Inspection on 24/11/06 for Tamarix Lodge

This inspection was carried out on 24th November 2006.

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

Tamarix Lodge 24/11/08

Tamarix Lodge 25/01/06

Tamarix Lodge 20/10/05

Tamarix Lodge 24/02/05

Tamarix Lodge 06/10/04

Tamarix Lodge 09/02/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Tamarix Lodge 142 Queen Street Withernsea East Yorkshire HU19 2JT Lead Inspector Rob Padwick Unannounced Inspection 24th November 2006 1:30 X10015.doc Version 1.40 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 Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tamarix Lodge Address 142 Queen Street Withernsea East Yorkshire HU19 2JT 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) 01964 615707 01964 612092 Humberside Independent Care Association Limited Mrs Lynn Allwood Care Home 37 Category(ies) of Dementia - over 65 years of age (37), Old age, registration, with number not falling within any other category (37) of places Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: Tamarix Lodge provides residential care older people some of who may have a dementia type illness. The home is owned and operated by Humberside Independent Care Association (HICA), a not for profit organisation and is located on the main street of Withernsea, East Yorkshire. Residents have easy access to the seafront, local shops, pubs, services and public transport. Tamarix Lodge is a purpose built property with accommodation on two floors. There is a passenger lift. Most rooms have en-suite facilities. All are designed for single occupancy. The standard fees charged by the home range from £395 to £440 with additional charges made for hairdressing, chiropody, toiletries etc. Tamarix Lodge provides information about the home to Residents in its Statement of Purpose and Service User Guide. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit for this service lasted for 6 hours and included a tour of the building and checking the progress in implementing the requirements and recommendations from the previous inspection. During the visit, time was spent observing the residents daily lives and talking with them in the home’s communal areas or in their private bedrooms. Other time was spent reading care plans and files and talking to staff. A Pre Inspection Questionnaire asking for information about the home was sent to the manager before this visit and information from this was included as part of the inspection process. Other information that was used included reports from monthly visits carried out by a senior manager from the parent company and notifications received by the Commission for Social Care Inspection about serious incidents that had taken place in the home. Questionnaires were sent out to relatives and Health and Social Services staff associated with the home. Four replies were received from the group of relatives who were contacted, all of these commented favourably about the home, but two of these expressed some concerns about the staffing levels in the home. These concerns, however, could not be substantiated from evidence obtained as part of this inspection visit. Four comment cards were returned from professionals associated with the home. These all expressed satisfaction with the service and others contacted by phone were equally positive. What the service does well: What has improved since the last inspection? The requirements from the previous inspections had been all been carried out. The information book that is given to residents when they are thinking about moving into the home, had been developed to include information about the home’s smoking policy. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 6 Improvements had been made to the building with repairs to the dining room floor being carried out and new carpets being laid in the home’s corridors. Improvements had been made in the recording of medication that is given to residents and staff training had been continued. 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. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. Assessments of the residents had been undertaken, in order to ensure that the home could meet their needs satisfactorily. Updated information about the home was available, in order to residents were kept informed about any changes to the service that would affect them and that prospective residents could make an informed choice about moving into it. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents indicated that they had been involved in decisions about moving into the home and recently updated information about the service was available to ensure that they were kept informed about changes to the service that would affect them. Inspection of the file of the most recently admitted resident confirmed that an assessment of her needs had been carried out prior to her moving into the home, in order to ensure that the service was able to meet her needs. Tamarix Lodge does not admit residents for intermediate care. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 10 and 11 Quality in this outcome area is good. The health and personal care of the residents was being well met by staff that had received training in order to ensure that they could do their jobs. This judgement has been made using available evidence including a visit to this service EVIDENCE: Residents indicated that staff were meeting their health and personal care needs. Individual support plans for each of the residents were available in their bedrooms and one of the residents confirmed that she regularly read hers, in order to ensure that she was in agreement with the information given to staff about how they should meet her needs. Support plans inspected contained copies of assessments of the residents, together with monthly summaries and amendments to these as needed, and daily recordings of the care that had been given. Discussion with a Social Services member of staff who was conducting reviews of two of the residents during this inspection visit, and another contacted by phone, confirmed that the standard of care planning was of a good standard. Risk assessments of known issues concerning the individual residents were contained in the support plans examined. A Community Psychiatric Nurse contacted as part of the inspection process Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 10 indicated that staff worked well with her and that her advice was followed appropriately. A visiting doctor attending one of the resident’s during this inspection visit, commented positively on the care that had been delivered to a seriously ill resident, in order that their wishes to stay in the home were respected, rather than being transferred elsewhere. A random check of the drugs confirmed that appropriate records were being maintained and discussion with staff indicated that only the senior staff members on duty had responsibility for the administration of medication. Evidence of training in this area of practice was seen and observation of a medicine round was satisfactory. Staff were observed to respect the residents’ individual wishes for privacy and displayed a friendly and courteous approach in working with them. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. The residents’ daily lives were being met by a variety of social activities, but their wellbeing would be enhanced by a greater consideration for their individual wishes and needs for personal autonomy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most of the residents indicated that they were content and that their daily lives were of a good quality. Residents were observed happily conducting their own bingo session during this visit and information submitted by the manager as part of the inspection process, indicated that a range of activities were available for the residents to participate. A special programme of events had been developed for the forthcoming Christmas period including trips out and visits from professional entertainers and notices about these were displayed in the residents’ bedrooms. Relatives were observed coming and going throughout the inspection and comment cards returned from them indicated that they were happy with the service. Residents confirmed that staff were “very caring” and “ helpful”. However, some of the more independent residents indicated that their wishes for independence were sometimes affected by staff “spoiling” them and “doing things for them”. No specific activity organiser is employed in the home and therefore a recommendation is Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 12 made that the registered manager gives consideration to the development of such a role, in order to enhance the residents individual wishes for personal autonomy and to foster a wider sense of all the residents’ emotional and psychological wellbeing. Residents confirmed that the food was good, and discussion with the cook indicated that the residents were able to influence the choices of food available. Evidence of this was confirmed by inspection of the minutes of a recent residents meeting. The home has achieved a “heartbeat” award for the provision of healthy and nutritious meals and inspection of the menus indicated that a balanced and nutritious diet was being provided. Case files contained evidence of nutritional assessments being carried out, together with the monitoring of the residents weight being appropriately monitored. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. The residents’ concerns were taken seriously and staff training had been provided, in order to safeguard the residents from abuse. This judgement has been made using available evidence including a visit to this service EVIDENCE: Policies and procedures were available to ensure that residents were protected from abuse and that their concerns and complaints were taken seriously. Staff indicated that they were aware of these and they would take appropriate action, should they have any concerns in these regards. The home’s training programme revealed that training on adult protection issues had been delivered to some staff since the last inspection visit. The home’s complaints book contained evidence of three complaints having been made since the last inspection, together with the actions that had been taken to remedy these. Some residents however, indicated a slight level of reluctance in fully using the complaints policy, for concern that these might be seen in a negative light. A recommendation is made that the complaints policy is made easier to use, in order to reassure residents and their families that complaints are welcomed and that they are positively viewed. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The residents’ environment was safe and well maintained. This judgement has been made using available evidence including a visit to this service EVIDENCE: The home was clean, comfortable and warm. New carpets had been laid in the home’s corridors as previously required and evidence of ongoing maintenance was observed in other areas of the home. Inspection of the records confirmed that health and safety checks were being regularly carried out and that equipment in the home was being serviced appropriately. A minor repair was needed to the hall carpet and some of the residents’ bedrooms were beginning to show signs of a need for refurbishment. However, discussion with the manager indicated that work on these had been included in the provider company’s action plan for the home. The home has two lounges, one of which is situated close to the dining room, which most of the residents were observed to have a preference for. The Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 15 larger lounge was being used for a smaller group of the more dependent residents and a game of bingo that residents had organised for themselves was therefore being held in the home’s dinning room, due to lack of space in the smaller lounge. Discussion with the manager indicated that plans were being considered by the provider organisation to extend the smaller lounge to incorporate the hairdresser’s room which is currently attached, and for this facility to be recited in a room which is currently not in use. A recommendation is made in these matters. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Staff had been safely recruited and training had been provided for them, in order that health and personal care of the residents were met. This judgement has been made using available evidence including a visit to this service EVIDENCE: Staff were observed to be sensitively supporting the residents and discussion with them indicated that they were committed to their jobs. Residents confirmed that staff were caring and considerate and a Social Services staff member commented, “Staff are helpful and always willing to discuss the residents needs and ways of improving their quality of life”. Inspection of the home’s rotas indicated that staffing ratios were sufficient to meet the residents’ needs and the home’s training log indicated that a good range of training relating to the needs of the individual residents had been provided to staff. Information submitted by the manager as part of the inspection process, indicated that 25 of the staff group had obtained an NVQ level 2 qualification in care and that a further 5 staff were currently undertaking this award. A recommendation is made in this matter. A recruitment policy and procedure was in place to ensue that staff are safe to care for the residents. Staff records inspected indicated that this was being followed appropriately with copies of Criminal Records Bureau checks and two written references being taken before staff could start work. Discussion with the manager indicated that residents are not included within the home’s recruitment process, and in relation to the comments received from some of Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 17 the residents, a good practice recommendation is made that the provider organisation considers ways of including their views in this, in order to enhance the measures for the residents’ active participation in the home. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. Appropriate checks were being carried out to ensure the health, safety and welfare of residents and staff were being safeguarded. This judgement has been made using available evidence including a visit to this service EVIDENCE: Feedback received from residents, relatives and professionals associated with the home indicated that Tamarix Lodge was being well run. Discussion with the manager confirmed that she is well qualified and has substantial experience of managing the resident group accommodated in the home. Staff indicated that her management style was open and approachable and inspection of the home’s quality assurance systems confirmed that regular and thorough checks were being made of various aspects of the service, in order to ensure that it was meeting its stated aims. Discussion with residents and inspection of the minutes of meetings held with residents and staff confirmed Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 19 that their views were considered and that they were consulted about matters affecting them. The Provider organisation has a computerised system for the management of individual resident’s personal allowance’s and a random check of the records for these indicated that their finances were being satisfactorily safeguarded. Inspection of the home’s records indicated that the health, safety and welfare of residents and staff were being promoted and protected. The previous requirements concerning repairs to the dining room floor had been satisfactorily carried out and evidence of compliance with the requirements with the fire authority was seen. Maintenance records were up to date and in good order and the home’s training plan indicated that staff had covered a variety of health and safety issues or that these been identified for them as a future development need. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP14OP14 Good Practice Recommendations The registered person should give consideration for appointment of an activities coordinator, in order to foster a wider sense of the residents’ emotional and psychological wellbeing and to enhance their individual wishes for personal autonomy. The registered person should consider amending the complaints policy, in order to make it easier to use and reassure residents and their families that complaints are welcomed and are positively viewed. The registered person should give consideration to developing the use of the home’s lounges and implement the proposals to extend the home’s smaller lounge, in order to ensure that that the use of these is managed better and the residents’ personal autonomy and choices are encouraged. The registered person should ensure that 50 of the staff have obtained an NVQ level 2 qualification in care. DS0000019732.V314380.R01.S.doc Version 5.2 Page 22 2. OP16OP16 3. OP19OP19 4. OP28OP28 Tamarix Lodge 5. OP29OP29 The registered person should consider ways of involving the residents in the recruitment of staff, in order to enhance their active participation in the home. Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Tamarix Lodge DS0000019732.V314380.R01.S.doc Version 5.2 Page 24 - 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. 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