Inspection on 30/10/08 for Tamarisk

This inspection was carried out on 30th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tamarisk 27/11/06

Tamarisk 09/11/05

Tamarisk 19/08/05

Tamarisk 05/01/05

Tamarisk 08/07/04

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Insight - Eastchurch

Southfields

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Tamarisk 48 Leonard Road Greatstone New Romney Kent TN28 8RX The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Geoffrey Senior Date: 3 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 23 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 23 Information about the care home Name of care home: Address: Tamarisk 48 Leonard Road Greatstone New Romney Kent TN28 8RX 01797364562 01797361702 alfiesid@aol.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Miss Laura Ann Martin Name of registered manager (if applicable) Miss Laura Ann Martin Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Learning disability - LD The maximum number of service users who can be accommodated is: 3 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 23 A bit about the care home 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 therapy 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. 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. The fees for this service range between #1000 and #1700 with additional charges for hairdressing, aromatherapy and transport costs. Care Homes for Adults (18-65 years) Page 5 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 23 How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced visit undertaken on 30th October 2008 as part of the key inspection of the service.The last inspection on this service was completed on 27/11/06. The visit lasted for about four hours. We spoke with the Deputy Manager, two staff members and observed interactions with the three service users during the visit. We looked at a range of documentation and records. We also consider information forwarded to the Commission in the Annual Quality Assurance Assessment completed by the Provider/ Manager. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the care home does well The home provides a homely and safe environment for profoundly disabled people. There is an established staff team who have a good understanding of the current service users needs. There is good leadership endeavouring to ensure the service continues to develop. The home has adequate personal and communal spaces to meet residents needs. There is also an enclosed garden area. Care Homes for Adults (18-65 years) Page 7 of 23 People living in the home are supported in maintaining contact with family and friends What has got better from the last inspection What the care home could do better The staff need to be conversant with the homes Statement of Purpose and Service User Guide in order that they can communicate, to interested parties, the stated aim, objectives and philosophy of the home, its services and facilities. Care Homes for Adults (18-65 years) Page 8 of 23 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Geoffrey Senior 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 9 of 23 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home endeavours to ensure that the support offered is appropriate and reflects the individuals changing needs.The staff need to be conversant with the homes sop in order that they can communicate to interested parties the stated aim, objectives and philosophy of the home, its services and facilities. Evidence: Two of the service users have lived at the home for at least 10 years. We were told that exceptional circumstances precluded the opportunity for thorough pre placement assessments of the most recent arrival. The home has however endeavoured to identify, record and address the individual support needs and, as with other service users, continues to monitor on a regular and ongoing basis. There was evidence that the changing needs of service users are acknowledged and catered for. For example, an increase of choice in general activities and, through positive links with local healthcare professionals and Occupational Therapists, additional therapeutic activity.Previous reports have noted the existence of the Homes Statement of Purpose and Service User Guide. Staff spoken with were not aware of these or whether they are offered to prospective service users and would benefit from the opportunity to view or remind themselves of the content. Care Homes for Adults (18-65 years) Page 11 of 23 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service user plans identify the needs of service users and the home ensures healthcare needs are addressed. Service users are encouraged to express preferences and make decisions affecting their daily lives. Evidence: The home has developed reasonably well structured and informative client files. The needs of each individual are clearly identified as well as the actions required by staff to support the needs. All care plans are reviewed on a regular basis as well as formal review twice a year. Team meetings and handovers are also used to pool ideas and develop support plans further.There is an activity schedule that records details of daily routines and activities. Documentation includes a record of parental communication. Contact with families is encouraged and enabled. Staff maintain contact with service user families to update and inform of any progress, changes or to take part in the decision making process. They also use consultation with families and daily observations to determine the clients preferences. Clients participation in the running of the home is limited but is encouraged where possible. Recent changes in OT programmes has led to a service users involvement in some meal preparation. Care Homes for Adults (18-65 years) Page 12 of 23 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home provides a good range of therapeutic and leisure activities based on personal needs wishes and interests. Family and friends are welcomed to the home and contact with the local community is maintained. Evidence: Staff have worked positively with service users to establish interests likes and dislikes. They are supported to provide a range of activities for