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Inspection on 10/08/05 for Tanglewood Care Home

Also see our care home review for Tanglewood Care Home for more information

This inspection was carried out on 10th August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home offers a comfortable, homely and well maintained environment which is cleaned to a high standard. The home was odour free throughout. There is a committed staff team with a largely stable workforce, many staff having worked in the home for several years. Positive comments received from residents include, `there is good food here`, and `I am very happy here`, and `there are kind staff here who help me`. Residents are assessed prior to them moving into the home, and they and their relatives are encouraged to look around the home to check it is right for them.

What has improved since the last inspection?

The corridors and communal rooms have been redecorated. The manager has discussed with the proprietor extra support and training arrangements for new staff. There were no requirements left at the last inspection.

What the care home could do better:

There is ongoing commitment from the proprietors and the staff team to ensure that they maintain and exceed the National Minimum Standards, but more activities must be identified and made available for those residents who wish to participate, with enough staff available to support these activities.

CARE HOMES FOR OLDER PEOPLE Tanglewood Care Home 36 Louth Road Horncastle Lincolnshire LN9 6EN Lead Inspector Jean Cope Unannounced 10 and 11 August 2005 th 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 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. Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Tanglewood Care Home Address 36 Louth Road Horncastle Lincolnshire LN9 6EN 01507 527265 01507 527965 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) Tanglewood (Lincolnshire) Limited Mrs Hazel Whittaker Care Home 55 Category(ies) of Old Age (OP) - 55 registration, with number Physical Disability (PD) - 9 of places Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 5 service users accommodated within the main body of the home under the category of PD (5) and can be aged between 50 & 64 years. 2. Up to five of the following rooms may be used to accommodate people within the category PD: 16,17,18,19,40,41,42 & 43. 3. When used by service users within the category PD, these rooms will be used on the basis of single occupancy and, where they are otherwise used by Older People as double rooms, the overall occupancy will be reduced proportionately. 4. Up to four service users can be accommodated in the bungalows and can be aged between 35 years and 64 years under the category PD (4). 5. The home is registered to provide personal care with nursing for service users for both sexes. The maximum number of service users to be accommodated is 55 under the category of Old Age (OP) not falling within any other category. 6. One service user can be accommodated within the main body of the home under the category of PD(1) and can be between 35 and 64 years. Date of last inspection 4.02.05 Brief Description of the Service: Tanglewood is situated in the market town of Horncastle, which has a range of local services and facilities. It is one of a group of homes operated by the same company.It is set in its own landscaped gardens and comprises of a main home with rooms on two floors which can be accessed by a lift or stairs and four bungalows within the grounds each having lounge, bathroom, toilet, kitchen and bedroom facilities. There are car-parking facilities to the front of the property.The home is registered as a care home with nursing for up to fifty five older persons, however, within these numbers it is also registered to provide care for up to nine service users with physical disabilities within the age range of fifty to sixty four years. The home has developed a comprehensive statement of purpose, which makes reference to the principles of care such as privacy, dignity, independence and choice. Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a two day period with the assistance of the manager. One inspector undertook the inspection spending eight and a half hours in the home. The inspector toured the building, spoke with staff members, the manager and with residents and relatives living in the home. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care that they receive through the checking of their records, discussion with them, the care staff and observation of care practices. What the service does well: What has improved since the last inspection? The corridors and communal rooms have been redecorated. The manager has discussed with the proprietor extra support and training arrangements for new staff. There were no requirements left at the last inspection. Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.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 Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These outcomes were not inspected. Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 EVIDENCE: Each resident has a plan of care which includes their past social and medical histories, likes and dislikes which is reviewed on a regular basis. During the inspection the home was visited by the community nursing team, the free nursing care advisor and a dietician who were reviewing the individual care needs of residents. A resident explained that she had recently attended a hospital appointment and following that had been visited in the home by an optician and was waiting for her new glasses. Residents receiving personal not nursing care from the home, are visited by the community nursing team, who also provide specialist equipment when necessary. Residents and visitors confirmed that they felt that residents’ privacy and dignity were respected. Medications administered in the home are pre-packed in monitored doses by the home’s pharmacist. A sample of their administration sheets were seen and staff had signed for them. When medicines are given to residents, as and Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 10 when they require, the administration sheet should show why, or why is was not given Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13 Although some activities are organised inside and outside the home, residents and relatives felt that there should be more activities available. EVIDENCE: There are regular communion services advertised in the front Reception area. Bingo sessions are organised on a monthly basis by one of the residents, which some residents said they enjoyed. Two trips had recently been organised for residents to visit a local mill and for them to have lunch out. There is an activities committee, which includes residents and a relative. The activities co-ordinator is a member of the senior care team and also has responsibilities for training and induction. A relative’s comment card said that they felt that there were not as many activities in this home as there were in other Tanglewood Homes from reading the organisation’s newsletter. Some residents said that there was not enough to do to fill their time in the home with relatives also saying that they felt there ought to be more activities available to keep residents’ minds active. Examination of the visitors’ book showed that residents’ families and friends were regular visitors to the home. Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 12 Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These outcomes were not inspected. Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 24 and 26 The home offers a comfortable, homely and well-maintained environment for residents to live in. Residents are provided with clean, safe and hygienic surroundings. EVIDENCE: The home was clean and tidy and odour free and maintained to a high standard. There are a variety of communal areas for residents to sit in and the home also provides a separate smoking lounge. The outside of the building and the gardens are also well maintained with seating areas for residents should they wish to sit outside. There are a variety of aids and adaptations for the more frail residents such as grab rails, raised toilet seats, hoists and bath hoists. One hoist is being replaced as a matter of urgency. Residents are encouraged to bring in their own possessions and small items of furniture and set out their rooms to suit themselves. Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 15 Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 Residents can be sure that all staff recruited by the home are done so safely. EVIDENCE: It is acknowledged that several members of staff left the home at the same time, which meant the manager has been using some agency staff. However, several new member of staff have been recruited and the manager is waiting to receive their CRB checks prior to them commencing work. The home provides nursing care so there is always a qualified nurse on duty supported by senior carers and care assistants. A selection of personnel files were inspected and were in good order. Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 38 Residents benefit from a well managed and run home where health and safety requirements are taken seriously. EVIDENCE: The home is run by a qualified nurse, who is an experienced manager and is studying for her Registered Manager’s Award. A member of staff said, ‘I love working here, the staff are very good and there’s a good staff team’, and ‘it’s a very supportive management team’. Records received by the Commission show that regular safety checks are undertaken on the equipment and facilities used in the home. Fire alarms are tested on a weekly basis and staff received annual fire training. Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 4 3 x x x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 x x x x x x 3 Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 19 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 12 Regulation 16(2)n Requirement The registered person must consult with residents about the social activities and interests and provide facilities for recreation. Timescale for action 30. 11.05 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 9 Good Practice Recommendations Medications given when required by a resident should indicate why they had not been given. It would also be good practice to have sheet identifying all signatures and who they belong to to identify which member of staff administered medication. It is recommended that any gaps in employment noted on a prospective employees application form are explored. 2. 29 Tanglewood Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN 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 Care Home C53 C04 S2521 Tanglewood V242069 100805 Stage 4.doc Version 1.40 Page 21 - 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. 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