Inspection on 14/07/05 for Tamarisk House

This inspection was carried out on 14th 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 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 House 03/08/07

Tamarisk House 07/08/06

Tamarisk House 04/01/06

Tamarisk House 09/03/05

Tamarisk House 14/09/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Tamarisk House 26 Holt Road Horsford Norwich NR10 3DD Lead Inspector Dot Binns Announced 14 July 2005 10.00am 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 House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tamarisk House Address 26 Holt Road Horsford Norwich NR10 3DD 01603 890737 01603 890840 info@cmg-corporate.com Care Management Group Limited 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) Andrew John Nelson Care Home 3 Category(ies) of Learning Disability (3) registration, with number of places Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Three (3) people with Learning Disability may be accommodated. Date of last inspection 9 March 2005 Brief Description of the Service: Tamarisk is a care home providing personal care and accommodation for up to 3 younger adults with a learning disability. The service user may also have a physical disability. Care Management Group Limited, whose registered office is located in London, owns Tamarisk. The home is located in the village of Horsford and close to the city of Norwich. Local amenities, shops and pubs are also close by. The home consists of an adapted bungalow. All bedrooms offer single occupation. One of the bedrooms has en-suite facilities. There is ample communal space. Externally, there is a large rear garden with patio, lawns and furniture. This is easily accessible to all service users. Limited off-road parking is available at the front of the home. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection lasting six hours. Discussions were held with the acting manager (the registered manager having recently left) and the staff were interviewed. The service users were only able to interact with the inspector in a limited way but their rooms were seen and they were observed in the Home and in the garden. Records and policies were also seen. What the service does well: What has improved since the last inspection? A new manager has now been appointed and will apply for registration. This will enable the home’s staff to be properly supported and innovations to be made. More staff have also been recruited. This will allow the same staff to work in the home (instead of agency or temporary staff) and the service users will enjoy a stable staff group who will know them well. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 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 House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 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 House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 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) 1,2 The service users and their relatives are given helpful information about the home to ensure they make an informed choice. The service users’ needs are properly assessed to make sure the home can care for them properly. EVIDENCE: The service users guide for the home is very good and has pictures to illustrate the words. This makes it easier for the service users to understand. It confirms the rights of the service users and emphasises the service user is to be at the centre of decision making. The terms and conditions of the home and the complaints procedure are included in the guide. The care records were examined and found to contain very comprehensive assessments covering a variety of topics to help the home understand the person’s needs, abilities and preferences. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 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 and 9 Care plans are very good and provide a lot of information for staff to help them understand where the service users need assistance and what they like to do. They are supported to make their own decisions and staff know the service users well and can interpret their choices. Risk assessments are appropriately in place. The way the Home looks after the finances of the service users is muddled and bureaucratic. EVIDENCE: Care plans were in place for each service user giving details of the assistance they needed from staff and what their routines and interests were. Service users sign their care plan and are involved in deciding what support they need. Reviews of the care were seen on the files and included other professionals and relatives being involved. Particular behaviour difficulties are recorded, for instance if the service user has a tendency to be aggressive and includes the actions which staff may need to take to limit it. Staff then write daily reports of how the service users have spent their day. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 10 Service users are encouraged to make as many decisions as possible and staff spoken to reinforced this view mentioning that in every day life the service user keeps to their own routine, choices and activities. They are not able to manage their own money and this is looked after by the Home. The records for these were scrutinised. Currently the benefits are dealt with at the head office of the organisation and then held locally in another resource of the organisation. All the Home receives is a limited amount of cash for each service user. This is then accounted for in a record and receipts kept. However it was not possible to check the records any further back than a month as the record was kept elsewhere. This system is not transparent enough. The system needs to show the money the home is collecting on behalf of the service users and where it is going. Service users should also have access to their own money in an easier way. It is understood that head office is reviewing these procedures and plans to enable each service user to have their money placed directly into their bank accounts. This will be much better. Had this not been proposed a requirement would have been made. Instead a recommendation is made to change the system as soon as possible. Risk assessments looking at areas where there might be a danger for service users were in place and showed the assistance they might need to perform certain tasks, for instance road safety, dealing with their own finances and self medicating. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 11 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) 12,13,14,16 and 17 Service users enjoy outings and activities organised by the staff but would benefit from the use of facilities outside of the Home and with other people. This would provide further stimulation and an opportunity to meet and do things with other people other than the resident service users. Service users are taken into the community by staff and enjoy a variety of leisure facilities including holidays. Routines are flexible and service users are given as much choice as they are able. They also enjoy good food. EVIDENCE: Service users are not able enough to work and currently do not attend any day services or sheltered training schemes. They are kept occupied with outings and activities by staff but are not benefiting from other facilities away from the home. Staff felt it would be beneficial for them to have something outside the home giving them a change of people and place to relate to. It is recommended that the manager looks into this possibility. