CARE HOME ADULTS 18-65
Tamarisk 48 Leonard Road Greatstone New Romney Kent TN28 8RX Lead Inspector
Wendy Mills Announced Inspection 9th November 2005 12:00 Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 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 Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 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 Adults 18-65. 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. Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Tamarisk Address 48 Leonard Road Greatstone New Romney Kent TN28 8RX 01797 364562 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) lauramartin09@aol.com Miss Laura Ann Martin Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th August 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 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. 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 DS0000023250.V250801.R01.S.doc Version 5.0 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 hours. The inspection included a tour of the home, time spent with three of the clients, the deputy manager and the registered manager. Key documentation was examined and both direct and indirect observation was used throughout the inspection. 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 6 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 Outcomes Statutory Requirements Identified During the Inspection Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 7 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 the following standard(s): 1, 2, 3, 4 & 5 The home provides the clients, their relatives and supporters with the information they need to make decisions about the home. EVIDENCE: The home has a statement of purpose and a service user guide. It maintains close contact with relatives and care managers. No new service users have been admitted since the last inspection. Prospective clients and their supporters can visit the home prior to admission. Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 6, 7 & 9 The home supports the profoundly disabled clients well. The staff work hard to minimise their disabilities and maximise their potential. EVIDENCE: Care plans are reviewed regularly and risk assessments are in place. There is a daily activity schedule that records details of daily routines and activities. Documentation includes a record of parental communication and contact with families is maintained. 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 staff are aware of this. Confidential care records are kept in the office in a locked cabinet. Other records are kept at Head Office. Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 11, 12, 13 & 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 continue to attend day care facilities and have outings into the local community. 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 another suitably adapted vehicle. Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 18 & 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 but should take care to ensure that medicines are stored at the correct temperatures. 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. Since the last inspection the cabinet in which medication is stored had been moved next to a radiator. There was no thermometer and therefore it is possible that medicines are being stored at temperatures above the recommended levels. The home should obtain a thermometer and maintain a
Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 11 record of temperature checks. In addition, the cabinet should be moved to a place in the room where the temperature is likely to be more constant. Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 22 & 23 There is a clear procedure for complaints. This allows for the clients’ relatives and supporters to make complaints on their behalf should the need arise. There are sound systems in place to protect the clients from all forms of abuse. . EVIDENCE: The home has comprehensive policies and procedures in respect of complaints and adult protection. Ms Martin has undertaken the “Train the Trainer” course and adult protection training for all staff will take place later this month. There is a good awareness amongst staff about adult protection issues and a whistleblowing policy is on display. The arrangements for the management of the clients’ personal monies were inspected. The deputy manager is diligent in the way she accounts for all monies spent of behalf of the clients. Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 24, 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. Specialist equipment is provided and well maintained EVIDENCE: A tour of the home was undertaken. The accommodation is all on one level and all areas are wheelchair accessible. Each client has 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. The broken cupboard identified at the last inspection has been replaced.
Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 14 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 & 34 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: There is a very low staff turnover and staff say that they are very happy working in the home. Staffing levels meet the needs of the clients. A sample of staff files was inspected. These were all in order and showed that appropriate checks had been made prior to employment. Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 15 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38 & 42 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. They 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. No health and safety hazards were noted on the day of inspection Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Tamarisk Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 3 X DS0000023250.V250801.R01.S.doc Version 5.0 Page 17 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 YA20 Regulation 13 Requirement Medicines to be stored at correct temperature. Temperature to be monitored Timescale for action 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tamarisk DS0000023250.V250801.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Kent and Medway Area Office 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
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