Inspection on 17/12/08 for Tandridge Heights, Memorial Care Home

This inspection was carried out on 17th December 2008.

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

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

Tandridge Heights, Memorial Care... 27/06/06

Tandridge Heights, Memorial Care... 06/12/05

Tandridge Heights, Memorial Care... 02/08/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Tandridge Heights, Memorial Care Home Memorial Close off Barnetts Shaw Oxted Surrey RH8 0NH     The quality rating for this care home is:   three star excellent 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: Mary Williamson     Date: 1 7 1 2 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. the things that people have said are important to them: They reflect 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 Older People 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. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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 Older People Page 3 of 25 Information about the care home Name of care home: Address: Tandridge Heights, Memorial Care Home Memorial Close off Barnetts Shaw Oxted Surrey RH8 0NH 01883715595 01883713990 tandridge@barchester.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Barchester Healthcare Homes Limited care home 75 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 75 The registered person may provide the following category/ies 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 categories: Old age, not falling within any other category - OP Dementia - DE Date of last inspection Brief description of the care home Tandridge Heights Memorial Care home is a new home, and was registered with the Commission for Social Care Inspection in April 2005. It is owned by Barchester Healthcare Homes Ltd. It is registered for seventy-five older persons, to include service users with dementia, and the provision of 10 beds for intermediate care. Accommodation consists of three floors, the ground floor for service users requiring personal and nursing care, the first floor for service users with dementia, and the second floor for service users requiring intermediate care. A passenger lift accessed all Care Homes for Older People Page 4 of 25 Over 65 0 75 75 0 Brief description of the care home floors. All the bedrooms are single and ensuite. There are large communal areas on all floors, consisting of dining and lounge facilities, and several smaller sitting areas at the end of each wing. There are pleasant secure garden areas with garden furniture, and there is adequate car parking facilities at the front of the property. The fees for the home range between £650 - £1,200. ICT beds are £542. Care Homes for Older People Page 5 of 25 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The overall rating for this service is a three star rating. This means that people who use the service experience excellent quality outcomes. This was the first site visit of a key inspection and was unannounced. The inspection was undertaken by Mary Williamson Regulation Inspector. The service was represented throughout the day by two unit managers, the regional manager and the administrator. A tour of the premises was undertaken and records relating to the care of the residents and the management of the home were seen. It was possible to meet and talk with some of the residents over the three units and with relatives who were visiting the home. The overall comments received were good, with residents stating thet the care Care Homes for Older People Page 6 of 25 and staff are excellent, and the food is good. Relatives commented that there is good communicatiuon and that they are kept informed of any relevant changes to care, and events in the home. The home was operating very well and there was plenty of pre Christmas activity taking place. Relatives were taking residents out to lunch, some residents were havig their hair done, others were sitting in small groups socialising, while others were enjoying their own company. There was opportunity to talk to staff on duty and gain feedback on their experiences about working in the home, the training they receive and the management structure and support in place. The management team submitted an Annual Quality Assurance Assessment (AQAA), which was used as part of the inspection. The Commission for Social Care Inspection would like the thank the residents, relatives and the staff for their help and hospitality during this inspection. What the care home does well: What has improved since the last inspection? What they could do better: 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 Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have access to sufficient information to help them make a choice about living in the home. Prospective residents have a full needs assessment undertaken to establish the suitability of the placement. Contracts of occupancy are in place . Residents admitted for intermediate care are helped to maximise their independence and return home. Evidence: The home has a statement of purpose and residents guide in place. This is available to all residents and their relatives in order that they can make an informed choice about living in the home. Relatives stated that this was a useful document and most informative. Care Homes for Older People Page 10 of 25 Evidence: Contracte of occupancy are in place. These outline the accommodation offered, the level of support required, the fees charged and the method and frequency of payment. All prospective residents have a full needs assessment undertaken prior to being admitted to the home. This is undertaken by the unit leaders or qualified staff, in order to establish if specific needs can be met. A selection of needs assessmnets were sampled throughout the home and these were detailed and informative. The needs assessmnets form the basis of the care plans. Intermediate care is provided in a dedicated unit of ten beds on the top floor. East Surrey Primary Care Trust fund this