Inspection on 26/07/06 for Tandy Court

This inspection was carried out on 26th July 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

Tandy Court 12/03/09

Tandy Court 04/10/07

Tandy Court 07/12/05

Tandy Court 11/05/05

Tandy Court 11/11/04

Tandy Court 15/07/04

Tandy Court 23/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Tandy Court Tandy Drive Kings Heath Birmingham West Midlands B14 5DE Lead Inspector Amanda Lyndon Unannounced Inspection 26th July 2006 09:45 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 Tandy Court DS0000016916.V305303.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. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tandy Court Address Tandy Drive Kings Heath Birmingham West Midlands B14 5DE 0121 430 8366 0121 430 7581 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) Anchor Trust Mrs Patricia Ann Jackson Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (40), Old age, not falling within any other category (40), Physical disability over 65 years of age (40) Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to accommodate 40 adults over the age of 65 who are in need of care for reasons of old age, not falling within any other category 40 OP, physical disability over 65 years of age 40 (PD(E), dementia over 65 years of age 40 (DE(E) and Mental Disorder over 64 years of age 40 (MD(E). Minimum staffing levels must be maintained to at least 4 care staff at all times during the waking day. This must be increased at peak times to meet the needs of service users. This is in addition to the manager, deputy manager, plus catering, ancillary staff and activities coordinator. The automatic fire detection system is to be extended to the roof voids by April 2006. 7th December 2005 2. 3. Date of last inspection Brief Description of the Service: Tandy Court is a well maintained two-storey purpose built Home, which opened in 1985 and is situated in a quiet cul-de-sac in the South of Birmingham. The Home is situated close to shops, a public house, post office and public transport. It provides accommodation for 40 residents over the age of 65 years for reasons of old age, dementia, physical disability or mental disorder. All flats are for single occupancy and have an en suite toilet and kitchen facility. There is a bath or shower in thirty-seven of the en suite facilities. However the baths within the flats have low-level access and may not be suitable for all residents. In addition, there are new communal assisted bathing facilities situated throughout the home, which are suitable for all residents to use and a portable bath seat that may be used in the low-level access baths. Staff are available to provide assistance in any of the Homes’ bathing facilities. Aids and adaptations are available to assist residents with physical disabilities and handrails are provided throughout the Home. Communal areas consist of the recently decorated dining room on the ground floor, which leads out onto a patio area leading in to the secure well maintained garden which is also suitable for wheelchair users. There are three comfortable lounges providing a choice of areas for residents to relax in. There is parking to the front of the property. Notice boards display any forthcoming events and other information of interest to residents and visitors. The weekly fee to live at Tandy Court is between £368 and £430 Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report reflects the findings of a one day unannounced fieldwork visit undertaken by one Inspector when there were thirty-eight residents living at the Home. Information was gathered by speaking with residents and staff, case tracking, examining care, medication and health and safety records and observing the staff perform their duties. A tour of the Home was undertaken. It was pleasing that all of the requirements and recommendations made during the last fieldwork visit had been addressed and this promotes the good standard of service provided at the Home. During and following the fieldwork visit positive comments were received from residents about the service provided at Tandy Court including: “I am very happy with the staff and facilities here” and “The staff here are marvellous and can’t do enough for us” Negative comments were received from residents about the early time of the day that the housekeeping staff vacuumed the Home and the lack of staff available to assist during the evenings. What the service does well: Residents are well supported by the staff to meet their health, welfare and personal care needs. Medical advice is sought promptly as required in order to ensure that the health of residents is safeguarded. Residents are involved in the agreeing and reviewing of their care plans and this ensures that their preferred routines are maintained. Residents are cared for in a respectful manner by staff and this ensures that their dignity and self-esteem are maintained. There are a variety of activities on offer for residents to participate in should they choose. Opportunities for religious worship are available. Residents are supported by the staff to maintain contacts with their friends and family and visitors are made to feel welcome at the Home and this ensures that residents feel comfortable within their home environment. One resident said “ My family visit me every day and we have a nice chat in my flat”. Residents are able to exercise choice over their daily lives and this promotes their independence and individuality. