Inspection on 22/09/05 for Tanglewood

This inspection was carried out on 22nd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tanglewood 29/05/08

Tanglewood 24/04/07

Tanglewood 07/12/06

Tanglewood 18/04/05

Tanglewood 22/11/04

Tanglewood 18/08/04

Tanglewood 10/02/04

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REACH Upton Court Road

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Treloar College

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Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Tanglewood Larch Avenue Holbury Southampton SO45 2PB Lead Inspector Craig Willis Unannounced 22.09.05 9:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Tanglewood Address Larch Avenue Holbury Southampton Hampshire SO45 2PB 023 8024 3091 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) New Support Options Ms Diane McCarthy CRH 5 Category(ies) of LD Learning disability registration, with number of places Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection 18.04.05 Brief Description of the Service: Tanglewood is registered to provide care and accommodation for five adults with learning disabilities between the ages of 18 and 65. The home is managed by New Support Options and is owned by Swaythling Housing Association. The home is situated in a residential area of Holbury, close to local amenities such as shops and transport services. The home has a car that service users are able to access when there is a member of staff working who is registered to drive. The home has five bedrooms, four on the first floor and one of the ground floor. There are two lounge rooms, a dining room, kitchen, a bathroom and a shower room. The home has a large enclosed garden to the rear. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection of the year April 2005 to March 2006. Key standards not covered in this report were assessed at the inspection of 18th April 2005. The inspector spoke with four of the service users, two members of staff and the manager during the inspection. The communal areas of the home were viewed during the visit. What the service does well: What has improved since the last inspection? The manager has started a review of the type of information that is being recorded on a daily basis about the support staff have provided to service users. This will ensure that the information recorded is relevant to the review of the care plans and risk assessments. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The home has good systems to assess the needs and aspirations of service users, which gives staff the information required to meet service users’ needs. EVIDENCE: Since the last inspection one new service user has moved into the home. Prior to the move, the prospective service user met with the manager to complete an assessment of their individual needs and aspirations. This assessment included likes and dislikes, medical details, communication needs, leisure and educational activities that would be needed. A copy of the service user’s care management assessment was also available. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 7 There are clear care planning systems in place, which provide staff with the information required to meet the needs of service users and support service users to make decisions about their lives. EVIDENCE: Individual care plans were available for the new service user and had been developed from their needs assessment. These had been completed when the service user moved into the home in June 2005 and had been reviewed twice, as part of the review of the placement with the service user. Service users spoken with said that their plans contained accurate information. The manager reported that since the last inspection she had started to review the type of information that was recorded on a daily basis by staff to ensure that it was relevant to the review of the individual plans. Work is underway on the development of a person centred plan with all service users. The manager Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 10 reported that additional work is planned to support service users to complete these documents. This will be followed up at the next inspection. Details of how service users are supported to make decisions about their lives, including their communication needs, are recorded in the individual plans and through the development of person centred plans. Details of a local advocacy service are available. One service user is supported to limit the number of cigarettes they smoke. Details of this limitation are included in the service users’ plan, which has been signed by the service user. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Staff respect the rights and responsibilities of service users, which promotes independence and choice. EVIDENCE: Service users are supplied with keys to the home and have access to all areas of the home, except the office and laundry room, which are kept locked when not in use. One service user who smokes said they were aware they would not be able to smoke in the house before they moved in. Details of household jobs that service users are supported to do are included in their individual plans. Staff were observed interacting with service users in a respectful and friendly manner during the inspection. Service users spoken with said that staff do not enter their bedrooms without permission. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The home meets the health needs of service users, with evidence of support to attend a range of health services. EVIDENCE: Service users are supported to attend a range of health services, including GP, dentist, optician, occupational therapist and district nurse. Details of the appointments were recorded, including any advice given by the practitioner. One service user required support to clean and change stoma bags. Staff that provided this support had received specific training from the district nurse, who had signed to say that they were competent. The manager agreed that other staff who will provide this support will also receive this training. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None These standards were assessed at the inspection of 18th April 2005. EVIDENCE: Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 The systems for maintaining the cleanliness of the home are good, providing a hygienic environment for service users. EVIDENCE: The home was clean throughout on the day of the inspection. There is a suitable washing machine, which the manager reported has a sluice programme and is capable of hygienically washing soiled clothing. There is a separate laundry room that does not require soiled clothing to be taken through food preparation or storage areas. The manager reported that she had confirmation from their waste contractor that a separate clinical waste collection was not required. The home has infection control procedures in place and staff are provided with suitable protective clothing. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The home has a good induction and training programme, which gives staff the skills and knowledge required to meet the needs of service users EVIDENCE: Staff spoken with said that they felt New Support Options provided good training, which enabled them to meet the needs of service users. Records indicated that staff had received an induction and training in adult protection, challenging behaviour, health and safety, food hygiene, medication, moving and handling, autism, first aid and communication skills. Staff that were providing support for one service user to clean and change a stoma bag had been assessed as competent by the district nurse. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 The home has good systems to ensure the views of service users underpin the review and development of the home. EVIDENCE: New Support Options has developed a regional ‘PATH’, which sets out their objectives and was developed as a result of a consultation of service users about how their services could be made more person centred. The home has developed their own ‘PATH’, which focuses on how the service users can be more involved in the running of the home and the development of the person centred plans. The consultation with one service user was recorded on audio tape due to their communication needs. The home holds fortnightly service users’ meetings and service users meet every week to plan the menu. Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x 3 x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tanglewood Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 18 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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 Good Practice Recommendations Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 19 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Tanglewood H54 S12373 Tanglewood V248531 220905.doc Version 1.40 Page 20 - 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!