arrangement and provide additional rehabilitation support for example, physiotheraly, occupational therapy and additional staff according to assessed needs. Care Homes for Older People Page 11 of 25 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Well maintained care plans outline in detail how personal care is delivered. Appropriate arrangements are in place to meet the health, and social care needs of residents. Medication procedures in place protect residents, who are also treated with dignity, privacy and respect Evidence: Individual care plans are in place and a variety of these were sampled throughout the home. These are well written on information gathered from the pre admission needs assessment, input from the residents, relatives, and relevant information obtained from the multidisciplinary team. Care plans are reviewed monthly or more frequently if needs or treatment change. Daily records are maintained as part of the care plan. Risk assessmnets form part of the care plan and assessments are in place for moving and handling, falls, use of bed rails, nutrition and skin care. The arrangements in place to meet the health care needs of residents are satisfactory. All the residents are registered with a GP who visits the home every Wednesday, or Care Homes for Older People Page 12 of 25 Evidence: more frequently if necessary. Residents and staff spoke highly of the support he provides and a relative was very satisfied with the quick intervention provided. The intermediate care team support residents in the intermediate care unit, and staff have received specialist dementia care training to care for residents on Memory Lane Unit. The chiropodist visits every six weeks and the optician every three months. Arrangements are also in place for residents to receive dental care. Currently there are no residents in the home with a pressure sore. There is a wide range of pressure relieving equipment provided including profile beds, propad matresses, and spenco cushions. The home has a medication administration policy in place. All staff administer medication according to the homes policy and The Nursing and Midwifery Council (NMC) Code of Professional Conduct. The medication administration procedure was observed on Memory Lane Unit. All medication inclucing controlled medication is stored correctly. Medication recording charts (MAR) were seen and are well maintained. Audit trails of medication entering and leaving the home are maintained. Regular training updates for staff are provided for safe practice. Privacy and dignity are observed. Staff were interacting with residents in a kind and professional manner. Residents are addressed in a way that they prefer. Staff knock on bedroom doors prior to entering. En-suite facilities are provided and residents can have visits in the privacy of their own rooms. Locks can also be provided for rooms on request. Memory boxes are provided on the dementia unit outside each room to prevent residnets from wandering into the wrong room. Care Homes for Older People Page 13 of 25 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activity arrangements in place meet the individual and collective needs of the residents. Family links and community links are maintained and visitors are welcome in the home. Residnets are offered a well balanced diet and are supported to exercise choice over their lives. Evidence: The home has an activity programme in place that is based on residents needs and interests. This is overseen by two activity coordinators. Activities are organised on all units and everyone is invited to joine in. Group sessions include music and movement, skittles, card and board games and quiz. One to one activity includes reading, talking, listening to music, or daily newspaper for residnets who do not wish to joine groups. The home has a mini bus and trips to the coast, places of interest, and shopping are orgainsed. A Christmas lunch was organised for thirty residnets the previous week in a local pub. During the summer residents have access to a sensory garden and encouraged to plant hanging baskets. Picnics and and outing to the golf range are also organised in the good weather. On Memory Lane Unit specialist activities for example a rummage box, a dressing up corner, a pam and an old fashioned office are available Care Homes for Older People Page 14 of 25 Evidence: for residents to occupy themselves. There is also a cat on this unit which residents enjoy. Spiritual needs are supported and a church service takes place every Thursday in the home. Visits from various clergy are welcome and Holy Communion is arranged on request. Visitors are encouraged in the home at any reasonable time. Relatives are encouraged to take an active part in the care planning process, attend reviews of care and are invited to home functions. Residents/relatives meetings also take place every three months. Relatives visiting during the inspection all gave positive feedback regarding the home and the standard of care provided. Menus are planned by the chef with input from the residents, knowledge of residents likes and dislikes, and their dietary needs. The chef meets with the residents regularly to listen to their views and comments which are then reflected in the catering arrangements. Menus are displayed in the three dining rooms and are varied and wholesome. Meals are served in a relaxed and pleasant athmosphere, and sensitive support is offered to residnet who require help with feeding. Several residents commented that the food was very good and they could order anything if they did not like the wide choice available. The kitchen is well managed and all the catering team have a current food hygiene certificate. Care Homes for Older People Page 15 of 25 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure and the safeguarding vulnerable adults procedures in place protect the residents living in the home. Evidence: The home has a complaints procedure in place. This is included in the welcome pack and is available to all the residents and