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 6 Residents receive a choice of wholesome and nutritious meals, which meet any dietary needs for reasons of health or culture/religion. One resident said “ There is a good variety of food here, if you wanted to you could have your meals served in your flat but I enjoy having my meals in the dining room”. The residents are provided with an attractive, homely, safe and clean environment. Residents personalise their flats to reflect their individual tastes and interests to ensure that they feel comfortable in their surroundings. Residents have the choice of using all facilities provided at the Home. One resident said; “The best thing about living here is good food and good company, I feel safe living here”. Another resident said “ The staff come and clean my flat for me, they are very good”. The physical environment of the Home is suitable for residents with physical disabilities and aids and adaptations provided ensure that residents’ needs are met. There is a comprehensive complaints procedure accessible to residents and visitors should they need to make a complaint and group meetings are also arranged in order for those living at the Home to put forward their comments and suggestions about the service provided at Tandy Court. There was evidence that any comments or suggestions made were acted upon. One resident said; “ I’d tell the staff if I wasn’t happy about anything but I’ve got no complaints though.” Another resident said; “ We have residents’ meetings and I go to those, they are beneficial”. Senior External Managers visit the Home regularly to ensure that the standard of service provided at Tandy Court is good. The Home does not use agency staff and has a longstanding and loyal workforce and this ensures continuity of care. Staff had received appropriate training and this ensures that they have the appropriate knowledge to work competently within their job roles. One resident said “The staff know what I like and my routines, especially at night”. Another resident said “ All of the staff are very nice and friendly here”. There were clear lines of accountability between the senior staff team and positive comments were received from residents and staff about their management style and this promotes a positive living and working atmosphere at Tandy Court. One staff member said “The Managers are approachable, I feel comfortable when I talk to them”. One resident said “ The Manager, Pat comes and sees us which is nice”. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 7 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. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 8 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 Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment processes and information are comprehensive and this enables residents and their families to make an informed choice about whether they would like to live at the Home. Residents know before admission and during their stay that the Home can meet their care needs. EVIDENCE: A comprehensive service user guide and statement of purpose had been produced informing residents of the services provided at the Home. A large print version of these was available for residents with poor eye sight. Service user guides were available in all residents’ flats for reference. Senior staff visit prospective residents who are in hospital in order to undertake an initial assessment prior to their trial visit thus preventing inappropriate trial visits if Tandy Court is not deemed to be suitable for their individual care needs. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 10 Prospective residents are encouraged to spend a day at Tandy Court in order to sample what it would be like to live there. During the trial visit, senior staff undertake comprehensive pre admission assessments of prospective residents’ care needs to ensure that these needs could be met at the Home. A letter is sent to prospective residents and their families confirming that their individual care needs could be met at Tandy Court. Residents come to live at the Home on a six week trial period and a review of the placement is undertaken on completion of this period to ensure that the resident, family and staff were satisfied that the resident’s individual’s care needs were being met whilst living at Tandy Court. A review of the procedure for the Home’s staffs’ involvement in participating in social work reviews had been undertaken recently in order to make it more robust. Reassessments are undertaken for residents who are admitted from the Home into hospital for a period of time and this is in order to ensure that their changing care needs could still be met if returning to Tandy Court. Six monthly care reviews are held at the Home involving the resident. Their key worker and family to ensure that all concerned are happy with the standard of care provided and to ensure that the individual resident’s care needs were being met at the Home. Intermediate care is not provided at Tandy Court Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 11 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. This judgement has been made using available evidence including a visit to this service. Residents’ ongoing health and personal care needs are well met and are adequately monitored and documented. Medication is administered in a safe manner. However not all medication was stored in a safe manner and this may pose a risk to residents’ safety. Residents are cared for in a respectful manner and this ensures that their dignity and self-esteem are maintained. EVIDENCE: On admission to Tandy Court comprehensive assessments called “pen sketches” of individual residents’ care needs are undertaken and these included excellent detail of individual residents’ preferences in respect of their daily lives and routines. This included oral health care needs, the time that they prefer to wake in the morning, how they like to spend their day and any dietary requirements or preferences. Copies of Social Care and Health assessments were available within residents’ care files. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 12 In consultation with residents and their families, individualised care plans and personal risk assessments were derived from this information which clearly identified the support required from staff in each of their areas of need dependent on their abilities in order to promote their independence and maintain their preferred routines. Care plans were reviewed and updated regularly to reflect the changing care needs of individual residents and were audited regularly by senior staff to ensure that they were up to date. Care files were well organised and in an easy to read and audit format. The preferred languages of residents were recorded within the care plans and any support required by staff in this area was identified. There was currently no need for interpreter services at the Home, however friends and family of residents had provided this support in the past. Some daily reports did not include