Inspection on 01/08/05 for Tamar House

This inspection was carried out on 1st August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tamar House 10/03/09

Tamar House 16/03/07

Tamar House 07/02/06

Tamar House 31/01/05

Tamar House 25/08/04

Tamar House 23/03/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Tamar House 175 Old Ferry Road Saltash Cornwall PL12 6BN Lead Inspector Mike Dennis Unannounced 1 August 2005 09:30 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 Older People. 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. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tamar House Address 175 Old Ferry Road Saltash Cornwall PL12 6BN 01752 843579 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) Mrs Mary Yvonne Beaumont Mrs Paula Barbara Hannon CRH 21 Category(ies) of Dementia (3), Mental Disorder, excluding registration, with number learining disability or dementia (3), Old age, not of places falling within any other category (21), Physical disability (6), Terminally Ill (3) Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Total number of service users not to exceed 21 Date of last inspection 31.01.05. Brief Description of the Service: Tamar House is a Care Home, with nursing, and is currently registered for 21 service users within the category of old age not falling into any other category; terminally ill 3, physical disability 6. dementia 3 and mental disorder 3. Tamar House is situated in a residential area of Saltash close to the shops, public transport and the facilities of the town centre. Tamar House is a detached corner site in Old Ferry Road. Limited parking is available. Accommodation is provided on the ground and first floor with a passenger lift for easy access Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 1st. August 2005 over a six hour period. The inspector met with the Registered Provider, Mrs. Beaumont and the Qualified Nurse on duty, Rosalind Hill, 2 of the staff on duty and with 2 service users. During the course of the day the inspector observed the service users being attended to by staff in a courteous and professional manner. Service users informed the inspector that their expectations of being in a care home were being fully met. Various records, policies and procedures were inspected and found to be satisfactory. The inspector visited all parts of the building and noted a satisfactory standard of hygiene. Service users expressed satisfaction with all aspects of the home What the service does well: What has improved since the last inspection? The home continues to provide a good standard of care. Standards have been maintained. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 6 A positive number of staff are on duty at any one time according to service user need. Forty five percent of care staff have achieved an NVQ qualification and further staff are currently being assessed, so the target of at least 50 of care staff with an NVQ. By the end of the year is achievable. 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. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 5 and 6 Prospective service users are provided with the information they require in order to make an informed decision about admission to the home. Contracts or Statements of Terms and Conditions are provided to all service users. Service users are now fully assessed prior to admission to the home. Prospective service users visit the home to assess it’s suitability prior to ad mission. This home does not provide Intermediate care EVIDENCE: A Statement of Purpose and Service User Guide is available. These documents have been recently reviewed and were readily available to service users and relatives. Four service user files were inspected and case tracked. All contained information pertaining to pre-admission assessment. A registered nurse obtains a full assessment of each service user that is developed into a comprehensive care plan. Each service user has a plan of care for daily living that includes longer-term outcomes based upon the initial assessment. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 9 Information from other health professionals, e.g. District Nurse, Community Psychiatric Nurse, General Practitioner, is obtained where necessary. Contracts and Terms of Conditions were also evident. Trial visits are encouraged with a trial period of between two and four weeks being the usual time for prospective service users to make a decision regarding admission The policies and procedures of the home allow for prospective service users and their relatives to visit prior to admission to assess the quality, facilities and suitability of the home. Standard 6 is not applicable as the home does not provide intermediate care. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The health care needs of service users are identified, planned for and met. Service users are treated with dignity and respect. Medication policies and procedures are comprehensive and followed by Trained staff. EVIDENCE: The care planning system contains all the relevant information required. Care staff maintain the personal and oral hygiene of service users who require assistance with such matters. Service users are assessed regarding the risk of obtaining pressure sores; with appropriate preventative equipment provided as required. The incidence of any pressure sores are recorded and reviewed. All service users are registered with a GP. The home will refer to the District Nurse / Psychiatric Nurse for support and advice as required through the GP practice. Dental and chiropody services are provided Medication storage and processes were inspected. Medication is correctly stored in the ‘treatment room’. Records were properly maintained. Staff were observed to treat service users with dignity and respect. Those service users spoken with confirmed this. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 11 Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 The routines of daily living and activities made available are flexible and varied. Service users receive visitors at any reasonable time throughout the day Service users are helped to exercise choice and control over their lives within the bounds of their individual capabilities Dietary needs EVIDENCE: The routines of daily living within the home appear to be flexible to suit individual preferences. The home offers various activities. Outside entertainment is brought to the home. Service users confirmed the above. A history page is written in all care plans to include individual hobbies and interests, past and present. The visitors book indicated that a steady stream of visitors attend the home. Service users confirmed that they were free to receive visitors at any time. Service users appear to receive a varied, appealing and nutritious diet suited to individual needs, likes and requirements. Lunch on the day of inspection was observed. The meal looked appetising and service users stated that it was hot at the point of delivery. Portions were of a good size and suited to the individual. Lunchtime appeared a sociable occasion Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 13 with staff offering discreet help as and when required. Many of the service users took lunch in the dining area; others preferred to remain either in the lounge or their bedrooms. Comments from the service users regarding meals were very favourable. Special diets are catered for and choices are available. Hot and cold drinks are offered and available throughout the day. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The complaints procedure is well publicised and would be used when required. The registered persons ensure that service users are protected from all forms of abuse with staff having knowledge through training of Adult Protection issues which helps to protect service users EVIDENCE: The home has a complaints policy that meets all the requirements of Regulation 22. A complaints log is available to ensure that a record of all complaints is recorded and kept. Details of the complaints policy are available in the statement of purpose and a full copy included within the service users guide The home has a policy in relation to adult protection, which includes information on whistle blowing. This policy references the Department of Health No Secrets guidelines and physical / verbal aggression by service users. Staff are made aware of this policy during induction and at training sessions. Service users informed the inspector that they were fully aware of the homes complaints procedure and stated that they were quite prepared to use it. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 25 and 26 The location and layout of the home is suitable for it’s stated purpose and provides a generally safe and well maintained environment. The home was clean, hygienic and free from offensive odours providing an attractive and homely place to live EVIDENCE: There is level access to the home, with limited car parking next to the main entrance. The home is homely and domestic in nature. The home was clean, hygienic and free from offensive odours. Disposable gloves and aprons are available as required. Hand washing facilities were satisfactory. The home has an Infection Control policy. The home is fully wheelchair accessible, although some corridors are rather narrow. There is a passenger lift to the upper floor. There is a call system provided in every room. Service users live in safe, comfortable surroundings. Pipe-work and radiators are guarded. Lighting and heating in service users accommodation is adequate. Water is stored at a temperature of at least 60 degrees C and distributed at 50 degrees C minimum Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 16 to prevent risks from Legionella. Pre-set valves are fitted locally to provide water close to 43 degrees C in all bathrooms. The bedroom hot water outlets are not regulated in the same way and those tested were found to emit water at temperatures above the recommended 43 degrees C. This represents a danger from scalding. Ideally pre-set valves should be fitted to all bedroom hot water taps. In any event signs warning of the danger should be posted and risk assessments drawn up for the occupant of each room. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Robust recruitment policies and procedures are implemented. All staff are supported and receive induction training. A positive number of staff are on duty to meet the service user’s needs EVIDENCE: The home has a duty rota that accurately reflected the number and skill mix of staff on duty during the inspection. Additional staff are on duty at busier times of the day. Currently at night there is one trained nurse and 1 carer on duty. Evidence that 45 of the staff team have now achieved NVQ level 2 was presented at the inspection. Several other staff are now enrolled on NVQ training so the target of 50 may well be reached by the end of the year. The home’s employment policies and procedures are implemented. 2 written references were evidenced within a random selection of staff files. CRB checks and POVA checks are completed. Staff training, induction and development programmes are undertaken Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 Quality assurance and monitoring systems should be broadened to encompass relatives and stakeholders views. Service users financial interests are safeguarded. He welfare of staff and service users is promoted. EVIDENCE: Staff and service users are given every opportunity to express their views and opinions regarding the running of the home. More formal Questionnaires should be developed, sent to relatives, service users and other stakeholders, eg. G.P.’s, District Nurses etc. at least annually, to determine performance satisfaction levels. An internal audit occurs every three months to review records and services. Records are well organised, up to date and appropriately signed. Where financial transaction are undertaken on behalf of service users a record is kept and receipts issued. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 19 The health, safety and welfare of service users is promoted and protected through staff training and maintenance of the home. Fire and accident books are maintained accurately and risk assessments for safe working practices are in place. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 2 x 3 x x 3 Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 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 OP 25.8 Regulation 13. (4) Requirement To consider fitting pre-set temperature valves to all hot water taps in bedrooms. To post warning signs and undertake a risk assessment on the occupant of each room. Timescale for action 1st. October 2005 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 OP33 Good Practice Recommendations Expand current quality assurance and monitoring systems to include questionnaires being sent to service users, relatives and other stakeholders. Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 Page 22 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell PL25 4AD 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 Tamar House D52-D04 S9225 Tamar House UI V234011 010805 Stage 04.doc Version 1.30 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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