Inspection on 05/07/05 for Tamar House Residential Home

This inspection was carried out on 5th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tamar House Residential Home 07/03/07

Tamar House Residential Home 24/11/04

Tamar House Residential Home 22/06/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

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 Residential Home 11 Brest Road Derriford Plymouth PL6 5XN Lead Inspector Kim Fowler Announced 5 July 2005 th 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 Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Tamar House Residential Home Address 11 Brest Road, Derriford, Plymouth, Devon, PL6 5XN 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) 01752 510810 01752 202545 The Abbeyfield Tamar Extra Care Society Limited Mrs Anita Mandy Vella Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28), Physical disability over 65 years of age of places (28) Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24/11/04 Brief Description of the Service: Tamar House is a care home providing personal care and accommodation for a maximum of 28 older people over the age of 65 who may also have a physical disability. The home is owned and managed by The Abbeyfield Extra Care Society Ltd, which is a registered charity, affiliated to The National Abbeyfield Society.The home is located in Derriford Business Park, on the outskirts of Plymouth, close to the hospital, transport routes and other amenities. The home was purpose built and opened in 1987. It consists of a two-storey building, which is fully accessible by service users with physical disabilities; it has wide doorways and corridors, level access throughout and automatic doors at the front and a shaft lift.All the home’s bedrooms are single: 13 on the ground floor and 15 on the first floor, 26 of which have en suite toilet facilities, whilst the other two rooms have toilets immediately outside. One of the bedrooms on the ground floor is kept for short-term respite care or for visitors who require an overnight stay. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5 hours and was a planned Announced inspection. A full tour of the premises took place and staff and care records were inspected. The Registered Manager, District Nurse, 2 relatives and 12 of the 28 service users were spoken with during this inspection. The CSCI received 2 Relatives/Visitors comment cards and 5 Service users comment card. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 6 The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 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 Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 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) 1/2/3/4/5 Information provided in the homes Statement of Purpose and Service Users Guide assist service users to make an informed choice of a care home. EVIDENCE: The homes Statement of Purpose and Service Users Guide were both seen during this inspection and evident was that these documents had been updated recently. Case tracking provided evidence that all service users had been provided with a contract with a statement of terms and conditions and some contract are private. Also seen on individual service users files were completed assessments and the manager informed the inspector that prospective Service Users are visited and assessed either by the manager or deputy manager. Evidence was seen of a recent visit to Cornwall to see a prospective service user. The manager informed the inspector that one service user who came from another county was unable to visit but was already from a Addeyfield Home and choose to move to be nearer family members. Some of the service users in the home have a physical disability and the home has a Manual Handling course booked for August. The manager has also attended a National Osteoporosis Society course to assist with the completion of Risk Assessment Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 9 for service user who may be at risk of falling. The home is designed to be fully accessible to people in wheelchairs, has equipment to assist people and the staff are trained. One service users spoken with confirmed that they had visited the home before moving in. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 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) 7/8/9/10/11 The home continues to provide excellent personal support for service users in the home. EVIDENCE: Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 11 Case tracking provided evidence on 2 service users files that the home has drawn up these plans with details for the staff to meet service users individual needs. These plans had been updated and reviewed and now include information on social activities as required in the last full inspection. Information on individual conditions such as diabetes are recorded on these plans and highlight all aspects of care needed. The manager informed the inspector that these plans have expanded over the last year and have completed and comprehensive risk assessment in place based on the information the manager obtained on the recent Osteoporosis course. All plans remain in each service user bedrooms for easy access for staff but the home now has a copy held in the main office. Case tracking provided evidence that accidents were recorded onto the homes accident forms and also the daily logs and individual care plans. The Inspector spoke with a District Nurse who regularly visits the home. They confirmed that the home provides excellent care, that staff appropriately call for support from the health service and follow advice. The home keeps a record of all contact with health services. The service user who self medication now has a completed risk assessment in place as required in the last inspection. Evidence was seen of this being reviewed monthly and recorded when reviewed into individual care plan. The home has completed drug awareness training and the home uses the Nomad system for medication. The manager and deputy oversee any in house medication training. The controlled drug book was seen and checked and was correct. All of the rooms in the home are single and all are lockable and all care is carried out in private. The service users spoken with during this inspection spoke highly of the care provided. The home has a hands free phone that service users can use and evidence was seen that some service users have their own phone installed. One service user who recently passed away remained in the home and the home received additional support from the GP and District Nurse team. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 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) 12/13/14/15 Service users can be confident that the home will enable service users to make decisions and choices about their own lives. EVIDENCE: All interests of the service user are recorded into individual care plans. The weekly activities are displayed on the homes notice board. Several service user informed the inspector that a 40 strong Choir came last week to sing for them. Other confirmed they had been out for a cream tea recently and the home hires a mini-bus when needed. During the inspection process the inspector overheard a conversation between the manager and a relative arrange a lunch date and visit. This information was then relayed to the service user concerned. The inspector spoke to and met 2 relative who confirmed that they visit regularly. It was clear that the home encouraged the service users to make as many choice’s as possible including service users who self medicate and the service users are addressed according to their preference, and are able to manage their own finances. The money was checked and was recorded and documented well. The home does not hold any pension books or bank accounts only everyday expenditure. Relative’s sign when handing money to the home into personal individual accounts. The home employ’s one chef and a kitchen assistant and the inspector met and spoke to the chef during this inspection. It was evident from the conversation with the chef that he provides varied and popular dishes and is enthusiastic about his work. The inspector spoke to 12 of the service users and the service users all agreed that the food was of high Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 13 quality, varied, wholesome and a different choice everyday. This also included meeting special dietary needs including vegetarian and diabetic as indicated by the service users. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 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) 16/17/18 Service users can be confident that their complaints or concerns will be listened to and acted upon. EVIDENCE: The homes complaints procedure was seen and the home has a designated complaints book that was seen during this inspection. The complaints received are recorded as well as the action and outcomes for each complaint. The complaint received and recorded is based on service users complaining about lost or misplaced clothing. The service users feedback cards indicated the service users are aware the home has a complaints procedure. The service users spoken with during the inspection agreed that they would be able to complain and felt that they could approach any member of staff or the management team to raise concerns or complaints. The manager informed the inspector that all voting ballot papers were received and service users were able to vote if they wished. Some of the service users spoken with agreed to this. Based on information provided in the pre inspection questionnaire all staff have completed CRB checks. The home has the Alerter’s guide and the inspector recommended that the Manager and deputy attend the Plymouth City Council Adult Protection course. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 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) 19/20/21/22/23/24/25/26 The home continues to maintain a suitable environment for its stated purpose. EVIDENCE: Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 16 The Home was well maintained and decorated. The layout of the home was accessible and safe for all the residents. The inspector spoke with the handyman who is employed for 20 hours per week to carry out any maintenance jobs as they occurred. It was evident from the tour of the premises that the handyman take care to maintain the upkeep of the home. Evidence was seen of one bedroom being painted as it was presently vacant. External contractors were used as necessary and on a regular basis, eg window cleaning and gardening. The grounds were very attractive, accessible and well used by the Service Users. There was a CCTV camera, for security purposes, monitoring the front entrance to the building. The home had two sitting rooms and a dining area. The visiting hairdresser had a separate room on the ground floor that also was used for a treatment room. There was a no smoking policy for communal areas. Furnishings and lighting were of good quality and appropriate to the needs of the Service Users. The garden was accessible from the lounge and dining rooms, as well as from the front of the building, with the use of gently sloping paths. There were grassed and patio areas and raised flower beds where Service Users could do some gardening if they wished. There were toilets close to the lounges and dining room and 26 of the bedrooms had en suite toilets. The 2 bedrooms that did not have en suite facilities each had a toilet immediately opposite for the private use of the occupants of