Inspection on 24/02/07 for Mrs Anita Gungaram

This inspection was carried out on 24th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mrs Anita Gungaram 22/11/05

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

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

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 Nancy Johnson Unannounced Inspection 24 February 2007 09:30 Mrs Anita Gungaram DS0000004542.V326722.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.V326722.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.V326722.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.V326722.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.V326722.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and carried out on 24th February 2007, 9.30 am to 4.15 pm. This was the second of the two statutory visits for this home for 2006/2007. During he inspection a tour of building was made, all three residents files sampled and one staff file. Other care and health and safety records were inspected. The inspector spoke with the residents and the full staff team; comprising the Registered Manager, Deputy Manager (husband and wife) and the care worker. What the service does well: What has improved since the last inspection? What they could do better: The quality assurance system could be expanded to include the views of families and professionals in order to gain their views of the service and to be used as a tool for improvement. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 6 Comprehensive health actions plans in line with the Government white paper ‘ Valuing People’ should be implemented to ensure the promotion of the health and wellbeing of service users. 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.V326722.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.V326722.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, 3, 4 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Prospective service users are given the opportunity to test drive the home and the existing service user is considered prior to any potential residents being placed. EVIDENCE: The home’s Statement of Purpose places emphasis on “providing training and opportunity for residents to live in an ordinary environment and to lead an ordinary life.” The Service User’s Guide has been reviewed, and no changes made. From the records seen and discussion with the residents, it was clear that the residents are familiar with and understand the procedures for admission to the home. There have been no new service users since the last inspection. The inspector was able to observe the residents over several hours and it was obvious that they related well with each other. The inspector was able to speak to two of the service users at the inspection and discussed with them their arrival to the home. They described how they were able to test drive the home prior to moving in. One of the residents Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 9 described how he first came for tea, then stayed for the night and decided that he liked the home and wanted to live there. Another resident spent the weekend prior to moving in. The opinions of the existing service users are also taken into account prior to an admission. Residents have chosen not to have locks on their bedroom doors. Service users were very complementary of the relationships they enjoy with the staff team and staff were very knowledgeable of service users’ needs and aspirations. Files sampled and discussion with staff highlighted the ‘high regard in which the home is held by residents. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 10 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, 8, 9, 10 Quality in the outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users are involved in decision making whilst being supported by the staff. EVIDENCE: The inspector sampled all three service users files and found that they were well organised and were up to date. Each file contained detailed care plans which identified the service users support needs and risk assessments. Each service users individual file included certificates of achievements received once they had completed their decided goals. Service users were encouraged to make their own decisions and where those decisions involve risk, risk assessments were undertaken and risk management plans were in place. Two service users are encouraged and supported in developing life skills and are able to make themselves hot drinks and snacks. The care staff was knowledgeable of service users’ needs and was able to clearly explain and give examples of situations when it was necessary for risk management plan to be Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 11 implemented. Assessments covered areas such as communication, behaviour, health needs, activities, relationships and preferences. The manager was receptive to advice that will promote quality outcome for the service users. In this regard the home should develop comprehensive health plans in accordance with the government white paper ‘Valuing People’. The inspector checked all service users financial records and found them to be in order. All residents had their own bank accounts and were given a personal daily allowance. As at previous inspections the manager of the home is the appointee for all residents. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 12 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): 11, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents have an active daily programme and are involved within the community. EVIDENCE: Residents were encouraged and supported to contribute and participate in their reviews. One service user who refused to attend a review, chose not to attend and it was recorded that the reason was “I am happy I did not need a meeting”. There was clear documented evidence of both internal and external activities of the service users choice. On the morning of the inspection, one service user was preparing for their Saturday morning activities and shared with the inspector the week’s activity programme. One of the service users worked at a day centre and at weekends went shopping, attended church, visited the pub Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 13 and the airport. All files indicated the support that each resident required and contained detailed risk assessments where risks were identified. Care plans were reviewed on a six monthly basis, signed and dated by the service user and manager. There has been improvement in areas of care planning in ensuring that care plans reflect the current activities and support needs of the residents. It seems that the managers are committed to quality outcomes for the service users and are happy to take on board suggestions for improving the service. Service users were encouraged to attend their Contact with family and friends Contact was encouraged both with telephone calls, and visits to the home and to the family home. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 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, 19, 20 The quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users physical and emotional needs are met and they are supported to be as independent as possible. EVIDENCE: The residents’ personal care needs are clearly identified in their care plans. A sample of service users’ daily living records evidenced where assistance was given to service users with their personal care. Each resident is registered with their own GP and records are kept detailing consultations with health care professionals, e.g. chiropodist and dental appointments. Records showed that the home maintain good relationships with the health care professionals. All medication is appropriately stored and case tracking of one service user’s file indicated that medication was administered and appropriately recorded as prescribed and in compliance with their medication policy. However, the inspector would suggest that a copy of the prescription should be kept with the MAR charts. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 15 There are written protocol in place for PRN (as required medication as it is known). All residents were reported to be in good health bar minor ailments. The medication policy was reviewed in December 2006 and coincides with the provision of pharmaceutical advice including ordering, storage, administration, recording and disposal. No problems were identified and it was suggested that copy of prescription to be kept with MAR Charts. This has since been implemented. The home is managed by two registered nurses, however, the other staff member has not received formal training on the management of medication. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 16 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): 22, 23 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users are protected from harm. EVIDENCE: Although the home had an extensive policy in relation to adult protection, this was found to be lengthy and cumbersome and would not have been easy to refer to in an emergency situation. Since the last inspection this policy has been reviewed and a concise adult protection procedure for staff to follow in the event or suspicion of abuse is now in place. The Complaints procedure has been reviewed and amended to ensure that complainants are aware they can refer a complaint to CSCI at any point. There have been no complaints since the last inspection. There was one incident recorded since the last inspection and this was satisfactorily resolved. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 17 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, 26, 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home provides residents with a comfortable well maintained environment. EVIDENCE: The inspector took a tour of the building and the home was found to be well maintained, safe and clean. All service users have their own bedroom which are personalised according to their tastes and contained appropriate equipment for their needs. There is a main bathroom and a toilet downstairs. One service user took pride in showing the inspector their room and the inspector was able to gain some insight of the service user’s personal profile from memorabilias. The home has passed fire safety checks in line with Standard 24. The heating system was checked by the Inspector and was found to be in working order. The water temperature was also checked and found to be satisfactory. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 18 The inspector checked all appliances, fire and gas safety records and these were found to be in order. Current gas and electrical safety certificates were in place. All hazardous substances were securely stored in a locked cupboard and manufacturer’s data information is in place. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 19 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, 35 Quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. There is a robust staffing policy which ensures that service users are adequately supported and protected by well trained staff. EVIDENCE: There have been no changes in staff since the last inspection. At the time of inspection all three members of staff were working on that day. Normally, one care staff with an overlap of a Manager would cover as outlined on the rotas. All three residents were at home, it was a welcoming environment and it was obvious that these three residents relate well with each other, even where there was communication difficulties. The warmth, patience and empathy demonstrated by service users and carers depict a small close knit family. One Staff file was audited and this contained CRB and POVA checks, application forms, proof of identity and written references. Supervision and annual appraisal have been undertaken. Throughout the inspection the Manager was observed to be aware of what the staff were doing and service users regularly approach staff with ease. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 20 The residents and staff have a meeting on Sunday of each week where weekly menus and activities were planned. Annual holidays and special outings feature frequently in meetings. First aid training certificate expires on 28/2/07; the inspector was informed by the manager that she will be attending a First Aid Course. The inspector was also informed that staff is booked on The Medication Awareness Training at Solihull and that the home is awaiting confirmation of start date. The inspector was informed that the care staff has successfully completed NVQ Level II Working with People with Disabilities in September 2006 and is awaiting the certificate; copy of the certificate has now been received by CSCI. The Registered Manager is currently undertaking her NVQ Level IV; she has successfully completed the Registered Manager’s Award. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 21 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, 42 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The owner/manager provides leadership and management which promotes residents wellbeing. EVIDENCE: The owners of the home is also the registered manager and assistant manager; both registered nurses. The home is a ‘family type’ home, the residents are settled and informed the inspector that they are happy and get on really well with all the owners and the staff. The Inspector met with both the Manager and Assistant Manager and care worker, who were knowledgeable about the policies and procedures and the needs of the service users in their care. Records, observation and discussion with staff and service users demonstrated that staff worked closely with the professionals, families and community in ensuring quality outcomes for the service users. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 22 The home has made significant improvement in complying with requirements made at the last inspection. The home has, since the last inspection, put in place quality assurance system for monitoring service users views. Regular consultation with service users has been evidenced by sampled files and regular meetings with service users. Records indicate unsolicited quality assurance - views from families; the following are comments by family members: “We consider ourselves very lucky to have found a place where my son is so well cared for” “Everywhere is always clean and tidy, Service users are always smartly dressed” “Service users receiving good welfare attention from visits to doctor, dentist, opticians and chiropodist”. “Service users are taken on holiday regularly, visits and trips”. Service user’s views: “I am happy here at Tenby Lodge, gets on very well with staff, I like the food. I like going out particularly swimming and shopping. I enjoyed my holiday in Butlins this year”. A parent commented: “We are more than happy with the care and attention “Service user” (anonymity) receives at Tenby Lodge; we went abroad to live with the peace of mind and knowing that “Service user” is safe, secured and very well looked after”. The home well maintained, service users feel cared for and there was evidence to confirm relevant safety checks were being carried out, such as fire drills and smoke detector checks. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 23 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 3 3 3 3 3 Standard No 22 23 Score 4 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 3 4 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA35 Regulation 18(1)(a) Requirement Timescale for action 01/07/07 2 YA37 9 The manager must ensure that the staff at the home undertake any training necessary in relation to the needs of the residents in the home. This requirement has been outstanding since 1/3/06 and has been partly met. The manager must be qualified 01/07/07 to NVQ Level 4 in Care and management or the equivalent. 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 Standard YA19 Good Practice Recommendations The manager should ensure that comprehensive Health Action Plans be developed in line with the Government White Paper “Valuing People”. Mrs Anita Gungaram DS0000004542.V326722.R01.S.doc Version 5.0 Page 25 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.V326722.R01.S.doc Version 5.0 Page 26 - 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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