Inspection on 04/08/06 for Tanglewood

This inspection was carried out on 4th August 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

Tanglewood 17/06/08

Similar services:

88 Church Lane

Harmony Care Home

Olivet Christadelphian Care Homes

Sayer House

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

CARE HOME ADULTS 18-65 Tanglewood 72 Albert Road South Malvern Worcestershire WR14 3AH Lead Inspector Dianne Thompson Unannounced Inspection 4 and 10 August 2006 10:00 th th Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 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 Tanglewood DS0000065328.V309194.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 Adults 18-65. 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. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tanglewood Address 72 Albert Road South Malvern Worcestershire WR14 3AH 01684 576231 01684 576219 wayne.whittaker@sense.org.uk 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) Sense Wayne Whittaker Care Home 7 Category(ies) of Sensory impairment (7) registration, with number of places Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: To provide care for a maximum of 7 young adults of either sex with sensory disabilities who may also have learning disabilities and/or physical disabilities. Date of last inspection N/A Brief Description of the Service: The service provider Sense is the national charity Sense. The building was extensively altered and refurbished to provide a service for a maximum of 7 young adults with sensory disabilities who may also have learning disabilities. Tanglewood provide facilities for seven young adults with sensory, physical and learning disabilities. Single bedrooms with en-suite facilities are provided, five of which are fitted with overhead hoists to facilitate movement from bedroom to ensuite. Communal facilities are spacious and mobility equipment is provided. A shaft lift has been fitted. There are excellent garden facilities suitable for the people who live in the home. The home is in a residential area of Malvern with access to shops, leisure centres and GP surgery locally. The home also has access to other recreational activities in the Malvern and Worcester area. The current fee for the service range from £1678.79 to £2392.00 per week. Charges which are additional to the fee includes: • • • • • Personal toiletries, clothing and electrical items (TV and music centre). Activities not covered by the allowance made by the provider or in the funding authority contract Holidays Major extra outings Hairdressing Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that included an unannounced visit to Tanglewood. A second visit was arranged so the manager could be available to discuss the development of the service. This was the home’s first inspection since it was registered. The main purpose of this inspection was to assess the service provided against key National Minimum Standards. Service user and staff records were examined, and a tour of the building was also carried out. Accumulated evidence from reports of monthly visits by the provider’s representative, and registration documents were used to inform this report. Time was spent with two service users and staff. Relatives visiting at the time of the inspection visit were asked for their views of the home. The home was not fully occupied at the time, but two service users were being assessed with a view to moving into the home soon. What the service does well: Tanglewood is located in a pleasant residential area of Malvern. The home is a two storey Victorian building that has been extensively converted and extended to provide a home for seven young adults with sensory, physical and learning disabilities. Single bedrooms with en-suite facilities are provided, five of which are fitted with overhead hoists to aid movement from bedroom to ensuite. Detailed information is provided about the services offered at the home to help service users make an informed choice about whether they would like to live at Tanglewood and whether the home will meet their needs. Service users receive help and encouragement to lead active and interesting lives at Tanglewood and are supported to access facilities within the wider community. They are also supported to maintain links with their families and to develop friendships. The home offers a well-balanced menu and promotes healthy eating for the welfare of all service users. Personal and healthcare needs are clearly identified in care plans. The plans provide information and make sure that care is provided in a consistent way that takes into account service users preferences. The home has a clear medication policy and procedure, which is followed to make sure that all medication is administered and stored safely for the protection of service users and staff. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 6 Service users are protected by the home’s complaints procedure that is available in easy to understand information about how to complain, with appropriate information for staff provided. Staff support service users to express their views and any concerns they may have. Tanglewood provides accommodation for service users that suitably meets their needs and offers them a safe, spacious and very comfortable home. The home is kept clean which ensures that good hygiene and infection control is maintained for the benefit of service users. Suitable staffing levels are being maintained and staff receive relevant training to help them meet service users’ needs. The staff team understand their responsibilities and are committed to their role. They are well supported and work together to provide service users with consistent and good quality care. The home’s recruitment policy and practices make sure that suitable staff are employed and that all necessary checks are made to ensure the safety of all service users. The home is managed with an open and positive approach. The registered manager is currently completing qualifications, which should be beneficial to service users and the staff team when achieved. Sense monitors the home in various ways to ensure that the service continues to develop as service users want and that the home remains a safe place to live and work in. What has improved since the last inspection? What they could do better: Individual service user risk assessments should be reviewed as specified. The home’s guidelines on abuse should include reference to the Vulnerable Adults Team and contact details. The home should consult with the Worcestershire multi-agency co-ordinator for Protection of Vulnerable Adults (POVA), with regard to training opportunities to ensure that all staff know where and how to refer any incidence or suspicion of Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 7 abuse/neglect of service users. safeguards for service users. These changes will provide additional 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 DS0000065328.V309194.