both recreational and therapeutic purposes. In addition to accessing local community facilities and events such as fetes and fayres, the service users enjoy trips out in the mini bus or in wheelchairs, locally and further afield. Service users also have frequent use of the Providers family owned swimming pool, spa and day care facilities for arts and craft sessions. Photos of service users engaged in activities assist recall and for future communication.Service users are supported to maintain contact with their families. Staff will contact significant others to update them on progress or changes.Staff said that they have worked with the service users for so long now that they are well aware Care Homes for Adults (18-65 years) Page 13 of 23 Evidence: of their food likes, dislikes and preferences and cater accordingly whilst being mindful of the need for nutritional balance and choice. Care Homes for Adults (18-65 years) Page 14 of 23 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users are treated with respect and their privacy is respected.Healthcare needs are addressed. Medication systems are adequate for the needs of the home Evidence: Staff were observed supporting and responding to service users in a friendly non patronising manner affording them both patience and dignity. All the service users require assistance with personal care and hygiene.The management ensures that staff are instructed and supervised to provide this thoughtfully and sensitively. The service users are not required to share rooms, all have their own private space. The healthcare needs of service users are monitored and addressed. It was reported that the home has developed positive relationships with the local healthcare professionals who provide good levels of support.The medication records and storage facilities were seen to be adequate for the needs of the home. Medication administration records were generally complete and up to date. It was noted however that staff had failed to sign on two days. The Deputy agreed to address this with the member of staff involved. It was also recommended that service users photos are attached to the meds records. Care Homes for Adults (18-65 years) Page 15 of 23 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . There are systems in place for safeguarding vulnerable adults from the risk of harm. Evidence: We were told that all staff have had training in protecting vulnerable adults from the risk of harm and the home has in place, written guidelines relating to concerns and complaints. Staff are aware of their responsibilities and the role they may be required to fulfil in safeguarding those in their care. There are robust procedures in place for managing service users personal monies. Care Homes for Adults (18-65 years) Page 16 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home provides a varied and comfortable environment in which to live and work. Evidence: The home provides a varied and comfortable environment in which to live and work. Service users have their own private space which may be decorated and furnished according to their own preferences. There is a choice of communal areas, a comfortable lounge and room for activities, dining or receiving guests in privacy. The rear garden is accessible but has few features. Hoists and adaptations are in place for the safety and convenience of service users and staff. We were told that service checks are up to date on all installations and equipment. Care Homes for Adults (18-65 years) Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users are supported by a well informed , committed and well established staff group. Evidence: There is a well established staff team, some having worked at the home in excess of 10 years, that benefits from a mix of youth and experience. Staff members are encouraged to attend statutory and specific training courses as well as attaining NVQ at level 2 and 3. Staff files indicate a generally robust recruitment procedure.Staff spoken with expressed an awareness, understanding and committment to providing a good standard of support to the resident service users. Care Homes for Adults (18-65 years) Page 18 of 23 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The service is being well managed resulting in a caring and supportive service thet promotes the health safety and welfare of those who live and work there. Evidence: The Provider/ Manager has many years experience in this field and has attained the Registered Managers Award. There appears to be an open and inclusive structure to the home where staff and interested parties are able to freely express their ideas, concerns, views and opinions. There is a clear line of accountability within the home. The health, safety and welfare of service users, staff and visitors is well maintained. Care Homes for Adults (18-65 years) Page 19 of 23 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 20 of 23 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 1 4 16/01/2009 The Statement of Purpose and Service User Guide to be made available to interested parties and staff members aware of content. Staff spoken twith were not aware of the existance or content.The staff need to be conversant with the homes sop in order that they can communicate to interested parties the stated aim, objectives and philosophy of the home, its services and facilities. 2 2 14 31/12/2008 New service users are admitted only on the basis of a full assessment undertaken by people competent to do so. Staff had no pre admission information about the most recent admission. Care Homes for Adults (18-65 years) Page 21 of 23 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 It was noted that staff had failed to sign MAR sheet on two days. The Deputy agreed to address this with the member of staff involved. It was also recommended that service users photos are attached to the meds records. The Manager is reminded of the need to ensure that all checks are satisfactorily completed on prospective staff prior to commencement of duties. 2 34 Care Homes for Adults (18-65 years) Page 22 of 23 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 23 of 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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