those rooms. All en suite facilities were accessible and adapted for use by Service Users with physical disabilities. There were three assisted bathrooms and one walk-in shower facility. There was a separate sluice room on each floor, although these are rarely used. Several of the bath and shower rooms have recently been upgrade to include plants and pictures. If two Service Users wish to share a bedroom, they would be provided with another room to use as a private sitting room. All the bedrooms were inspected and were comfortably furnished and it was evident that service users were able to bring their own possessions with them. All the bedroom doors had locks that were accessible to staff in an emergency and all the service users had keys to their own rooms. Each bedroom contained lockable storage space. All rooms had central heating radiators that could be controlled individually and thermostatic valves were fitted. The whole premises were found to be clean, pleasant, hygienic with no offensive odours. There was a sluice room on each floor and laundry facilities were satisfactory. Infection control practices were satisfactory. A local contractor disposed of clinical waste. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 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) 27/28/29/30 Staff training is encouraged and supported enabling service users to receive the best possible service. EVIDENCE: Staff rotas seen provided evidence that the home provides sufficient staff on each shift as well as a duty manager. The home is well supported by domestic, kitchen staff and a chef. The Inspector discussed staffing levels with the service users and they agreed that there was sufficient staff around to meet their needs. The service users and the relatives spoke very highly of staff. The manager informed the inspector that additional staff was provided when needed for example when service users became unwell. The home has 10 of the 15 staff already qualified to NVQ level 2 or above. Case tracking provided evidence that staff files checked during this inspection contained all the necessary documents that would be taken during the recruitment process. The manager also stated that POVA First were carried out on new staff. The recruitment process was clear and well documented. As indicated in the pre inspection questionnaire all staff had completed CRB checks. The staff training records seen during this inspection demonstrated a commitment by the staff to complete relevant training. to competent staff. The home uses an Induction and Foundation Training format that is to National Training Organisation Standards, and evidence was seen of some of these completed by the staff. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 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) 31/33/34/35/36/37 EVIDENCE: The Registered Manager has worked at the home for many years and has been the Registered Manager since 2001. It was evident that the manager continue her own professional development and has now completed her Registered Managers award and her NVQ 4 in Care. The manager is also an NVQ Assessor to assist staff with their NVQ work. The lines of accountability within the Home and with the Executive Committee were clear. The homes quality assurance system was seen and also feedback provided to service user after the completion of the questionnaires. Insurance certificates were in place. The homes finance and business plan are available on request. 14 of the service user are subject to Power of Attorney and the home does not manage the financial affairs of any service user, but does hold some cash for individuals. This money is properly accounted for and is audited by the Honorary Treasurer Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 19 and are open to the home’s audit process. Information on staff files showed that staff has regular supervision and appraisals. Records seen in the home were up to date and well used and all records are kept securely in the main office. Policies and procedures were available on health and safety issues and practices described and observed were found to be satisfactory. The staff are trained in manual handling and risk assessments were available. The home has a infection control course due to start for all staff and the work books seen for this course were comprehensive in detail. The Home had carried out a fire safety risk assessment and all tests and checks of equipment, as well as staff training, were being carried out as required and a fire training course is booked for later this week. All staff were trained in emergency procedures and were qualified first aiders. All staff had attended training in basic food hygiene, fridge/freezer and cooked meat temperatures were recorded and there was a cleaning rota available in the kitchen. Window restrictors were fitted to all windows and the home has low surface temperature radiators. All hot water outlets accessible by the service users were regulated. Risk assessments had been carried out for all safe working practice topics. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 4 3 3 3 4 3 3 4 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 4 x 3 3 3 3 3 3 Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 21 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 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. Refer to Standard 18 Good Practice Recommendations The manager and deputy manager should complete the Plymouth City Council Adult Protection course. Tamar House Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Residential Home D52-D04 S3520 Tamar House Residential Home V215007 050705 Stage 4.doc Version 1.20 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. 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