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 12 Staff do spend a lot of their time occupying the service users and evidence of the activities were seen in the care files and spoken about by staff. They go out into the community most days with the Home’s transport and horse riding, shopping, trips out were mentioned. Staff said they find out if there are any events happening in the community and take the service users to them. Staffing is consistent throughout the week and staff confirmed that supporting the service users outside of the Home is considered part of their duties and that they can leave the premises on most days. This is good practice by the Home. Staff also see that service users have things to do in the Home. Where they can, the service users help with the chores and have their own music or hobbies. The organisation also pays for holidays for the service users and there was evidence of this in the care records. The daily routines are flexible and on the day of the inspection one service user was still having her breakfast at 10am. Staff confirmed that they are very relaxed and judge what the service users want to do. They said the service users can have a bath every day and stay up late or go to bed early. Staff were seen to interact well with the service users who were relaxed and moving around the house as if it were their own. One service user showed the inspector their room and said she was happy living there. The atmosphere was easy and relaxed. The menus were seen and looked good and nutritious with a choice. Lunch was served during the inspection and consisted of French bread and cheese and salad with staff and service users sitting together. Everything was presented attractively. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 13 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) 19 and 20 The health needs of the service users are monitored and attended to in the Home ensuring that the service users are comfortable and well. There are good procedures for looking after the service users’ medication to make sure they have the right medication at the right time. EVIDENCE: The care files showed plenty of evidence of the health needs of service users being monitored. There was reference to appointments with the doctors, dentists and chiropodists and the nurse visiting, Staff monitored the weight of service users and looked after their skin. Service users had flu injections and reports of accidents were kept. Staff understood the service users well and gave them one to one attention ensuring that they were comfortable. All service users have their medication looked after by the home. The records were checked and were completed satisfactorily. Stock control was also recorded. Drugs are kept in a locked cupboard. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 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) Not inspected on this occasion. EVIDENCE: Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 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) 25,26,27 and 28 This is a small home for only three service users and it is domestic and homely. The bedrooms are all single and well decorated and comfortable. A review of the furniture and plugs has been recommended to ensure that the service users have all the facilities. The home was clean and bright. EVIDENCE: The three bedrooms of the service users were visited and although quite small were bright and attractively decorated and the service users had been encouraged to display their own pictures and possessions to make the rooms homely and individual. They were missing a chair and a bedside light and these items should be considered. The number of plugs should also be reviewed to ensure that the increasing amount of electrical appliances can be catered for. One bedroom had an ensuite toilet and shower but this was without a door. This is not ideal and should be reassessed. The service users had an attractive sitting room with a dining table at one end. It was well decorated and furnished. French doors lead to a pleasant back garden with furniture and a swing. The bathroom was also satisfactory and service users are able to have a bath every day. There was no offensive odour in the Home. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 16 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) 34,35 and 36 Recruitment procedures are satisfactory giving protection to the service users. Some training is provided but more NVQ training should be promoted. One to one supervision of staff is not currently in place and should be reinstated to benefit the service users. EVIDENCE: Three staff files were checked at random to see what procedure was used in recruitment. All had an application form, references, identity check and criminal records check. A contract and job description was in place as well. Training files were also examined. They included induction training and an individual training record for each staff. Only one staff is qualified to NVQ2 level and the Home is below standard on such training. The supervision of staff was mentioned in the staff files and there was a supervision contract explaining what was involved. However there was not enough evidence to show it was being carried methodically and this is something the new manager will need to implement. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 17 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) 42 The health and safety of the service users and staff is protected with policies and training. EVIDENCE: The fire record was checked and showed that procedures were in place to prevent a fire. Staff had received training and there was a risk assessment of the building. Monthly health and safety checks were carried out by the Home and checks had been made on electrical and gas appliances. Water temperatures were also checked and monitored. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 18 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 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 2 3 3 x 3 Standard No 11 12 13 14 15 16 17 x 2 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tamarisk House Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 19 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 36 Regulation 18(2) Requirement One to one supervision of staff should be provided. Timescale for action 31.8.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 7 12 26 26 35 Good Practice Recommendations It is recommended that the work being carried out to review the procedures in looking after service users finances is brought in as soon as possible. It is recommended that opportunities are investigated for the possibility of service users being able to attend outside facilities. A review of the facilities in each bedroom is recommended to ensure there are enough chairs, bedside lights and plugs It is recommended that a door is put on to the ensuite in a service users bedroom. It is recommended that more NVQ training is provided. Tamarisk House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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 House I55 S27586 Tamarisk V228073 140705 Stage 4.doc Version 1.30 Page 21 - 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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