Inspection on 12/12/05 for Tangneffydd

This inspection was carried out on 12th December 2005.

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

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

Other inspections for this house

Tangneffydd 05/04/06

Tangneffydd 17/02/06

Tangneffydd 16/03/05

Tangneffydd 05/01/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOMES FOR OLDER PEOPLE Tangneffdd 82 Lincoln Road Metheringham Lincoln Lincs LN4 3EE Lead Inspector Sue Hayward Unannounced Inspection 12th December 2005 10:15 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 Tangneffdd DS0000002669.V272062.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 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. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tangneffdd Address 82 Lincoln Road Metheringham Lincoln Lincs LN4 3EE 01526 322098 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) Mrs Dorothy Rae Mr Derek Andrew Rae Mrs Dorothy Rae Care Home 1 Category(ies) of Learning disability over 65 years of age (1) registration, with number of places Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One bed in the category LD(E) is registered for a service user as named in the Notice of Proposal to Register dated 5 May 2005. 16th March 2005 Date of last inspection Brief Description of the Service: Tangneffdd is a four-bedroom bungalow with a large garden to the front and rear of the property, with a pond and patio area. This is a small family run home which is situated on the outskirts of the village of Metheringham, 8 miles north of the town of Sleaford and 7 miles South of the city of Lincoln. Metheringham has a variety of shops and services including a post office as well as a bus service and railway station. The home is registered for one person who has needs associated with learning disabilities and is over sixty-five years of age. The proprietors have confirmed in writing that that they intend to only offer a “home for life” for the one person who currently lives at the home and who has done so for a number of years. The providers confirmed that they do not employ any other staff to work in the home. The service user lives as part of the family. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector over 2 hours and was the first of two inspections required by law for April 2005 – March 2006. The inspection took the form of tracking the care and support the service user receives through checking care records, discussion with the service user and with both of the registered persons. A sample of regulatory records and a tour of the premises and facilities used by the service user were also undertaken. What the service does well: What has improved since the last inspection? What they could do better: To ensure that the service users rights are fully safeguarded further action needs to be taken to ensure records are kept up to date and demonstrate the care provided. Risk assessments need to be recorded in relation to some activities that the service user participates in to demonstrate how any identified safety issues have been considered and addressed. The arrangements for storage of medicines need to be reviewed although it is acknowledged that the registered providers confirmed at the time of the inspection that this matter would be attended to as a matter of priority. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 6 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. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 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 Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 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 – standard 6 does not apply. As it is not the intention of the registered persons to provide a care home service to any other person most of these standards do not apply. Information is available to demonstrate that the current service user was satisfactorily assessed and that the home is able to meet his needs. EVIDENCE: Information is available about the service in the form of a service users guide however it is not the intention of the registered persons to provide a service to any person other than the person who is currently accommodated at the home. Records demonstrated that a care plan had been drawn up which was dated 26/06/03. Records also contained background information and a brief history about the service user. The registered persons have a good knowledge of the needs of the current resident accommodated as he has lived as part of the their family for seven years. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 9 The registered persons said that the service user prefers is always involved in any discussions about his care and this was confirmed by the service user. He said that he would talk to the registered persons if he had any problems. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 10 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): 7, 8, 9 and 10 Care records need to contain more detail to demonstrate that service users health, personal and social needs are being reviewed regularly. Medication storage systems must be reviewed in order to provide a safer system. Residents’ privacy is respected. EVIDENCE: The service users needs and how they are to be met are well known by the providers however records do not demonstrate fully that all potential risks to the service user and how they may be reduced have been considered. For example it was discussed that the service user spends some short periods of time at home alone. Records did not reflect whether a risk assessment had been done in relation to this, although one had been done in relation to the service user requiring the support of another person when in the community. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 11 Discussion with the registered persons and the service user confirmed that should the service user require any health care then local services are used such as G.P’s. The service user is not currently prescribed medication. The registered manager said that a stock of homely remedies is kept if needed. The storage arrangements need to be reviewed to ensure they provide a safer system. The registered persons agreed that this would be addressed as a priority. The service user made comments, which indicated that his privacy was respected. His bedroom is lockable and he made comments, which indicated that he could come and go as he pleased. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 12 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): 13 and 14 Visitors are made welcome at the home and there are opportunities for service users to visit the local community. Service users have choices and are able to make decisions about how they lead their life at the home. EVIDENCE: From discussion with the registered persons and service user, comments were made which indicated that visitors are welcomed at the home and that the service user is considered to be part of the family and is therefore included, should he wish to be, in any visits to or from friends and neighbours. It was also confirmed that the service user has holidays and weekend breaks with the registered providers. Comments from the service user indicated that he is able to follow his preferred routines in the home such as time of rising and retiring to bed and can help with tasks around the home and garden. The service user also commented that he had been able to arrange his bedroom to his own taste. The service user made positive comments about the meals provided. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18 There are satisfactory arrangements in place for handling complaints and allegations of abuse. EVIDENCE: There is a complaints procedure in place. This needs to be reviewed in order that it reflects the change of name of the regulatory body from the National Care Standards Commission (NCSC) to the Commission for Social Care Inspection (CSCI). There is also a copy of the Lincolnshire Adult Abuse procedure in place which would be followed should any issue arise. It was recommended that the providers obtain a copy of the most up to date version, which was issued in February 2005. One of the registered persons had training in 2000 in relation to adult protection. Discussion with the service user indicated that he would feel comfortable to raise any problems with the providers and that they would listen to him. The providers said and it was confirmed by the service user that he prefers to be involved in any discussions about his care. The service user made comments, which indicated that he felt safe in the home and had no wish to move. The CSCI have not received any complaints about the service in the last twelve months or been notified of any adult protection issues. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 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 the following standard(s): 19, 21 and 24 A homely and comfortable environment is provided which is generally well maintained and respects the privacy of the service user. EVIDENCE: The home is a domestic style property. Work has recently been undertaken to replace the lounge and hall floor and is nearing completion. The fire brigade has not inspected the home since the last inspection however records are kept of tests of smoke detectors, which are checked on a monthly basis. There is a fire extinguisher in place, which Mr Rae confirmed had been purchased approximately 2 years ago. It was advised that this should be checked. There is a garden and the service user indicated that he enjoyed and was able to pursue his interest of growing vegetables. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 15 The service user has a lockable bedroom with a bathroom and shower adjacent to it. He said that he found his room to be comfortable and warm enough and it had been furnished to accommodate his preferences. The registered persons confirmed that they had equipment to assist service users to get in and out of the bath however he preferred that they help him. The registered persons said they had made some alterations to the bath in order to make access easier. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 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 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): 27 Service users needs are being satisfactorily met by the staffing arrangements within the home. EVIDENCE: The registered persons do not employ any other staff. They provide the care and support themselves and therefore standard 29 does not apply. Observations made at the time of the inspection indicated that the registered persons had a good rapport with the service user and a comment made by the service user indicated that he liked living at the home. (See also comments made at standard 7-11 in relation to a risk assessment being completed for times when the service user stays at home alone). Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 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 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): 31 and 35 The home is being well managed but the lack of up to date records in some instances to demonstrate practices in the home has the potential to put service users at risk. EVIDENCE: The registered persons have had a number of years experience caring for the service user. Some record keeping systems need attention in order that they reflect the care that is provided. Records in relation to the handling of service users monies were not up to date. Whilst the registered providers had pursued opening a bank account on behalf of a service user this did not fully protect the service users interests, as it was not in his name. This matter needs to be reviewed for example through the use of advocacy services Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 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 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x 3 x x 3 x x STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 2 x x x Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 19 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. 1 Standard OP7 Regulation 13(4)b&c 15(2)(b) Requirement Timescale for action 18/02/06 2 OP9 13 (2) 3 OP35 20(1)a & 17(2)(9) The care plan must detail any identified risks to residents and how as far as possible they have been eliminated. Records must demonstrate that care plans are reviewed on a monthly basis and any significant events are recorded in relation to health, personal and social care of service users. The registered person must 18/02/06 ensure that storage arrangements for medications are secure. Any accounts opened on behalf 18/02/06 of service users must be in their name. Records of any monies or valuables in safekeeping must be up to date and show all transactions. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 20 No. 1 Refer to Standard OP16 Good Practice Recommendations The complaints procedure should be reviewed to reflect the change of name from the National Care Standards Commission to the Commission for Social Care Inspection. Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 21 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. Extracts may not be used or reproduced without the express permission of CSCI Tangneffdd DS0000002669.V272062.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!