detail of how the resident had spent their day and were repetitive at times and this did not reflect the good standard of care that was provided to the residents living at the Home. Care plans had not been written in respect of a resident who was registered blind and a resident who was in chronic pain and the impact that this had on their lives both physically and psychologically. This may prevent the care staff from appropriately supporting these residents to promote their comfort and safety whilst encouraging their independence. Comprehensive moving and handling risk assessments were undertaken in order to promote the independence of residents and safeguard both themselves and staff. Residents were weighed and nutritional risk assessments were undertaken and reviewed regularly ensuring that residents were not at risk of malnutrition. Health care provision was good and residents had the option of retaining their own General Practitioner on admission to the Home (if the GP is in agreement). Residents had access to other visiting Health and Social Care Professionals including district nurses, dentists, chiropody, opticians and social workers and this ensures that residents’ health care needs are met. An effective key worker system was in place and residents met during the field work visit were aware of who their key worker was and this was important that residents had a special staff member who they could speak to if they had any questions or concerns. Residents appeared to be well groomed and well supported by staff to choose clothing that was appropriate for the time of year, their age and gender. A Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 13 number of female residents had chosen to wear jewellery and make up to suit their tastes and this ensures that their individuality is maintained. The management of medication is generally good and the procedures for the receipt, administration and disposal of medication were robust in order to safeguard residents. Regular medication audits are undertaken in order to ensure that staff are administering medicines correctly as prescribed. All senior staff responsible for the administration of medication had received accredited training and this ensures that medication is administered in a safe manner. Residents have the option to self administer their own medication and compliance checks are undertaken to ensure that their safety is maintained. Prescription inhalers were left unattended in the care office and the door to this area had been left open. Prescription inhalers were also left unattended on top of one of the drug trolleys that are stored in the medication room. Medication had been transferred in to this room a month ago and a lock had not been fitted to the door of this room. Both of these poor practices pose a risk to the health of vulnerable residents who may unwittingly swallow or use this medication by accident. There is also the risk that this medication may become mislaid if not stored securely. The current system for the recording of variable doses of Warfarin medication may put individual residents at risk of receiving the incorrect dose and it is recommended that the anticoagulation book be kept with the medication administration charts in order to double check the dose to be given. Some residents choose to hold the key to their flat door in order to maintain their privacy and to exercise their control over the safe keeping of their personal items. The locks could be overridden in the event of an emergency and this safeguards residents. There was a public telephone located in a quiet area of the Home for residents to make telephone calls in private. All staff had recently undertaken a course entitled “ End of Life” which provided staff with information about how to support residents and their families during their final days. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 14 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. This judgement has been made using available evidence including a visit to this service. The activities on offer meet the needs and expectations of the majority of residents living at the Home. Residents are supported to maintain contacts with their friends and families and are given choice and freedom to make decisions regarding their daily lives and this promotes their individuality and independence. The choice of wholesome and well-presented meals meet any special dietary needs of residents for reasons of health or cultural/religious beliefs. EVIDENCE: A part time activities organise, working 15 hours per week is employed at the Home and a variety of activities were on offer for residents to participate in should they choose to do so including quizzes, pub lunches, dances and musical bingo. The activities organiser spends time with individual residents who are unable to participate in group activities and this ensures that they are socially stimulated and feel valued and involved in life at the Home. A number of residents choose to go on holiday with their family and friends. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 15 One resident said “ There doesn’t seem to be many organised trips here but it doesn’t bother me”. Another resident said; “ I would like more outings to be arranged”. Another resident said; “ I enjoy having the daily newspaper delivered to me”. Evaluation reports are completed following an activity in order to rate the success of the event and this assists in planning future events. Residents’ meetings in respect of activities on offer at the Home are arranged in order for residents to put forward their suggestions about the activities on offer. The hair salon is open once a week and a number of residents choose to use this facility. Holy Communion is available at the Home and the Home’s staff are aware of how to access opportunities for residents of other faiths to practice. There is an open visiting policy and visitors are made to feel welcome at the Home. One resident said “ My family visit me every day and we have a nice chat in my flat”. There are no rigid rules or routines at Tandy Court and residents are able to go out side of the Home with their friends and families as they choose which is important to maintain their independence. One resident said “ I enjoy going out