Inspection on 16/11/05 for Tanglewood, St Austell

This inspection was carried out on 16th November 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tanglewood, St Austell 19/03/10

Tanglewood, St Austell 17/02/09

Tanglewood, St Austell 23/02/07

Tanglewood, St Austell 03/05/05

Tanglewood, St Austell 07/12/04

Tanglewood, St Austell 10/06/04

Tanglewood, St Austell 11/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Tanglewood Coombe Road Lanjeth, High Street St Austell Cornwall PL26 7TL Lead Inspector Richard Coates Unannounced Inspection 16th November 2005 10:00 Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 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 DS0000009119.V266045.R01.S.doc Version 5.0 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 DS0000009119.V266045.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tanglewood Address Coombe Road Lanjeth, High Street St Austell Cornwall PL26 7TL 01726 71088 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) Spectrum Miss Sharon Elizabeth Conibear Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2005 Brief Description of the Service: Tanglewood is a detached bungalow in the village of Lanjeth, near St Austell. The home provides accommodation and care for up to three service users with a learning disability. The registered provider is Spectrum, an organisation which provides specialist services for people who have autistic spectrum conditions. The aim is to provide service users with a homely environment in a community setting and enable them to enjoy ordinary valued living. Senior managers from the organisation are available to provide consultation and advice when required. The accommodation consists of three single bedrooms, a large lounge, separate dining room, kitchen, bathroom and an activity room. The front access has two sets of two steps. There is a rear access with one step. There is a large garden with a patio, lawn and fishpond at the back and car parking space at the front. The office is also used as the staff sleeping-in room. The home has two vehicles. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a planned unannounced inspection and the aim was to review compliance with the requirements and recommendations set at the last inspection report, dated 3 May 2005, and to focus on key standards in the areas of lifestyle, complaints and protection, and environment. The key standards in the other areas were included in the previous inspection. The registered manager had provided follow up information since the last inspection as the requirements and recommendations had been met. The inspector was at the home for over four hours and spent time, including lunch, with staff and service users, and had discussions with the registered manager and staff, toured the premises, and examined policies and procedures, records and care plans. The inspector is grateful to the registered manager, staff and residents for their assistance in completing the inspection. What the service does well: What has improved since the last inspection? The provider has revised and improved the medication policy and procedure to ensure the safe handling of medicines by giving staff clearer instructions and guidance. The provider has improved the consistency of submitting reports of the monthly management visits to the home as required by regulation. The registered manager has added a summary of the outcomes of the quality assurance survey to the service users guide so that the views of residents and their representatives are included. The home has improved smoke detectors and emergency lighting system in order to enhance fire safety. The floor in the en suite bathroom to one of the bedrooms has been replaced. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 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 DS0000009119.V266045.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 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 the following standard(s): These standards were included in the announced inspection report dated 3 May 2005. EVIDENCE: These standards were not inspected in detail. The registered manager has added a summary of the outcomes of the quality assurance survey to the service users guide as required in the last inspection report. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 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 the following standard(s): These standards were included in the announced inspection report dated 3 May 2005. EVIDENCE: Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 10 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): 12, 13, 15, 16 and 17 Service users have opportunities for personal development and take part in a range of appropriate educational, social and leisure activities. Service users are supported to make choices about their meals, eat a healthy diet and enjoy their mealtimes. EVIDENCE: The residents attend a range of activities for personal development. There are written weekly activity plans for each resident. Each resident has an individual plan which identifies their needs in relation to social, communication and independent living skills. Further records set out goals for each resident. Two residents are seeing a speech and language therapist and attend regular art and dance and music therapy sessions. The registered manager discussed strategies for developing their language and communication skills. One resident attends the Foundation Studies Department at Camborne College three days weekly. Another resident attends college one day a week and works as a volunteer at a pony centre on another day. One to one staffing supports all attendances at these activities. Residents leave the home only in the company of staff and this is documented in their risk assessments. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 11 All residents regularly attend Polkyth gym, swimming pool and hydro pool. They go bowling in St Austell regularly. The records show frequent shopping expeditions in local towns and lunches out in public houses and restaurants. Two residents went out to the local supermarket for the home’s weekly shopping during the inspection. The home has two vehicles. The registered manager stated that residents have used public transport in the past, but most of the current staff are drivers and make use of the home’s vehicles. Residents have recently enjoyed concerts at the Hall for Cornwall. Spending time with residents outside the home is a recognised part of the staff duties. A detailed inspection of the records for one resident over two weeks, including her own daily diary, confirmed the range of activities and her involvement in ordinary valued living. The home provides television, video, DVD and music. Residents have their own entertainment equipment. In one case this is modified suitably to meet the resident’s risk assessment. One resident who particularly enjoys jigsaws and art work discussed her interests with the inspector. Another resident enjoys making jewellery. Last year the residents had a holiday at Colvennor, the Spectrum holiday home, and this year a week of day trips and activities from the home is planned. Records show that residents are supported to maintain contacts with their families. The registered manager reported that families are welcomed when visiting the home and their involvement in care planning is encouraged. There are no restrictions on movement in the communal areas of the home. Two residents have keys to their rooms. One can close and lock her door from the inside and staff can override this if necessary. Residents access the patio area and garden. The registered manager stated that all three residents tend to prefer to be up and about quite early and they have their own preferred times for going to bed. Staff were observed to interact appropriately with residents during the inspection. Residents assist with housekeeping tasks. There is a cleaning plan in the kitchen and daily diaries detail the tasks carried out. The home does not have a rolling menu for a number of weeks. There is a suggested list of the residents’ preferred main meals in the kitchen and selections are made from this. The registered manager stated that this list is not adhered to exclusively and residents could have a different choice from the main meal provided. Breakfast consists of cereals, toast, fruit, yoghourts, juices and drinks. Lunch is usually a sandwich, soup or a snack like scrambled eggs. The inspector enjoyed a relaxed and unrushed lunch with residents and a staff member. One resident told the inspector that she was able to choose meals and enjoy her preferences, and the food was ‘good’. Staff described how they support residents to become involved in preparing food according to their Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 12 level of interest. A resident made her sandwich for lunch during the inspection. Records evidence regular meals out and take away meals. None of the residents is assessed as having particular nutritional needs, but the provider encourages a healthy diet and residents are weighed regularly. One resident has a picture preference chart for communicating her food choices. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 13 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): These standards were included in the announced inspection report dated 3 May 2005. EVIDENCE: These standards were not assessed in detail. However, Spectrum has introduced a revised and expanded policy and procedure on the safe handling of medicines which complies with the standard and regulation. This also meets a requirement set in the last inspection report. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 14 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 and 23 There are basic systems in place but the revision of the adult protection procedures needs to be completed and staff require further training to ensure that vulnerable adults are completely protected. EVIDENCE: There is a written complaints procedure and a copy is included in the home’s statement of purpose. There is also a policy for dealing with complaints. The registered manager provided some examples where the views of service users’ representatives had been listened to and acted upon. Each service user has a simple language and widget guide to making complaints. This has been talked through with them. No formal complaints have been received since the last inspection. Staff are provided with some training on the protection of vulnerable adults from abuse as part of their induction, but this is not followed up with regular refresher training. The home has written policies and procedures but these are in the process of revision to reflect current best practice. Staff should be supported to attend the multi-agency ‘alerters’ training available locally. The registered provider has a copy of the local inter-agency adult protection guidance and has also obtained this from residents’ placing authorities which are outside the area. The home manages the personal allowances for all three service users. The registered manager reported that all transactions are documented and the records are audited monthly at the head office. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 15 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, 26, 27, 28 and 30 The service users live in a comfortable and well-maintained home which provides a safe and suitable environment and meets their needs. EVIDENCE: Tanglewood is a spacious three-bedroom bungalow in a rural setting fairly close to St Austell. The premises were well maintained and safe. There are two steps to the outside entry area at the front access and a further two steps to the front door. There is another entrance with one step. Internally there are two steps down into the lounge area. The home would not be suitable for a person with anything other than minor mobility problems or a wheelchair user. The premises were airy and clean and there were no odours. Furnishings and fittings were of good quality and domestic in style. Since the last inspection the provider has installed additional smoke detectors and emergency lighting. The bathroom floor has also been refitted in the ensuite to one bedroom. The environmental health officer visited on 9 November and set a requirement regarding the risks to food hygiene from laundry being carried through the kitchen to the utility room. The registered manager is addressing this issue. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 16 Residents have their own rooms. These rooms are have furniture and fittings which reflect the residents’ lifestyles and interests, and for one resident, are adapted to provide a safe environment in line with the risk assessment. Two residents share a bathroom which provides a bath, shower, hand basin and toilet. The bathroom has a suitable lock which staff can override from outside. One resident has an en suite bathroom with toilet and shower. There is a toilet and shower for staff off the garage. Shared space exceeds the requirement. There is a spacious hall leading on to a lounge area. The lounge has two new sofas and a new armchair. There is a separate dining area. There is a large garden, which is well maintained with a level patio area at the rear of the house. The garage is used as an activity area and storage area. Staff have sleeping accommodation in the office and lockers are available in the garage. The premises were clean and hygienic with no odours. The baths, toilets, basins and showers were all clean and hygienic. The refrigerator was well ordered and no out of date food was evident. There is a domestic style washing machine and a tumbler dryer in a utility room with a vinyl floor. The washing machine is adequate for the limited amount of incontinence linen that is laundered. There are reminders about hand washing and suitable cleansers. The registered manager stated that staff prompt and support service users in personal care rather than provide direct intimate care. Gloves are available for applying creams and changing bed linen. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 17 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): These standards were included in the announced inspection report dated 3 May 2005. EVIDENCE: The staffing standards were not inspected in detail but the following were noted: The registered manager reported that the home had been one staff short of its full complement and had been maintaining staffing levels with bank staff. A new member of staff is due to start later in November. There were at least two staff on duty during the inspection including one at college with a resident. A sample of staff records inspected showed that staff were up to date with their induction training and other required training and refresher training. The new member of staff is booked for all required induction and introductory training. The registered manager reported that access to training had improved. All the staff except one at this home were reported to have a qualification at NVQ level 2 or above. The provider has not, however, introduced regular appraisals for staff. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 18 The provider has been more consistent in submitting monthly reports required under regulation 26 to the commission. This will be reviewed at future inspections. . Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 19 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): These standards were included in the announced inspection report dated 3 May 2005. EVIDENCE: Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 20 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 X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tanglewood Score X X X X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000009119.V266045.R01.S.doc Version 5.0 Page 21 Yes 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 YA23 Regulation 13(6) Requirement The registered person must provide an adult protection procedure which complies with the local multi-agency procedure and includes guidance about the POVA list. The registered person must review the provision of regular refresher training for staff on the protection of vulnerable adults. Timescale for action 28/02/06 2 YA23 13(6) 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA36 Good Practice Recommendations Staff should receive an annual appraisal to review performance and agree personal development plans. Tanglewood DS0000009119.V266045.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 DS0000009119.V266045.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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