Inspection on 19/08/05 for Tamarisk

This inspection was carried out on 19th 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

Tamarisk 30/10/08

Tamarisk 27/11/06

Tamarisk 09/11/05

Tamarisk 05/01/05

Tamarisk 08/07/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Tamarisk 48 Leonard Road Greatstone New Romney, Kent TN28 8RX Lead Inspector Wendy Mills Unannounced 19 August 2005 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. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Tamarisk Address 48 Leonard Road, Greatstone, New Romney, Kent, TN28 8RX 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) 01797 364562 Laura Ann Martin Care home only 3 Category(ies) of Learning Disability x 3 registration, with number of places Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2005 Brief Description of the Service: Tamarisk is registered to provide accommodation for up to 3 adults with a learning disability. Ms Laura Martin is the registered provider/manager. The home provides spacious, wheelchair-accessible accommodation. The property is a detached bungalow with 3 single bedrooms. There is and additional room used for staff sleep-in duties and a small therpay room with equipment to help posture and to provide sensory stimulation. There is a bathroom with shower, kitchen, lounge and conservatory. The laundry is situated in the garage. Currently there are two permanent clients and two respite clients. Tamarisk has a garden at the rear of the property with shrubs, lawn, patio area and a swing. The front and side areas are laid to concrete for parking. The Home is situated in a quiet residential area of Greatstone. Within a short walk are the beach, pub, newsagents, hairdressers and convenience stores. Tamarisk has a minibus with tail lift and also another vehicle to transport residents. There is a local bus service to the nearby towns of Lydd and New Romney, which are approximately 3 miles away. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Ms Laura Martin, registered provider/manager for the home assisted during this inspection, which lasted approximately two and a half hours. The inspection included a tour of the home, time spent with three of the clients and two staff members and examination of key documentation. What the service does well: What has improved since the last inspection? There has been an improvement in the level of staff training since the last inspection. All staff have completed their statutory training and there has been further training in the administration of medicines. Ms Martin is due to complete the National Vocational Qualification (NVQ), in Management and Care, level IV, in one month’s time, and one carer is due to complete the NVQ at level III by Christmas. New furniture has been provided for the sitting room and a new hoist is currently being fitted. Adult Protection training has become more intense. Ms Martin has completed a “Train the Trainer “ course in adult protection. She has planned an adult protection course for all staff in November. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 6 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. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 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 Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 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) None of these standards was inspected at this visit. No new clients have been admitted since 1999 and previous inspections have shown that the home meets these standards. EVIDENCE: Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 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,&10 The home supports the profoundly disabled clients well. The staff work hard to minimise their disabilities and maximise their potential. EVIDENCE: There is comprehensive, risk assessed and recently reviewed information contained in the care plans. There is a daily activity schedule that records details of daily routines and activities. Although this is good, it could be improved by including prompts for staff to carry out daily therapy regimes. Care documentation includes a record of parental communication and Ms Martin said that the home has a good record for maintaining positive contact with families. Due to the severity of the clients’ disabilities the home has to use consultation with families and daily observations to determine the clients preferences. None of the clients is able to participate in the running of the home. Regular care reviews take place and relatives are invited to these reviews. The Home has a policy on confidentiality and all staff are aware of this. Confidential care records are kept in the office in a locked cabinet and other records are kept at Head Office. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 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) 11,12,13,14,15&17 The home supports the clients to be accepted as part of the local community and to take part in suitable activities. The clients are offered a varied and healthy diet and special requirements in respect of feeding and nutrition are catered for. EVIDENCE: Records show that the clients attend day care facilities and have outings into the local community. Staff said that they view the clients as their extended families and that they try to include the clients in as many activities as possible. Indirect observation also showed that there are a number of opportunities for activities and stimulation within the home. There is a therapy room with sensory and postural correction equipment, ball games and a specially adapted swing in the garden. The Home has a minibus and other suitably adapted vehicle. One Service User has an adapted bicycle. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 11 Those clients who are able, have freedom of movement around the house and staff were observed to interact with the clients in a pleasant and friendly manner. The daily log includes a record of food provided. There are no set menus and shopping is done on a weekly basis with fresh produce being purchased daily. The clients’ likes and dislikes are recorded and they are weighed regularly. All staff are aware of the importance of fluids. Appropriate assistance was noted to be given at mealtimes. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 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&20 Personal support is offered in a way that protects the clients’ rights to privacy and dignity. The Home supports the health needs of the clients and promotes good health. The home has sound systems for the administration of medication in place. EVIDENCE: Personal support is delivered in a sensitive and discreet way. Specialist equipment is provided to ensure that the clients can achieve postures that will minimise their disabilities and enable then to participates as much as is possible. One client has a static bicycle and others have specialist wheelchairs. All equipment is properly maintained and reviewed. Service Users have access to a GP and other health specialists as e.g. dentist and chiropodist. Health care professionals are consulted appropriately. The home is well supported by the learning disabilities specialist nurse. Records show that visits have also been made by a chartered physiotherapist and a speech and language therapist. Specialist advice is clear and recorded on the care plans. Ms Martin said that staff routinely carry through with these specialist programmes. As already mentioned earlier in this report, it would be helpful to include written prompts for these programmes in the daily activity schedule to ensure that there is no lapse in routine delivery. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 13 The management of medication has been delegated to the deputy Manager who is a registered nurse. There are good systems for the recording and administration of medication. Staff have recently undertaken medication administration training. A separate locked cabinet is available for medication storage. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 14 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) 23 EVIDENCE: The home has a comprehensive policy and procedure in respect of adult protection. Ms Martin has undertaken the “Train the Trainer” course and plans to deliver adult protection training to all staff this coming November. There is a good awareness amongst staff about adult protection issues and a whistleblowing policy is on display. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 15 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) 24,25,26,27,28,29&30 The standard of the environment within the home is good and provides the clients with a pleasant, homely and safe place in which to live. EVIDENCE: A tour of the home was undertaken in the company of Ms Martin. The accommodation is all on one level and all areas are wheelchair accessible. Each client has a good-sized bedroom and specialist equipment. Equipment is well maintained and stored appropriately when not in use. The bathroom had both a bath and a shower and a hoist is fitted. There is a large lounge, a pleasant conservatory when the clients take their meals and a therapy room. Outside there is a large, well-maintained garden with a swing. On the day of inspection all areas of the home were clean and tidy and there were no offensive odours. Only one health and safety hazard was noted during the inspection. A cupboard door is missing from a kitchen cupboard. Ms Martin said that they are trying to find a door that matches the other units but Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 16 so far have been unsuccessful. She said that the home was aware of the problem and were taking action to get it fixed. In the meantime, they are minimising risk by ensuring that the one client who is mobile is given appropriate support whilst in the kitchen area. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 17 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) 31,32,34&36 The staff have a good understanding of the clients’ support needs. This is evident from the positive way they interact with them. Staff morale is high resulting in very low staff turnover and good consistency of care. EVIDENCE: Staff said that they are very happy working in the home and enjoy caring for the clients. They said that there is a family atmosphere and that they can discuss any concerns they may have with the manager. Staffing levels meet the needs of the clients and ensure that they can take part in scheduled activities. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 18 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 Ms Martin is well supported by senior staff and has a good understanding of good care practice. This means that the clients benefit from a well run home. EVIDENCE: Conversation with Ms Martin and the deputy manager confirmed that they both have a good understanding of the specialist needs of the clients. Them were open and honest and receptive to constructive comments about the home. There is a relaxed and friendly atmosphere in the home and arrangements for staff supervision are in place. Good relationships exist with families and there is frequent contact and consultation with most families. Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 19 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 x x x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score 3 3 x 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tamarisk Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 20 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 24 Regulation 23 Requirement Kitchen cupboard door in kitchen to be repaired Timescale for action 30th September 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 Good Practice Recommendations Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 Tamarisk H56-H05 S23250 Tamarisk V239654 190805 Stage 4.doc Version 1.40 Page 22 - 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!