CARE HOME ADULTS 18-65
Tamar House 5 Riseholme Road Lincoln Lincs LN1 3SU Lead Inspector
Ken Hague Unannounced 29 June 2005 @ 8am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Tamar House Address 5 Riseholme Road Lincoln Linc LN1 3SU 01522 524093 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) Prime Life Limited Mr S Haines Care Home 13 Category(ies) of LD (Learning Disability) -13 registration, with number LD(E) (Learning Disability over 65 years) - 2 of places Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 24 November 2004 Brief Description of the Service: The Care Home is an adapted detached two-storey Victorian property situated on the edge of a residential area, in the northern part of the City of Lincoln. A small-secluded garden is situated at the side of their home with an enclosed garden at the front and both can be used by service users. A large extension to the property has provided eight single bedrooms bringing the total provision to twelve. The home offers care services to 13 service users with a learning disability. The service users are provided with opportunities to access a number of day care facilities within the local area and Prime Life Ltd provides transport. . Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out over a period of 4.5 hours. There were two service users spoken to during this inspection, one taking part in a very detailed discussion. A member of staff was interviewed. A second interview was held with the registered manager. A sample of care records was inspected. What the service does well: What has improved since the last inspection? What they could do better:
The home carries out risk assessments as part of the initial assessment made before the service user comes into the home. The care records would be improved if the risk assessment and the management of any identified risk was cross-referenced with the care plan.
Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 6 The risk assessments should be filed individually within the care file and not kept together in a plastic folder. This could result in staff missing an important risk assessment. 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 C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 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 standard(s) 1,2,4&5 Service users are provided with information which allows them to make an informed choice whether the homes resources can meet their needs. All new service users are invited to visit the home prior to them being admitted to the care home. Every new service user receives an assessment which includes a risk assessment prior to them being admitted. Service users are given a statement of the terms and conditions for their stay at the care home. EVIDENCE: A new service user admitted to the home in May 2005 confirmed that he had been given the opportunity to visit the home prior to being admitted for shortterm care. He said that he had spoken to the registered manager and all staff had been very helpful. He stated at the end of this visit he felt “Im going to like it here”. The service user confirmed that he had been given a copy of the terms and conditions for his stay at the home. He was able to tell the Inspector the details of his personal contributions towards the cost of his placement. He was also aware of the details of his personal allowance. Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 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 standard(s) 6,7&8 Care plans contain the personal goals of each individual service user which is agreed with them at their review. Service users are consulted regarding the day-to-day running of the care home. They are encouraged to make decisions regarding their own life style. EVIDENCE: All of the files inspected contain the personal goals of individual service users. One service users goal was “I would like to do more activities, but these limited by my health problems. Staff are helping me to improve my health so I can achieve my dreams”. A second service users goal was “ I wish to be able to return into the community and live independently.” The Inspector observed service users being encouraged to take on small tasks in the home, eg looking after their own bedrooms and washing their own crockery. A service user confirmed that he looked after his bedroom and only asked assistance from staff to make the bed. Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,16717 There are a wide range of leisure activities and training opportunities offered by the home. Service users can develop their personal skills and take-up educational opportunities. The catering arrangements of the home meets the dietary needs of service users while providing choice and quality. EVIDENCE: The registered manager stated that there are activities held at the care home which include barbecues, visits to local restaurants and outings to places of interest. Service users can attend local leisure centres and further education opportunities are offered through colleges and day centres. Service users interviewed confirmed this to be the case. Service users are encouraged to maintain their own individual skills by carrying out small domestic tasks and taking responsibility for their own individual bedroom. Family and friends are often invited to take part in social activities carried out at the home. There are TV and video equipment in the lounges of the care home. Some service users have their own TV, video and DVD’s in the bedrooms. A phone is provided for service users to keep in contact with the family, some service users have their own mobile phones.
Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 11 Service users stated that the food provided is good and enjoyable. A service user told Inspector his likes and dislikes in relation to his menu. These details were recorded on his individual care file. Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 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 standard(s) 18,19, The home consults with service users in agreeing the manner in which personal care and support is to be given to each individual. Service users physical, emotional and health needs are being met by the home by using community services, consultants and GPs. EVIDENCE: The care plans seen during this inspection contained details of dental care eye care and chiropody. One service users files stated that he needed assistance with eye care and that an eye test appointment had been made. A second file contained details that a service user refused to wear dentures. Evidence was found on this file that this choice was being reviewed with the service user on a regular basis. A service users file contained details of hospital appointments and this information was confirmed to be correct by the service user during informal discussions. This service user also confirmed that he had previously been taken for hospital outpatient appointments on several occasions. Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 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 standard(s) 22,23 The home has policies and procedures to ensure that all service users are protected from any possible abusive situation. The home listens to the views of individual service users and records the details in individual care files. EVIDENCE: The home has a complaints policy in place and a vulnerable abuse policy which meets the National Minimum Standards. The company provides training in the recognition and prevention of abuse. A copy of the Lincolnshire County Council Vulnerable Abuse Policy is kept in the office and is displayed on the staff notice board. Staff confirmed in interviews that they have been provided with training in the recognising and prevention of abuse. A member of staff interviewed, explained the companies abuse policy and stated she would report any incident immediately to her line manager. The home has received no complaints since the last inspection. The home holds service users meetings. Staff stated that they speak to service users on a daily basis obtaining their views regarding the provision of services. These comments are referred back to the registered manager. The register manager confirmed that Prime Life Ltd continue to hold its own quality assurance programme sending out questionnaire to service users on a regular basis. Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 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 standard(s) Not inspected EVIDENCE: Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34&36 The home provides training for all staff and encourages NVQ training. There are sufficient staff on duty to provide essential care for service users. The night staff provision needs to be kept under review as agreed with the Commission for Social Care Inspection. EVIDENCE: The registered manager stated that the home will have 50 of its staff with an NVQ Level II in care by the end of 2005. Service users stated that staff are kind and helpful and all seem to be available when help was requested. An inspection of the individual file for a new member of staff provided evidence that the recruitment policy of Prime Life Ltd is being followed. This policy meets the National Minimum Standards. The registered manager stated that staff meetings were held on a monthly basis and were minuted. The Inspector saw a copy of the minutes of the last staff meeting held in June. Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39&42 The home has an experienced registered manager in post who has specialised knowledge in working within the field of learning disabilities. Staff stated that he is a supportive and proactive manager. Staff are receiving supervisions and an appraisal. The registered manager is supported by his line manager in ensuring that the National Minimum Standards and Care Home Regulations are met. EVIDENCE: Care home records provided evidence that supervision and appraisals are being provided to all staff at the frequencies set out in a National Minimum Standards. The registered manager and the staff confirmed this to be the case. The registered manager will have completed his NVQ 4 by the end of July 2005. There were no health and safety issues identified at this inspection. Service users confirmed that they found the home a safe place to live in. Staff stated that they felt it was a safe environment in which to carry out their employment. The care staff confirmed that their manager is approachable and encourages them to take part in NVQ training.
Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 17 Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 18 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 x 3 4 Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Tamar House Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 19 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 Regulation None Requirement Timescale for action 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 7 Good Practice Recommendations The home is recommended to review its recording of risk assessments to ensure they are cross-referenced with care plans. Completed risk assessments should be filed individually on the service users files not in a common plastic folder Tamar House C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 C53 C04 S2433 Tamar House V234872 29-6-05 Stage 4.doc Version 1.30 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