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including visits to the service. Detailed information is provided about the services offered at the home to help service users make an informed choice about whether they would like to live at Tanglewood and whether the home will meet their needs. EVIDENCE: The home’s statement of purpose and service user guide provides information about the home to help prospective service users to decide if they wish to live at Tanglewood. Copies of this information are accessible to all, including visitors to the home. All service users receive copies of the relevant information prior to moving into the home. All information is offered in preferred formats, e.g. Braille, symbols/pictures, audio and large print. Parents visiting the home at the time of the inspection visit confirmed this. There are 3 service users currently living at Tanglewood, having moved in when the home opened earlier this year. The home is currently assessing two more people with a view to them moving into the home. Significant time and effort is spent making sure that admission to the home is personal and well managed. Throughout the information gathering process, prospective service users and their families are treated with dignity and respect. A parent who also praised the reassurance and support they received from all staff confirmed this. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 10 Service users have a wide range of complex needs and the manager and staff are aware of the need to make sure people are compatible and not placed at additional risk. The manager said he takes responsibility for the decision about compatibility when completing assessments, ensuring that prospective service users will ‘fit in’ with those people already living at Tanglewood. The assessment process is very detailed and the manager and service users care records demonstrate that the home receives full information about prospective service users, their background, their needs, their likes and dislikes when they are referred for a placement. One set of Parents visiting the home said the transition for their son to Tanglewood was a very complex process. They felt the organisation had managed this successfully and ‘left no stone unturned’ throughout the assessment process. Information is gathered from a range of sources including other relevant professionals, visits to previous homes or schools, and discussions with other family members e.g. grandparents and brothers/sisters. Introductory visits and stays are arranged at the home prior to admission. During the introduction to the home prospective service users are given a copy of the statement of purpose and service user guide, which gives pictures of the home and the surroundings, in a preferred format, such as Braille or audiotape. Written comments received from parents about service user’s move to the home were seen. Two statements were seen which confirmed that the moves had gone well and both service users have settled into their new home. Parents have noticed some encouraging changes and improvements in their confidence and their ability in the short time they have lived at Tanglewood. There is evidence that service users families, social workers and other interested parties have been involved in the assessment and admission process. Records show that regular reviews, followed by a three monthly review meeting have taken place to monitor and assess the suitability of the placement. The review meeting includes the service user, their relatives and any other relevant/appropriate parties. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence, including visits to the service. Person centred care plans provide staff with relevant information about users assessed needs. They include risk assessments detailing how risks are to be reduced and independence promoted. Service users are enabled to make choices and decisions in their daily lives and routines. EVIDENCE: Service user care plans are very detailed and informative. The plans show monitoring of identified goals, and how these are to be facilitated and achieved. Staff have information to make sure that all care is provided in a preferred and consistent way that encourages independence. A person centred approach is followed and the care-planning format shows service users are appropriately involved in planning and reviewing their own care and are enabled/supported to express their wishes and goals. A full care plan review was taking place at the time of the inspection visit, which involved service user, family members, education practice development coordinator, registered manager and a management representative (Regional Director) Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 12 from Sense. The Regional Director attends some review meetings as part of the Organisation’s quality monitoring process. Files for two service users were examined. Case tracking provides a view of how the home responds to the diversity of needs and how this is being managed and supported. This is particularly evident where health needs and disability requires greater input and support from all staff within the home. Relevant information and monitoring is provided in service user files to make sure all staff have the necessary information to provide quality care. Each service user is allocated a key worker to oversee their care. Each key worker builds a closer relationship so they gain more understanding and knowledge of individual needs, goals and wishes. Plans are reviewed regularly or as any changes in need occur. Staff spoken to are fully aware of the plans and clearly use them to guide their practice. A service user said that the staff are very good and always help them to do what they want. Service users are supported to make choices in all aspects of their care. One service user was observed asking for a drink, for which a choice was offered. A choice was possible using information about individual likes and dislikes, and using objects of reference associated with the choice of drink. The service user, having made a choice, was then supported to make a cup of tea. This was achieved using hand over hand technique, talking through each stage and giving encouragement throughout the whole process. The resulting cup of tea was a symbol of the support and empowerment that is considered standard practice for all service users living in Tanglewood. A record is kept of all choices that are offered and made. This includes the way in which choices are offered: for example, if symbols are used and whether the service user is receptive to them. The home aims to make sure that all staff follow the records and maintain consistency throughout the whole team both in communication methods used and choices offered. One service user who spoke with the inspector confirmed that they like living at Tanglewood, and that the home was much better than where they had lived previously. The house and gardens are very nice and service users are able to choose when to get up, what activities to take part in and can go where they want in the community. The manager and staff talked positively about how well service users have settled and have become more independent. Parents who were visiting at the time of the inspection also confirmed this. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 11, 12, 13, 14, 15, & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence, including visits to the service. Service users receive help and encouragement to lead active and interesting lives and are supported to access facilities within the wider community. They are also supported to maintain links with their families and to develop friendships. The home offers a well-balanced menu and promotes healthy eating for the welfare of all service users. EVIDENCE: Tanglewood offers a wide range of activities, both in-house and in the community. A full time educational practice development coordinator is employed by the home to plan and oversee activities with service users and staff. The co-ordinator supports, monitors and evaluates the competence of staff to deliver planned activities. This process is formalised and conducted in a structured way, to achieve a consistent and purposeful programme of activities for all service users. A copy of the format of the evaluation and a Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 14 sample monthly audit was supplied during the inspection visit. Information is available to staff to suggest alternative activities if required, with guidelines for delivery if needed. Aims and objectives are clearly set out for all planned activities, and include a list of resources needed and the communication techniques to be used, such as speech, gesture, and environmental cues. Daily schedules of activities are available for all service users, which includes information about any costs that may apply. The home also has a designated activities room and a sample of work that has been taking place was seen. This includes making objects out of Papier Mache, such as hand and animal shapes. Activities focus on tactile and sensory experiences. Board games are available in Braille for individuals who have sight impairment. In house activities include arts, baking, crafts, music, signalong, makaton, tactile activities, beauty therapy, massage, sensory box and board games. All service users are encouraged to participate in household tasks according to their abilities. External activities include horse riding, Malvern Hills College courses, weekend outings, visits to the Forest of Dean, the local pub, aromatherapy sessions, rock climbing, canoeing and rambling in the Malvern Hills. Family visits to and from the home are actively encouraged and supported. Staff said that regular telephone contact is organised and supported for one service user. Parents of one service user said that home visits are well supported, with the home and parents sharing the travelling. They also said that their son has settled into the home really well and has made friends with other people living in the home. Their son participates in various activities and the family is very pleased with the choices that are made available to him. Service users are offered a varied and healthy menu. A record of menus is displayed on the home’s notice board, and a record of all food intake and fluids is recorded. The balanced meals include plenty of fresh fruit and fresh vegetables. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 18, 19, 20, Quality in this outcome area is good. This judgement has been made using available evidence, including visits to the service. Personal and healthcare needs are clearly identified in care plans. The plans provide information and promote consistency of care and support for all service users in a way that takes into account their preferences. The home has a clear medication policy and procedure, which is followed to make sure that all medication is administered and stored safely for the protection of service users and staff. EVIDENCE: Service users’ care records and plans provide detailed information about their physical and mental health and the support needed from staff to maintain their good hygiene and health. The care plans sampled contained information about service users preferred personal care routines. The registered manager states that all staff are able to communicate with all of the service users verbally and, in certain cases, with the additional use of gestures, sign language, and using objects of reference. Health Action Plans are used and included in individual service user files. Records of all physical checks are completed where service users have Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 16 particular health related issues e.g. weight and fluid intake. In this way the home is able to closely monitor and respond to changes or obtain appropriate medical input whenever necessary. Information written in daily records should however be followed through, e.g. when a potential difficulty is highlighted, details of all action that has been taken should be recorded to make sure there is a practice trail which can be replicated or developed as required. Service users and the home are well supported by medical services, which includes GP’s, audiologist, ophthalmologist, dentist, community learning disability team, occupational health, and dietician. All service users have given consent to their medical treatment and a record of this is kept on their files. Arrangements are in place for preventative health services, e.g. dental checks and annual health screening. Staff on duty and the registered manager say that all personal care is given in private to promote dignity for all service users. The manager is very aware of the specialist services that could be needed to support service users and how to access them. The home has a medication policy and procedure in place. Medicines are suitably and safely stored and there is appropriate storage for controlled drugs, should they be required. Medication storage and records were checked and all was satisfactory. A list of all staff that have been trained and assessed to administer medication was seen. Information is available to advise all staff about all prescribed medication together with any possible side effects. All staff have received training in first aid. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence, including visits to the service. Service users are protected by the home’s complaints procedure that is available in easy to understand information about how to complain, with appropriate information for staff provided. Staff support service users to express their views and any concerns they may have. EVIDENCE: Time was spent with a service user who said staff support them when they need it and they feel able to ask for help or can talk to staff if they have any concerns. During the inspection visits staff were observed engaging with service users in a supportive and respectful way. Details of staff on duty and a copy of the rota, using photos, are displayed on the notice boards. Information is also available in signs and symbols telling service users how to complain if they are not happy. The home’s complaints procedure is also completed in widget signs and symbols for all service users. The complaints log was examined and there have been no complaints to the home or to the Commission for Social Care Inspection. The home has relevant policies for service users’ protection. Policies and procedures are available in the home to advise and guide staff in protecting Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 18 service users. Posters (in symbol format) are prominent in the home to tell service users how to make a complaint. Staff undertake training in relation to abuse and service users’ protection during their induction. However it is recommended that the home should consult with the Worcestershire multi-agency co-ordinator for Protection of Vulnerable Adults (POVA), with regard to training opportunities to ensure that all staff know where and how to refer any incidence or suspicion of abuse/neglect of service users. The registered manager was advised that the home’s guidelines on abuse should indicate how and to whom references should be made should an incident of abuse occur or be reported. Information should include reference to the Worcestershire Vulnerable Adults co-ordinator and contact details. Information should be provided for action to be taken where it is not appropriate for the home to conduct an investigation, as per Section 3, Department of Health ‘No Secrets’ guidance. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 19 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 the following standard(s): 24, 25, 26, 27, 28, 29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence, including visits to the service. Tanglewood provides accommodation for service users that meets their needs and offers a safe, spacious and very comfortable home. The home is kept clean which ensures that good hygiene and infection control is maintained for the benefit of service users. EVIDENCE: A detailed site visit was undertaken before the home was registered when it was confirmed that the accommodation would be suitable for service users’ needs. It was also confirmed that the premises complied with all the National Minimum Standards and requirements of other Regulators i.e. Building Control, Planning Department, the Fire Authority and Environmental Health. Tanglewood is located in a pleasant residential area of Malvern. The home is a two storey Victorian building that has been extensively converted and extended to provide facilities for seven young adults with sensory, physical and Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 20 learning disabilities. Single bedrooms with en-suite facilities are provided, five of which are fitted with overhead hoists to facilitate movement from bedroom to ensuite. Communal facilities are spacious and acceptable mobility equipment is provided. A shaft lift has been fitted. There is a large lounge, a hallway and a separate dining room available to service users as communal space. The kitchen is spacious and well organised with adjustable units to enable service users to access the worktops. All the rooms have been furnished to a high standard complimented with light coloured decor. For staff there is an office, storage areas with lockers and a sleep in room on the first floor. A tour of the home was completed and all service user bedrooms were seen. Those bedrooms occupied have been personalised by the service users. Tactile signs on doors assist service users with their orientation, such as sponge for bathroom and toilet roll inner for toilet. Each service user has their own sign for their bedroom door that they have chosen, for example a dolphin or a piece of wood carved as a tree. There are excellent garden facilities suitable for the people who live in the home and a gardener is employed to maintain the grounds. There is a summerhouse in the garden, and a patio area with furniture and a barbecue. A shed for equipment and tools storage is nearby. The premises are clean and tidy. Policies & procedures for infection control are in place and staff are provided with disposable gloves and aprons. Communal bathrooms have paper towels and liquid soap available and there are suitable arrangements made for the disposal of clinical waste. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 21 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence, including visits to the service. Suitable staffing levels are being maintained and staff have received relevant training to help them meet service users’ needs. The staff team understand their responsibilities and are committed to their role. They are well supported and work together to provide service users with consistent and good quality care. The home’s recruitment policy and practices make sure that suitable staff are employed and that all necessary checks are made to ensure the safety of all service users. EVIDENCE: The registered manager indicates that staffing levels are being gradually increased as new service users are admitted. The levels of staff will also depend on future individual service user’s assessed needs for specific staff supervision. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 22 Staff complete the mandatory health & safety training such as fire safety, first aid, food hygiene, moving & handling and infection control. Other training courses include communication, safe handling of medicines, abuse, working with disabled people and managing challenging behaviour. Other training such as epilepsy is being arranged. Dates when refresher courses are due are highlighted on staff individual training plans. The induction programme appropriately is accredited for people working in care services with people who have learning disabilities (LDAF). Induction also includes new staff being supported by senior staff to familiarise themselves with the home, service users and safety matters A sample of staff records was examined. The manager confirmed that all prospective staff complete an appropriate application form and that appropriate references are obtained including one from their most recent employer. An enhanced CRB/POVA (police) check is undertaken before their appointment is confirmed and copies of these were seen. All staff are required to work a probationary period at the home. Evidence was seen on the staff supervision overview that all staff receive regular structured supervision from the management team. Staff meetings are held regularly and communication within the home is facilitated through the use of a communication book. Staff handover time is structured into the rota pattern to make sure all staff are kept fully informed and up to date. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 23 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42, 43 Quality in this outcome area is good. This judgement has been made using available evidence, including visits to the service. The home is managed with an open and positive approach. The registered manager is currently completing NVQ 4 and the Registered Managers Award, which should be beneficial to the service users and the staff team when achieved. Sense monitors the home in various ways to ensure that the service continues to develop as service users want and that the home remains a safe place to live and work in. EVIDENCE: The manager Wayne Whittaker has worked for the provider Sense since 1993. He has 13 years experience in residential care, the last four years as a manager. Mr Whittaker says he operates an open door management style. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 24 Mr Whittaker has undertaken a range of relevant training and is currently completing his Registered Managers Award and NVQ level 4. He has undertaken a wide range of other training relevant to service users’ needs. It is evident he is knowledgeable about learning disabilities and the implications for service users themselves and their care. Management responsibilities in the home are also shared with two deputy managers and the education practice development coordinator. They are all involved in organising day-to-day activities, health & safety promotion, staff supervision and induction. The manager has a diary plan on the office wall so all staff and service users are fully informed of his plans and whereabouts. Staff confirmed the manager is approachable and said that service users are always put first. They say the staff team works closely together to help service users settle into their new home and to make sure that all their needs are met. Service users were seen to get on well with the manager and said they ‘liked Wayne and all the staff’. In respect of management support from the provider, Sense has Training and Human Resource Officers who are always available to advise and support the home. An Operational Manager regularly visits the home and provides supervision for the manager. Service manager meetings are held monthly and the manager confirmed that he and the home are well supported. The provider’s monthly visits are one of the ways that Sense monitors the service and how the home is being run. These visits include interviews with staff and service users and also include an audit of relevant aspects of the service, including records, environment, complaints received, finance and safety. Periodically, themed visits take place which focus on particular service areas, such as medication. Any actions that may be needed to address shortfalls are specified. The resulting reports are also part of the home’s quality assurance and monitoring system and are intended to form an annual development plan for the service. This report will include service users, stakeholders and interested parties views on the service provision. A full health and safety audit was completed in the home in July 2006. Generic risk assessments are in place that includes consideration of community activity hazards such as rock climbing and ice-skating. General risk assessments includes the home’s vehicles. Risk assessment documents specify that reviews should take place at 6monthly intervals. Those risk assessment seen dated 18th January 06 and 28th December 05 do not comply and should be reviewed in keeping with the specified timescale. Records seen show that monthly checks of the fire safety system & equipment, water temperature & storage, fridge, freezers and electrical appliances are completed. Staff undertake all mandatory health & safety training topics. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 25 Maintenance request forms are completed and faxed to the relevant department within the organisation. The home needs to make sure that all requests are signed and dated, and the form should show when work has been completed. There is a property and maintenance file that contains all contact details for services/suppliers that are used by the home. This information file is available and accessible to all as needed and includes details of local taxis, Malvern District Council and Citizens Advice Bureau, as well as various leisure contacts such as the local theatre. Tanglewood DS0000065328.V309194.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 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 Standard No Score 1 3 2 4 3 3 4 4 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 4 25 3 26 3 27 4 28 4 29 4 30 3 STAFFING Standard No Score 31 3 32 X 33 3 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 3 3 Tanglewood DS0000065328.V309194.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. 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 YA19 Good Practice Recommendations Where health concerns are raised in daily records, action taken should be recorded to make sure a clear audit trial is evident. Information should be provided in guidelines on abuse for action to be taken where it is not appropriate for the home to conduct an investigation, as per Section 3, Department of Health ‘No Secrets’ guidance. The home should consult with the Worcestershire multiagency co-ordinator for Protection of Vulnerable Adults (POVA), with regard to training opportunities to ensure that all staff know where and how to refer any incidence or suspicion of abuse/neglect of service users. 2. YA23 3. YA23 Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 28 4. YA42 Risk assessment documents specify that reviews take place at 6monthly intervals. Risk assessments should be reviewed in keeping with the specified timescale. Tanglewood DS0000065328.V309194.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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. 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