Inspection on 17/02/06 for Tangneffydd

This inspection was carried out on 17th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 12/12/05

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 17th February 2006 09:15 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.V283757.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. Tangneffdd DS0000002669.V283757.R01.S.doc Version 5.1 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.V283757.R01.S.doc Version 5.1 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. 12th December 2005 Date of last inspection Brief Description of the Service: Tangneffydd 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.V283757.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the second required by law for April 2005 to March 2006. It was undertaken by one inspector and took place over two hours. It consisted of tracking the care and support the resident receives through checking care records, discussion with the resident and one of the registered persons and a tour of the premises and facilities used by the resident. What the service does well: What has improved since the last inspection? What they could do better: Further work needs to be done to ensure that the requirements, which remain outstanding from the last inspection, are fully addressed. These relate to ensuring that records are in place to demonstrate that all elements of risk in relation to the resident have been assessed and of any outcomes or actions that need to be taken as a result of this to ensure the resident is adequately protected from any potential safety risks. Tangneffdd DS0000002669.V283757.R01.S.doc Version 5.1 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.V283757.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 Tangneffdd DS0000002669.V283757.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): N/A EVIDENCE: The above standards were not inspected on this occasion. Most do not apply. Standard three was inspected during the last inspection of 19/12/05 and was met. This statement is based on information seen at the time of the last inspection. The registered persons have confirmed in writing that it is not their intention to provide a service to any person other than the one 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 a family member for the past seven years. Tangneffdd DS0000002669.V283757.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): 7 and 9 Care records have improved as significant events are recorded to demonstrate in more detail how residents’ needs are being met, but they do not show that there is a regular review system in place. Risk assessments are not in sufficient detail to demonstrate that all aspects of residents’ health and safety have been addressed. The arrangements for storing medication have been made more secure. EVIDENCE: The resident’s needs and how they are to be met are well known by the provider. The care plan seen was dated 23/06/03. Since the last inspection the registered providers have set up a system to record any significant events, which pertain to the resident. This demonstrated the social events and interests that the resident participated in. The record is not currently being signed by the person completing it and should be as they are legal documents. Some risk assessments had been completed for example in relation to the resident accessing the community but the requirement in relation to ensuring that a risk assessment was in place should the resident be left alone for any period remains outstanding. Tangneffdd DS0000002669.V283757.R01.S.doc Version 5.1 Page 10 Discussion with one of the registered persons indicated that there had not been any formal review held of the care needs of the resident since 2002 although any care changes necessary were implemented on an on-going basis. He said that he had telephoned social services on previous occasions and that anyone was welcome to visit the home but no one had. (See also comments made at standards 31 – 38). Whilst the resident is not on any regular medication the storage arrangements for any medications have been made more secure by ensuring they are kept in a facility that can be locked. The resident made comments that he felt he received the help he needed Tangneffdd DS0000002669.V283757.R01.S.doc Version 5.1 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 the following standard(s): 12 and 15 Resident’s choice in how they lead their lives in the home and independence is promoted. Meals are provided to suit the resident’s preferences. EVIDENCE: Comments from the resident indicated that he was able to come and go as he pleased around the home and garden. Records indicated that he had opportunities to participate in his preferred social and leisure activities such as gardening. The home does not keep records of the food provided, however comments from the resident demonstrated that he is consulted about the meals and asked for example “what he would like for tea?” He said that the food was “good”. It was observed that at the time of the inspection the resident freely helped himself to a hot drink and biscuits. Tangneffdd DS0000002669.V283757.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 There are satisfactory arrangements in place for handling complaints and allegations of abuse. EVIDENCE: There have been no concerns or adult protection issues raised with the Commission or the home since the last inspection. The resident said that he would feel comfortable to raise any problems with either of the registered persons and liked living at the home. There is a complaints procedure and adult protection procedure in place. One of the registered providers confirmed at the time of the last inspection that Lincolnshire County Councils policy and procedures would be followed should any adult protection issue be raised. One of the registered providers had training in relation to adult protection in 2000. Tangneffdd DS0000002669.V283757.