their relatives on admission to the home. The home also maintaines a complaints log which also included thank you cards and letters. During discussion with residents and relatives they were confident that any concerns or issues they had would be resolved before a formal complaint would have to be made. The home has a safeguarding vulnerable adults procedure in place and all staff undertake training in this procedure during their period of induction. Staff are aware of this procedure and stated that they would not hesitate to report issues of abuse if necessary. There is also a copy of Surreys multidisciplinary policies and procedures on safeguarding vulnerable adults in place and all senior staff have attended training regarding these procedures. Care Homes for Older People Page 16 of 25 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residnets live in a home that is well maintained, safe and suitable for its stated purpose. It provided residnets with a homely, comfortable and spacious environment to live in. Evidence: Accommodation is arranged over three units each with its own communal facilities. There is also a reception area on the ground floor where residents like to meet and chat over a cup of tea. Each unit has a lounge, dining room, and additional sitting areas if people wish to sit in smaller groups. The standard of decoration and furnishing is excellent providing residents with a well maintained, and comfortable environment. Bedrooms are all single en-suite and are comfortably furnishes to individual taste. Residents are able to heve their personal possessions around them and encouraged to personalise their own rooms. In Memory Lane Unit residents have a memory box outside their door to help them remember their bedroom. In Woodlands Way residents have a small fridge in their bedrooms and access to a patio. The standare of housekeeping is excellent. The home is clean, hygenic and odour free. There is an infection control policy in place and all staff undertake training in this policy. Care Homes for Older People Page 17 of 25 Care Homes for Older People Page 18 of 25 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. The number and skill mix of the staff employed are sufficient to meet the assessed needs of the residents. The organisation is committed to the training and development of the staff team. The recruitment procedure in place protects the residents living in the home. Evidence: Duty rotas were seen for individual units and the number and skill mix of the staff on duty were sufficient to meet the assessed needs of the residents. The staff on the intermediate unit are funded by the primary care team and if additional staff are required they will be supplied by the PCT. The home employs a large team of ancillary staff with individual roles and responsibilities. The training and development of the staff team is ongoing. The organisation is committed to staff develpoment and have a training coordiantor in post to oversee this. Induction training is in accordance with Skills for Care and the Barchester induction policies and protocols. NVQ is ongoing with 50 of staff having NVQ level 2 or above. The unit manager from Memory Lane Unit provides the dementia awareness training and has now introduced this training for relatives which has been very successful. The home has a recruitment policy in place. All staff employed have a face to face interview. Three staff employment files were seen. These are well maintained and Care Homes for Older People Page 19 of 25 Evidence: include all the required documentation, for example two written references, an employment history, and a Criminal Records Bureau (CRB) disclosure. Care Homes for Older People Page 20 of 25 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 is well managed by the two unit managers pending the announcement of the newely appointed manager. The home is managed in the best inerests of the residents. The health, safety and welfare of the residents and staff are observed and promoted. Evidence: Currently the home managers post is vacent. The Regional Manager stated that interviews had taken place and a manager identified. She could not disclose this information until the applicant had accepted the post. The home is being managed well by the unit managers in the interim, with satisfactory outcomes for residents. Systems are in place to monitor quality assurance. Regulation 26 visits are undertaken monthly and reports retained in the home for information. Satisfaction surveys are distributed to residents/relatives, the PCT and other health care professionals, and feedback is formulated in an action plan and sent to residents, Care Homes for Older People Page 21 of 25 Evidence: relatives and other stakeholders. Barchester also undertakes monthly audits. A clinical development nurse undertakes health and care audits and provides feedback to the nursing team. Procedures are in place to safeguard residents financial affairs. Personal money is not managed by the home and fees are paid by direct debit. Health, safety and welfare of residents and staff are observed. The home has a wide range of health and safety policies and procedures in place and all staff receive training relating to these procedures. Risk assessmnets are in place for all identified risks and to promote safe working practice. The maintenance department undertakes all the necessary checks and maintaines records and certificates for inspection. Fire safety is observed and all the staff attend fire safety training yearly. Accidents and incidents are reported and recorded in a satisfactory manner. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Older People Page 23 of 25 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 Requirement 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 Requirement Timescale for action 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 Care Homes for Older People Page 24 of 25 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 Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!