manager. The inspector met with the assistant manager who demonstrated a very good knowledge of the residents in their care. The home was run very much like a family home but with an awareness of the requirements of regulation. The registered manager needed to ensure she enrolled to undertake a qualification in management this year and to complete as soon as possible. The home needed to have in place some systems for monitoring the quality of the service offered to the residents based on seeking their views and the views of their families/representatives with a view to continuous improvement. Ways Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 18 of achieving this were discussed with the assistant manager. It was suggested that one to one discussions with residents were recorded and any suggestions made acted upon and relatives and that health care professionals who knew the residents could be asked their views and opinions of the service offered. The majority of the required records were available and up to date. The home were recording on daily basis how the resident who did not receive a day service spent his time. For the other two residents records were available as to how they spent their time at weekends as they spent every weekday at a day centre. The assistant manager was also advised records should be kept detailing how residents spend their evenings to evidence that their social and personal care needs and preferences are being met. Health and safety at the home were well maintained. The home was well maintained and there was evidence that the smoke detectors were checked weekly and that regular fire drills were being carried out. Mrs Anita Gungaram DS0000004542.V263742.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 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mrs Anita Gungaram Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 2 X 1 X 2 3 X DS0000004542.V263742.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. 1. 2. Standard YA6 YA22 Regulation 15(1)(b) 22(1)(7) Requirement Care plans must reflect the current activities and support needs of the residents. The complaints procedure must be amended to ensure complainants are aware they can refer a complaint to the CSCI at any point. (Previous time scale of 01/09/05 not assessed for compliance at this visit.) There must be a concise adult protection procedure for staff to follow in the event or suspicion of abuse. 50 of care staff must be qualified to NVQ level 2 or the equivalent. The manager must ensure that staff employed at the home undertake any training necessary in relation to the needs of the residents in the home. The manager must be qualified to NVQ level 4 in care and management or the equivalent. (Previous time scale given had not lapsed.) Timescale for action 01/02/06 01/01/06 3 YA23 13(6) 14/01/06 4 5 YA32 YA35 18(1)(a) 18(1)(a) 01/02/06 01/03/06 7. YA37 9 31/12/05 Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 21 8 YA39 9 YA41 24(1)(a)(b) The home must have in place 01/03/06 systems for monitoring the quality of the service offered based on seeking the views of the residents. 12(1)(a) Records should be kept detailing 01/02/06 how residents spend their evenings to evidence that their social and personal care needs and preferences are being met. 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 Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Mrs Anita Gungaram DS0000004542.V263742.R01.S.doc Version 5.0 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. 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. 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