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 and 26 There is a homely, comfortable and generally well-maintained environment provided which respects residents’ privacy. However, the standard of cleanliness in some areas of the home is inconsistent. EVIDENCE: The home provides a family type environment for the resident accommodated. Those areas of the home seen were the resident’s bedroom, which was clean tidy and since the last inspection has had new flooring provided, lounge, kitchen and conservatory. The resident said that he found his room to be comfortable and has been able to furnish it with items of his own personal taste such as pictures and paintings and he chose his bed. Two additional pets have joined the household since the last inspection. A rescue St. Bernard dog and puppy, one was in the conservatory area, which the resident needs to access to get to his bedroom. It was noted that this area did have an unpleasant odour and was less tidy and clean than other areas of the home. There is a domestic type washing machine in the conservatory. Tangneffdd DS0000002669.V283757.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): 27 The staffing arrangements meet the current resident’s needs. EVIDENCE: The registered persons do not employ any other staff. They provide the care and support themselves therefore standards 28, 29 and 30 do not apply. Discussion with the resident indicated that he liked living at the home and felt able to talk about any problems with the registered persons. Observations made at the time of the visit indicated that the resident felt able to air his views with the registered person present who had a good knowledge of his needs. (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.V283757.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): 31, 33, 35 and 38 The registered providers have the necessary experience to manage the home. However, a system must be introduced which shows that the views of residents are actively sought and acted upon to improve the quality of the service that the home provides. EVIDENCE: The registered providers have had a number of years experience caring for the resident. Records were seen during the previous inspection to indicate the training that one of the providers had undertaken. There is no formal system in place to monitor the quality of the service. The resident lives as part of the family and he was observed to be able to come and go as he pleased around the house and garden and said he liked living in the home. He is able to be involved in some household tasks around the home Tangneffdd DS0000002669.V283757.R01.S.doc Version 5.1 Page 16 such as washing pots and gardening if he chooses. It needs to be demonstrated that there is a formal review system in operation, which provides the registered persons with feedback as to the quality of the service and includes seeking the views of residents as well as any other interested parties such as relatives, social services or advocates. Since the last inspection there has been improvements with ensuring that records are kept to demonstrate any transactions in relation to residents money and the resident signs these. The registered provider has also pursued further opening a bank account for the resident but it still does not did not fully protect the residents interests, as it is not solely in the residents name. A fire procedure is in place and records are kept to demonstrate when checks of smoke detectors are carried out. There were some documented risk assessments completed but these need to be developed further to fully ensure the health and welfare of the resident. For example this is a family type home with pets however no risk assessments were in place about these. As this a small family type home that does not employ any other staff policies, procedures and records are minimal, however the registered persons need to ensure that they are sufficient to ensure the health and safety of the resident. Tangneffdd DS0000002669.V283757.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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 2 X 2 X X 2 Tangneffdd DS0000002669.V283757.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. 1. Standard OP7 Regulation 13(4)(b) (c) & 15(2)(b) Requirement The care plan must detail any identified risks to residents and how as far as possible they have been eliminated. Previous timescale of 18/02/06 not met. Any accounts opened on behalf of service users must be in their name. Previous timescale of 18/02/06 not met. The registered persons must ensure that there is a system in place for independently reviewing and improving the quality of the service, which must include consultation with residents and their representatives. Timescale for action 17/05/06 2. OP35 20(1)(a) 17/05/06 3. OP33 24(1)(2) (3) & 15(2)(c) 17/05/06 Tangneffdd DS0000002669.V283757.R01.S.doc Version 5.1 Page 19 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 OP15 Good Practice Recommendations It is recommended that records are kept of the meals provided. Tangneffdd DS0000002669.V283757.R01.S.doc Version 5.1 Page 20 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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