with my family to wherever they take me in their car”. The menus identified a variety of wholesome and nutritious meals and residents confirmed that they are consulted each day about what they would like to eat from the menu options of the day. A snack meal is available at suppertime and during the night and this ensures that residents are not hungry and receive regular meals for health reasons if required. Special diets are available for reasons of health or cultural preferences and the Home often prepared Caribbean dishes for a resident who enjoyed eating these. One resident said “ There is a good variety of food here, if you wanted to you could have your meals served in your flat but I enjoy having my meals in the dining room”. A number of residents had chosen to be served a ham salad on the day of the visit due to the hot weather outside and this was well presented and substantial in portion size. There was a relaxed atmosphere in the dining room during the lunchtime meal, staff were enjoying a meal with the residents and there were good social interactions between residents and staff. One resident said; “The best thing about living here is good food and good company, I feel safe living here”. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 16 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. This judgement has been made using available evidence including a visit to this service. The complaints procedure is comprehensive and accessible to residents and their visitors should they need to make a complaint. Complaints are dealt with in an appropriate and timely manner. Residents’ suggestions in respect of improvements required to the services provided at the Home are acted upon and care practices are revised as a result of this. Staff knowledge in respect of adult protection procedures is good and this safeguards residents. EVIDENCE: A comprehensive complaints procedure was on display in the Home and was in an easy to read format that clearly identified the relevant people to refer to should a resident or their visitors need to make a complaint. A suggestions box was available in a prominent position of the Home and a report of any action taken by the Management team in response to any suggestions made was displayed. Many compliments had been received about the good standard of service provided at Tandy Court. Residents met during the visit stated that they would feel confident to approach the staff or management team if they had any areas of concern that they wished to discuss with them. One resident said; “ I’d tell the staff if I wasn’t happy about anything but I’ve got no complaints though.” Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 17 CSCI had not received any complaints, concerns or allegations in respect of Tandy Court since the last visit. The complaints register held at the Home identified a few concerns that had been brought to the attention of the Management team and although these had been resolved in a timely manner to the satisfaction of the complainants, written documentation in respect of this was not always available. Staff had recently undertaken training in respect of the protection of vulnerable adults. The adult protection procedure included local Multi Agency Guidelines and staff knowledge about this was good. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 18 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, 20, 21, 22, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The physical environment of the Home is suitable for residents with physical disabilities and aids and adaptations provided ensure that residents’ needs are met. Residents live in a safe, comfortable, homely and well-maintained environment and the Home is designed to respect the privacy of all residents living there. Some poor practices may cause the spread of infection at the Home and this may be a risk to the health of both residents and staff. EVIDENCE: Positive work and progress had been made in respect of the secure external grounds and garden and this was an attractive facility for residents to enjoy. Hanging baskets and flowers in tubs were colourful, paved areas were suitable for both fully mobile residents and wheelchair users and good quality garden furniture and sun parasols had recently been purchased and were available for use by residents. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 19 The internal environment of the Home was furnished and decorated to a generally good standard and there was a rolling programme of redecoration and refurbishment in place. There were three lounges and these were homely in style and decorated to a high standard. New furniture had been ordered for these areas. In addition there were smaller seating areas located in the Home for residents to use if they preferred a quieter environment or wished to entertain their visitors in private and did not want to use their flats. The recently decorated dining room was appealing and comfortable and the dining furniture was of a good quality and appropriate for residents to use. Since the last fieldwork visit the assisted shower room had been refitted, was decorated to a high standard and was homely in appearance ensuring the comfort of residents when using this facility. In addition to this were two new assisted bathing facilities and these were appropriate for the use of all residents living at the Home. A number of residents had dementia care needs and adequate security measures in respect of both the internal and external environment of the Home were in place in order to safeguard those residents deemed to be at risk. Handrails were available in corridors and near to toilets, raised toilet seats were provided as required and there was suitable hoisting equipment to assist residents with impaired mobility in order to safeguard both residents and staff. On the day of the fieldwork visit, staff training was being undertaken in how to use a new transfer hoist and this ensures that both residents and staff are safeguarded. Appropriate pressure relieving equipment was available for those residents deemed to be at risk of developing sore skin due to their limited mobility. Residents generally provide their own furniture and furnishings for use within their flats and these were decorated to reflect the tastes and interests of individual residents. Each flat had an en-suite facility consisting of a toilet, wash hand basin, low-level bath or shower and a small kitchen area. A call bell was located in each flat for residents to use if they require assistance from staff and this ensures that they feel safe and secure in their surroundings. One resident said; “The staff answer my call bell quickly if I need them”. Fans were located throughout the Home in an attempt to keep residents cool during the unusually hot weather on the day of the visit. Despite a shortage of housekeeping staff on the day of the fieldwork visit, the Home was clean and fresh. Hygienic hand washing facilities were suitably located throughout the Home and residents were satisfied with the standards of cleanliness in their flats. One resident said “ The staff come and clean my flat for me, they are very good”. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 20 There was a generally hygienic system for the cleaning of residents’ personal clothing and bed linen. However, despite appropriate red alginate laundry bags and sluice cycles on the washing machines being available for use, staff continued to manually soak soiled items of residents’ clothing prior to putting them in the washing machine and this unnecessary practice is deemed to be a risk to the health of staff. There were currently ten residents using commodes during night time hours and appropriate mechanical commode pot washer/disinfector facilities were not available at the Home for the hygienic cleaning of these which may place the health of both residents and staff at risk. Based on the increasing dependency levels of residents coming to live at the Home, professional advice must be sought in respect of the need of providing appropriate sluicing facilities for staffs’ use. An interim infection control risk assessment must be undertaken and a care procedure must be written for staff to refer to when manually cleaning commode pots in order to eliminate the risk of cross infection. Staff stated that a weekly deep clean of the commode pots was undertaken in the “sluice” area adjoining the laundry. This area consisted of two deep sinks, one being used inappropriately for the soaking of soiled items of residents’ personal clothing and the weekly cleaning of commode pots and the second sink was being used for the cleaning of medicine pots. This practice is considered to be highly inappropriate and poses a high risk of cross infection. This was brought to the attention of the Registered Manager who stated that this poor practice would cease with immediate effect as a more suitable location for this had been identified. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 21 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 adequate. This judgement has been made using available evidence including a visit to this service. Staff working at the Home feel valued and this has a positive effect on the standard of care provided to residents. Staff are supported and guided and this ensures that they feel confident to perform well within their job roles. Minimum staffing levels are not maintained at all times and this may prevent residents from receiving a good standard of care and may pose a risk to their safety. Staff recruitment procedures are robust. However a lapse in procedures on one occasion does not safeguard residents. Staff had received training to ensure that they perform within their job roles in a competent manner in order to meet the needs of residents. EVIDENCE: It was pleasing that the Management team organise an “Employee of the Month” award and nominations are put forward by residents and staff in respect of this which boosts staff morale and in turn ensures that a good standard of care is provided for residents living at the Home. There is a longstanding and loyal staff team working at Tandy Court. One resident said “The staff know what I like and my routines, especially at night”. Another resident said; “ All of the staff are very nice and friendly here”. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 22 The staffing rotas identified that minimum staffing levels were maintained for the majority of the time with the exception of during periods of last minute staff sickness. A “bank” of temporary nurses had been developed however staff met during the field work visit expressed their concerns about the limited availability of this small team of care staff and as a consequence of this staffing levels were depleted during a small number of shifts each week which may adversely affect the standard of care provided for residents. Agency staff, are not used at the Home and whilst this ensures that residents received continuity of care, some shifts are short staffed as a result of not arranging alternative staff cover. Negative comments were received by residents about the lack of staff available to assist during the evenings and this may prevent residents from receiving care at the time that they choose. Negative comments were received from residents about the early time of the day that the housekeeping staff vacuumed the Home. Kitchen, laundry and housekeeping staff provide ancillary support to the care team on duty and this ensures that the residents receive the required support in all aspects of their daily lives. The Management team and senior staff provide on call support to the person in charge of the shift and this ensures that the staff on duty feel supported at all times. Staff recruitment records included the majority of information required by Regulations. However there was no evidence of an enhanced criminal records check for one staff member and this does not safeguard residents. Interview notes were kept in keeping with good practice Staff had received training relevant for their job roles including comprehensive induction training, care planning, promotion of continence, diabetes, mental health, dining with dignity, dementia care and skin care. 63 of care staff had achieved an NVQ Level 2 and other staff members are currently working towards this and this ensures that residents receive a good standard of care. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 23 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, 32, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This is a well managed home, and is run in the best interests of the residents living there. The systems for resident consultation are good and there is evidence that the residents’ views sought are acted upon. There were systems in place to monitor the quality of the service on offer to the residents. A robust system for the management of residents’ personal allowances is in place. Maintenance checks of equipment used at the Home are undertaken and staff, are trained in health and safety issues to ensure that residents’ safety and welfare are protected. EVIDENCE: Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 24 The Registered Manager has had much experience of working within a managerial role in a care environment and she holds appropriate qualifications in both management and care. The Deputy Manager has had much experience in working at Tandy Court and has taken the lead in respect of staff training, as well as other designated responsibilities. The Administrator had a good knowledge of her job role. It was apparent that there were clear lines of accountability between the senior staff team and positive comments were received from residents and staff about their management style. One staff member said “The Managers are approachable, I feel comfortable when I talk to them”. One resident said; “ The Manager, Pat comes and sees us which is nice”. Quality monitoring visits are undertaken by Senior External Managers each month and reports of these visits were available ensuring that residents receive a good standard of service. Residents’ meetings are held regularly in order for individual residents to put forward their suggestions for improvements about the services provided at the Home and there was evidence that these were acted upon. One resident said; “ We have residents’ meetings and I go to those, they are beneficial”. Staff meetings are held regularly and this ensures that staff are informed about any new procedures or services provided for residents living at the Home. A comprehensive quality assurance system is in place in order to monitor and improve the quality of care provided to residents living at the Home. As previously agreed with CSCI, residents’ personal allowances are paid into one general bank account and individual electronic and paper records of this were well maintained safeguarding residents who choose to use this facility. A comprehensive health and safety audit was being undertaken at the Home the day following the CSCI field work visit and this will ensure that Tandy Court is a safe place for residents to live. Staff had received on going training in health and safety issues including food hygiene, fire safety and moving and handling and this safeguard’s the residents in their care. A fire drill had been undertaken recently. There were robust systems in place for ensuring that all staff undertook the appropriate statutory training in order to provide a good standard of care to residents. Health and safety checks on equipment used at the Home are undertaken and this ensures that they are safe to use. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 25 The records of accidents involving residents living at the Home were well maintained and identified that the appropriate medical advice is promptly sought if required. The management team audit any accidents that have occurred in order to implement measures to reduce further occurrences of the same and thus safeguard residents. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 26 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 17 X 18 3 3 3 3 3 x 3 3 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 27 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. 1 Standard OP7 Regulation 15(1) Requirement Care plans must include all aspects of the physical and psychological care needs of individual residents. Daily reports must include detail of the activities that individual residents have participated in during the day and must be less repetitive. Medication must be stored securely at all times The Registered Manager received this in the form of an immediate requirement A written record of complaint investigations must be maintained and clearly identify any action taken as a result of a complaint being received. A record of any outcomes reached on completion of a complaint investigation must be kept. A suitable location for the hygienic cleaning of medication pots must be sought Staff must not manually soak soiled items of residents’ personal clothing and must use the appropriate resources DS0000016916.V305303.R01.S.doc Timescale for action 30/09/06 2 OP9 13(2)(4) 26/07/06 3 OP16 22(3)(8) 31/08/06 4 5 OP26 OP26 13(3) 13(3) 31/08/06 15/08/06 Tandy Court Version 5.2 Page 28 6 OP26 23(2)(k) 7 OP27 18(1)(a) 8 OP29 13(6) 19(1) already provided in respect of this. Professional advice must be sought in respect of the need for a mechanical washer/disinfector for the hygienic cleaning of commode pots. A risk assessment/infection control procedure about the manual cleansing of these must be written and available for staff to refer to in the interim in order to safeguard staff and prevent the risk of cross infection. Minimum staffing levels must be maintained and a review of the staffing levels during evenings must be undertaken. New staff must not commence employment at the Home without satisfactory enhanced criminal records clearance 01/10/06 15/08/06 15/08/06 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 Refer to Standard OP9 OP12 OP27 Good Practice Recommendations Anticoagulation books should be kept with the medication administration charts in order to double check the doses of Warfarin to be given. Residents should be consulted about whether they would be interested in more trips outside of the Home. It is recommended that the “bank” of temporary staff be further developed in order to cover duty shifts at short notice. It is recommended that a review of the time of day that the vacuuming of the Home is undertaken is reviewed so as not to disturb residents. Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Tandy Court DS0000016916.V305303.R01.S.doc Version 5.2 Page 30 - 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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