Inspection on 27/01/06 for Tanglewood Care Home

This inspection was carried out on 27th January 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 Care Home 23/10/07

Tanglewood Care Home 08/06/06

Tanglewood Care Home 10/08/05

Tanglewood Care Home 04/02/05

Tanglewood Care Home 15/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Tanglewood Care Home 36 Louth Road Horncastle Lincs LN9 6EN Lead Inspector Jean Cope Unannounced Inspection 27th January 2006 09:30 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 Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 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. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tanglewood Care Home Address 36 Louth Road Horncastle Lincs LN9 6EN 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) 01507 527265 01507 527965 Tanglewood (Lincolnshire) Limited Mrs Hazel Whittaker Care Home 55 Category(ies) of Old age, not falling within any other category registration, with number (55), Physical disability (9) of places Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 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 and 64 years. 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. Occupancy 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. 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). Condition of Registration The home is registered to provide personal care with nursing for service users of 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. 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. 10th August 2005 4. 5. 6. Date of last inspection 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 DS0000002521.V280940.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day with the assistance of the manager. One inspector undertook the inspection spending four 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 two 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 manager and proprietors have tried to involve residents’ relatives and supporters by requesting their comments on the service provided in the home. As a result of those comments, the manager has taken action. There is a rolling programme of refurbishment and re-decoration. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 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 DS0000002521.V280940.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 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 the following standard(s): 3 The manager will only accept new residents into the home if she is sure that their needs can be met. EVIDENCE: The manager assesses prospective residents prior to them moving into the home and they, and their families are encouraged to visit the home at any time to have a look around. The initial assessment includes details relating to the resident’s medical history and the sort of care that they will need. Copies of assessments for new residents were seen. The manager is able to assess new residents in their own homes, in a care or hospital setting. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 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 the following standard(s): 9 There are safe arrangements for residents who require medications to be given to them. EVIDENCE: Medications administered in the home are pre-packed in monitored doses by the home’s pharmacist. A sample of administration sheets were seen and staff had signed for them. There are safe arrangements for the storage and disposal of medications. The nurses administer medications to those residents requiring nursing care and senior care staff administer medications to those residents who require personal care only. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 10 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 The manager is aiming to improve the options and sorts of activities available for residents living in the home. Relatives and visitors are welcomed into the home. EVIDENCE: Since the last inspection activities have improved in the home. All relatives of residents living in the home were contacted and asked for their suggestions about the sort activities the home could provide. Some relatives met with the activities co-ordinator. A poster in the reception area was advertising a coffee morning on the first Friday of every month, a bingo session every second week and a forthcoming Valentine’s Day buffet. Friends and families are also invited to this event. A resident’s relative also reads to some residents. The more able residents confirmed that they could choose where they spent their time in the home. Residents said that the food was good and that there was plenty of choice. The home has received a food health award issued by the local authority environmental health officer for ‘consistently achieving a high standard of food hygiene’. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 11 Since the last inspection a system of colour coding menus has been introduced to indicate which residents should have a diabetic, soft or other specialist diet. Fluid intake and dietary intakes were recorded for those residents at risk. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 12 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 The management team take complaints seriously and are committed to provide a safe environment for residents. EVIDENCE: The home has a complaints procedure, which is now placed, on the back of each resident’s door. The home is run as a family run business and the proprietors are keen to receive feedback on the service provided in the home. Since the last inspection there have been no complaints. All new staff receive training on what adult abuse is and what to do if they suspect that it may be happening. A poster is posted in various places within the home, which explains what adult abuse is, it says that it is everyone’s duty to ensure that residents are safe and live in a safe and sheltered environment. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 13 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, 21, 22, 23 and 25 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. Toilets and bathrooms were also cleaned to a high standard. Residents are encouraged to bring in their own possessions and small items of furniture and set out their rooms to suit themselves. A maintenance person is employed by the home who is advised by the manager of anything that needs attention in the home and deals with it quickly. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 14 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): 28 and 30 Residents’ benefit from having a well trained staff group. EVIDENCE: All new staff received induction training by the home’s trainer, which includes fire training, health and safety at work, adult protection and care practices. The trainer said that she offers ongoing support to new staff and that she works alongside them initially. Currently all staff are being updated on moving and handling techniques. Development of training plans is currently being reviewed by the organisation with ongoing commitment to training staff at National Vocational Training Level 2 in care. A new senior carer has recently been appointed who is also receiving extra training to enable her to perform her duties. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 15 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): 33, 35 and 38 Residents live in a safe environment where health and safety matters are taken seriously. EVIDENCE: The proprietors recently undertook a quality assurance review and wrote to relatives asking about the service provided in the home. One of the outcomes was that relatives said that they did not know how to complain. As a result of these comments the complaints procedure has now been pinned to resident’s doors. A resident also said that one of the proprietors had visited them in the privacy of their own room to discuss their care. A sample of resident’s monies was checked and found to be correct and kept safely. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 16 The maintenance person checks the water temperatures in the home on a monthly basis, but all water outlets are fitted the thermostatic valves to prevent the risk of residents scaling themselves. Fire alarms and emergency lighting are checked on a weekly basis. Fire extinguishers and electrical equipment had been tested to ensure they were safe and usable. Hoists also had stickers on them to ensure that they were safe. Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 17 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 3 X 3 X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 18 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. Refer to Standard Good Practice Recommendations Tanglewood Care Home DS0000002521.V280940.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby 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. 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