Inspection on 14/03/07 for Tanners Wood Close

This inspection was carried out on 14th March 2007.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tanners Wood Close 13/02/09

Tanners Wood Close 24/01/06

Tanners Wood Close 19/09/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Tanners Wood Close 5 & 5a Tanners Wood Close Tanners Wood Lane Abbots Langley Hertfordshire WD5 0HR Lead Inspector Julia Bradshaw Unannounced Inspection 14th March 2007 10:00 Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 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 Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 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. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tanners Wood Close Address 5 & 5a Tanners Wood Close Tanners Wood Lane Abbots Langley Hertfordshire WD5 0HR 01923 270270 01923 270095 tannerswoodclose.residentialunit@ 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) Hertfordshire County Council Mrs Brenda Chance Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: Tanners Wood Close respite care unit is a local authority facility operated by Hertfordshire County Council, located in a quiet residential area of Abbots Langley. Local amenities and shops are close by. The respite facility comprises of two wheelchair-accessible bungalows providing eight places within a large site that includes other residential provision excluded from the registration and therefore not inspected by the CSCI as a residential home but as a domiciliary service. The service provides mainly short stay accommodation on a prearranged rotational basis for over 100 service users with learning disabilities, many of whom have complex needs. Staffing numbers and skills and appropriate special equipment are provided that reflect the diversity of the client group accommodated. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive inspection; it was carried out by one inspector over one day. The registered manager and staff continue to work very hard to provide a very good service to the service users. The home was clean and fresh and the service users appeared well cared for. All service users spoken with were very positive about the living at Tanners Wood Close. Various areas within the respite care unit are in the process of being updated and redecorated, including new floor coverings. The kitchen should be upgraded within the next financial year 2007/8. The grounds have also been updated and generally improved. What the service does well: Care plans with progress notes were kept up to date. These were well documented and reflected the how the needs of individual service users were being met. A senior member of staff has visited the home on a monthly basis from Hertfordshire Adult Care Services and has prepared consistent written reports on the conduct of the home and a copy is supplied to the Commission, since the last inspection took place. The standard of staff training within this service is excellent. The manager and staff have developed a detailed and comprehensive induction programme for this respite care unit, which they should be congratulated on. Staff in the unit work closely with other agencies to ensure that a consistent approach is provided for the service users and to enable service users to continue with regular activities, while in the home. There is a good Quality Assurance system in operation, through which the views of service users can be officially noted and acted on. The staff team work well together as a unit and benefit from strong and consistent management, which benefits the service users who regularly use the unit. There is a calm and homely atmosphere in the home. The home should be congratulated on how they respond to emergency situations, which have occurred in recent months, managing service users who have very complex needs and requiring specialist support and ensuring the placement was well supported and appropriate. Good relationships with the carers of the service users are maintained. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 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 Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1-4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed information was available to current and prospective service users and their families. Assessments of needs were carried out to ensure that staff have sufficient information on each person’s needs prior to an offer of respite care being made. EVIDENCE: The home has a ‘Statement of Purpose’ and the ‘Service User’s Guide’ and both documents were available to service users and their families. All service users were referred through the Adult Care Services. Care plans were comprehensive and met the requirements of this standard. Service users and their families were given the opportunity to visit and view the home prior to a planned offer of respite care is made. The trial period gives more time for the staff to further assess the needs of the service users. This unit also provide emergency admissions, Three service users files were inspected and they contained assessments of service users needs. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6-10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were detailed and comprehensive. Information on all assessed health care needs, social needs and risk assessments were carried out. At the time of the inspection there were four service users staying within the respite unit. EVIDENCE: Each service user had a care plan generated from the Care Management Assessment (CAR 210) and the services own assessment, which covered all aspects of personal, social support, and healthcare needs. Service users spoken to on the day of the inspection stated that had all previously stayed within the respite unit and found that staff were all very kind and supportive. Risk assessments have been updated on all service user records. All records and information about service users are kept securely and dealt with in line Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 10 with the Data Protection Act, the Local Authority’s Access to Records Policy and the home’s policy on confidentiality. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11-17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were encouraged to make choices in relation to their food, clothes and activities to optimise their abilities in developing their skills. They were also encouraged and supported to pursue social and leisure activities as stated in their individual care plan. EVIDENCE: Staff endeavour to support service users to continue with the regular activities and commitments they take part in, when they are not in the respite unit. Visits to religious services or to regular therapy sessions would be supported by staff in the home whenever possible. Service user are able to take part in any appropriate local events, with staff support, whilst staying at Tanners wood. Appropriate relationships are supported by staff and relatives of service users are involved in all aspects of daily life in the home. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 12 The manager said that, as most service users are regular visitors and therefore known by staff, the staff endeavour to place service users with people who are compatible. Evidence was seen of on-going work taking place between families and care staff from the unit. There are written guidelines on promoting individual choice and staff clearly promote this policy. The parameters of the daily routines in the unit are also set out in the information given to service users and their families. The care staff prepares a weekly list of activities and residents are able to take part in these events if they wish. Meals are prepared by staff who usually know in advance if there are any special dietary needs to be catered for. Service users are involved with meal planning and their views are incorporated in the meal planning and provision. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was good record keeping of service users health care needs. EVIDENCE: Care plans detailed the individual needs of service users and daily records, completed by staff, show how these needs were met. Reviews were recorded and plans for service user support where confirmed or changed, as necessary. There are male and female care staff on the staff team and the service is therefore able to fulfil any gender preference an individual might have for staff providing personal care. Appropriate aids and adaptations are in place to promote service user independence and staff work closely with other health professionals where additional support is required. There is always a member of staff with a First Aid qualification on duty. The procedures for the administration of medication were checked and were thorough. Photographs of service users and details of all medication taken are recorded on entry and relatives sign for the administration of any non-prescribed medication. A new record sheet is produced for each service user, every time they enter the home Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 14 and documents and risk assessments are completed for residents who selfmedicate (where necessary). Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users using the respite service at Tanners Wood Close are well protected. There is a comprehensive complaints procedure in place. EVIDENCE: There have been two complaints since the last inspection. The management team have worked hard in resolving both these complaints to a satisfactory conclusion. Service users have their legal rights protected and they are protected from abuse. Staff are aware of the Safe-guarding of Vulnerable Adults Policy and the staff were also aware of the whistle blowing policy. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24-30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment of Tanners Wood Close is homely and welcoming. Service users bedrooms are maintained to a satisfactory. In the main the home is well maintained. The home was clean and odour free and nicely decorated. The kitchen is in need of replacement EVIDENCE: The required standards are met in providing living space for service users. The premises were safe, accessible and comfortable. Each room has sufficient light, heat and ventilation. All rooms are for single accommodation. Service users’ bedrooms included all the necessary furniture. There are several areas of the home that have been decorated since the last inspection was carried out and these include, new flooring/carpets in the Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 17 hallway and work has been completed on the grounds around House 5 and further work is expected in 2007/8. The manager has also improved the soft furnishings of the respite units (5 and 5a) including new table linen and bedding. The kitchen is considered to be in a poor state and should be replace within the 2007/8 budgets. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31-36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported and protected by procedures in place which ensure that appropriate staff are recruited and that all staff are provided with adequate basic and specialist training. EVIDENCE: Staff are aware of and promoted the main aims and values of the home including the key worker system. Staff confirmed that they received a job description on starting employment and they underwent a period of induction. Staff received regular, recorded formal supervision and an annual appraisal. The details on individual records demonstrate an understanding of each individual’s needs and how these needs are all met. Where an individual service user has a specialist need, there was evidence that staff training is provided for the particular condition. In general staff training is given a high priority in the unit and the care workers on the respite unit have been booked Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 19 on a new course “Working with Carers”. All staff working on the unit have had training on the prevention of Adult Abuse. The numbers of care staff in the home who have completed, or are undertaking, NVQ training is especially good. Currently, almost 86 of care staff have completed NVQ training in levels 2 or 3, and most of the remaining staff members are completing this training. This high level of qualified staff is reflected in the professional attitude of care staff and in the way care is provided for a wide range of service users. Recent training includes, epilepsy, autism, sexuality, sensory awareness, food hygiene, challenging behaviour and risk assessments. There are adequate numbers of staff on duty in order to provide the necessary support to the service users within this respite service. There are two team leaders who have overall management responsibility for the respite care service. The manager and staff should be congratulated on providing an excellent service to people who present with both complex and high dependency needs Staff were observed on the day of the inspection to be highly professional and motivated in their work with the service users. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 & 43. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users have their views listened to and benefit from a well run home, with a supportive staff team and are protected by the Health and Safety procedures in place. EVIDENCE: The manager of the home is registered with the CSCI and has completed NVQ level 5 training. The manager has successfully managed the whole of Tanners Wood Close for a number of years and has enabled the smooth separation of service provision into the respite care unit and the remaining supported housing provision. The manager currently manages both areas and is also responsible for providing the domiciliary care to the service users in supported housing. There is clearly a very good working relationship between senior staff Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 21 members, which benefits the whole staff team and therefore the service users. A Quality Assurance system, linked to that of the Local Authority is in place. Leaflets asking for comments on the services provided are sent out to service users twice each year. The service could further benefit from developing all information that is provided to service users, in a format that is easily understood by all service users and covering all abilities. This information should also be provided in pictorial and on audiotape, where necessary. Work in underway in developing a new parental/carer questionnaire in order to obtain as much information as possible to further improve and develop the services of respite care. Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 3 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 4 4 3 x x 3 3 Tanners Wood Close DS0000064254.V333357.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 16 (2)(g) Requirement The kitchen must be refurbished in the 2007/8 major works plan. Timescale for action 31/03/08 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 YA38 and YA39 Good Practice Recommendations The home should further develop any information that is provided to service users, in a format that can be comprehended by everyone accessing this service. 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