Inspection on 07/02/06 for Tamar House

This inspection was carried out on 7th February 2006.

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 01/08/05

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 Tamar House 175 Old Ferry Road Saltash Cornwall PL12 6BN Lead Inspector Mike Dennis Unannounced Inspection 7th February 2006 09:30 X10015.doc Version 1.40 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 Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 DS0000009225.V277352.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tamar House Address Tamar House 175 Old Ferry Road Saltash Cornwall PL12 6BN 01752 843579 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) Mrs Mary Yvonne Beaumont Mrs Paula Barbara Hannon Care Home 21 Category(ies) of Dementia - over 65 years of age (3), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (21), Physical disability over 65 years of age (6), Terminally ill over 65 years of age (3) Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Service users to include up to 21 adults of Old Age (OP) Service users to include up to 6 adults with a Physical Disability (PD[E]) Service users to include up to 3 adults with a Terminal Illness (TI[E]) Service users to include up to 3 adults with a Mental Disorder (MD[E]) Service users to include up to 3 adults with Dementia (DE[E]) Total number of service users not to exceed a maximum of 21 Date of last inspection 1st August 2005 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 DS0000009225.V277352.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 7th. February 2006. over a six hour period. The inspector met with the Registered Provider, Mrs. Beaumont, the Registered Manager, Mrs. Hannon, the qualified nurses on duty, and with several service users and one relative. 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. A positive number of staff are on duty at any one time according to service user need. Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 6 The Monitored Dosage System for the administration of medication has been introduced which should prove beneficial to all concerned. Quality assurance and quality monitoring systems are operated at the home. This has now been put on a more regular and formal basis which can be developed to encourage reflection on the services provided. 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 DS0000009225.V277352.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 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 the following standard(s): 1 to 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 Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 9 comprehensive care plan. Each service user has a plan of care for daily living that includes longer-term outcomes based upon the initial assessment. 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 DS0000009225.V277352.R01.S.doc Version 5.1 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 the following 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 inspector met with the G.P. who regularly visits on a fortnightly basis. 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’. The home has recently changed over to the Monitored Dosage system. Records were properly maintained. Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 11 Staff were observed to treat service users with dignity and respect. Those service users spoken with confirmed this Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 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 the following standard(s): 12 and 13 The routines of daily living and activities made available are flexible and varied within the limitations of the individual service user. Service users receive visitors at any reasonable time throughout the day 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 majority of service users are unable to leave the building. 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. The inspector met with one relative. Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 16, 17, 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. There has been one recorded complaint received in the last six months from an anonymous source. It was promptly dealt with by management. 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. The inspector and manager had a full discussion on reporting procedures necessary to instigate POVA strategy meetings and the importance of these meetings. It is recommended that training courses are accessed by senior staff re: abuse and alerting procedures. They can then cascade information to other staff as part of induction training and on going in house training. Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 14 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. A service user informed the inspector that she had regular contact with her solicitor indicating that service users legal rights are protected. Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 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 the following standard(s): 19 to 26 The location and layout of the home is suitable for it’s stated purpose and provides a generally safe and well maintained environment. Accommodation to include communal space was seen to be satisfactory. Facilities and equipment meets service users needs. 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 in the majority Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 16 of areas. 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 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. Ideally pre-set valves should be fitted to all bedroom hot water taps. Signs warning of the danger have been posted and risk assessments drawn up for the occupant of each room. Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 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 35 of the staff team have achieved NVQ level 2 was presented at the inspection. Other staff will be enrolling on NVQ training. This represents a reduction of 10 over the last 6 months due in part to staff leaving 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. A list must be kept in respect of CRB/POVA checks to include the staff members name, date sent, date received, certificate number and findings. This will enable an inspector to verify records. Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 37 The registered manager is qualified and experienced. Quality assurance surveys and monitoring systems have been introduced. Service users financial interests are safe guarded. Staff are appropriately supervised. The records and policies inspected were found satisfactory. EVIDENCE: The registered manager has been in post for the past 11 years and is a qualified RGN. The registered provider visits the home on a daily basis. Staff and service users are given every opportunity to express their views and opinions regarding the running of the home. More formal Questionnaires have been developed and are now being sent to relatives, service users and other stakeholders 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. Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 19 Staff supervision is recorded as are staff and residents meetings. Where financial transaction are undertaken on behalf of service users a record is kept and receipts issued. Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 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 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 X Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation 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 2 3 Refer to Standard OP18 OP25 OP28 Good Practice Recommendations It would be beneficial for staff to attend training on the prevention of abuse and ‘alerting’ procedures. As finance allows, hot water outlets in bedrooms should be fitted with pre-set control valves to regulate water temperatures at 43C. Those care staff without NVQ training should be encouraged to obtain this qualification in order to achieve the national minimum standard of having at least 50 of staff with an NVQ Compile a list of the staff stating, name, date CRB/POVA sent for, date received, certificate number, result. 4 OP29 Tamar House DS0000009225.V277352.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall 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 DS0000009225.V277352.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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