CARE HOMES FOR OLDER PEOPLE
Taptonholme 14 Taptonville Crescent Sheffield South Yorkshire S10 5BP Lead Inspector
Shirley Samuels Unannounced 20th July 2005 09:00-13:30 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 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. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Taptonholme Address 14 Taptonville Crescent Sheffield South Yorkshire S10 5BP 0114 2663440 0114 2663440 None Taptonholme Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss Suzanne Victoria White PC Care Home Only 19 Category(ies) of OP Old age - 19 registration, with number of places Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 22nd March 2005 Brief Description of the Service: Tapton home is located in the Broomhall area of sheffield and provides personal care to 19 service users. The aims and objectives of the home is to provide a caring, safe and stimulating environment. All bedrooms are single with some having ensuite facilities. There are sufficent bathrooms and toilets which are situated close to bedrooms and communal areas. The home is situated in its own grounds and has as large mature garden with seating areas. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over four and a half hours. A notice was displayed to inform visitors that an inspection was taking place and that any comments would be welcome. Eight service users, seven staff and the manager of the home were spoken to. A selection of records was checked and an inspection of the building was made. What the service does well: What has improved since the last inspection?
Records now show that service users do not move into the home without first having their needs assessed. A tripping hazard noted at the last inspection has been repaired. Action has been taken to reduce the risk of cross inspection, and staff have received training on infection control. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 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. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 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 standard(s) 3 Service users do not move into the home without having their needs assessed. EVIDENCE: Three-service user files were checked all included assessment carried out prior to moving into the home. This ensuring the staff had the information they needed to make judgement abut the care they could provide. Service users said they were satisfied with the care they received and that their needs were met. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 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 standard(s) 10 Service users are treated with respect and their right to privacy is upheld. EVIDENCE: Service users said the staff treated them with respect, approached them sensitively and always had a caring attitude. Staff said they respect service users dignity and privacy by “offering choices” “ providing information” “getting to know service users as individuals” “approaching bathing and washing etc, in a sensitive manner,” promoting service users rights. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 & 15 The lifestyle experienced at the home matched with service users expectorations and preferences. They were able to maintain contact with friends and family and were helped to exercise choice and control over their lives. Service users received a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: Service users said they were told about the home before they moved in, Ensuring they knew what to expect. Service users said they were able to spend their time as they wished, that staff respected their choices and preferences. Ensuring they were able to exercise control over their lives. Service users said visitors were always made welcome and offered a drink, links with friends and family were maintained and encouraged. This promoted their sense of wellbeing and belonging. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 Page 11 Service users said the food was “excellent”, “plentiful”, “varied”. Meals were provided in pleasing surroundings at convenient times. Hot and cold drinks and snacks were available. Ensuring that service users received a wholesome balanced diet. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 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 standard(s) Not assessed on this occasion. EVIDENCE: Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 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 standard(s) 19 & 26 In the main service users lived in a safe well-maintained environment, which was clean pleasant and hygienic. EVIDENCE: Service users said the home was “Lovely and clean” “ my room is very comfortable, it has everything I need”. The manager said that bedrooms are redecorated when they become vacant. In Some bedrooms however the decor was in a poor state of repair, lacking personalisation and homely touches. All areas used by service users were clean, the laundry area however was dusty and untidy the paint on the floor was flaking. Radiator guards had become unattached from the wall, doors to vanity units were missing in some bedrooms and staff said there was a leaking drainpipe at the front of the house, which caused water to pool in the porch creating a slipping hazard. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29, & 30 The number and skill mix of the staff met Service users needs, staff are trained and competent to do their jobs. The homes written procedures for the recruitment of staff had not been fully implemented. EVIDENCE: Service users said there was always enough staff on duty “ there is always someone around” “ when I ring my buzzer staff always come and attend to me.” Staff said there was enough staff on duty but added it can be difficult when service users are ill, “ but we work well together and manage.” Ensuring that service users are in safe hands at all times. The manager said that some staff had been employed without obtaining two references. This contravened the homes policy and procedures and could place service users at risk. The manager said that more than 50 of the staff had completed the NVQ level two in care and added that the senior cares were to commence on NVQ level 3, promoting staff development and competence. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 & 38 Staff were not receiving regular formal supervision. The health, safety and welfare of service users and staff are, in the main promoted and protected. EVIDENCE: Staff said they did receive support and guidance on a daily basis but did not receive regular formal supervision, to enable them to formally discus their role and receive feedback. Staff had received training in health and safety, moving and handling, fire instruction and infection control. They were able to verbalise the steps they took to promote the health and welfare of service users, and maintain a safe environment for them to work in. Therefore reducing the risk of harm. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 Page 16 The water temperatures were noted to be very hot from wash hand basins and baths, creating a risk of scalding. There was no evidence that there had been an electrical system check in the last five years. The push bar fire exits were not alarmed during the day, the manager said there was minimal risk of service users exiting the home and coming to any harm. One of the push bar fire doors jammed on the platform at the top of the stairs, making it difficult to open. Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x 2 x 2 Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 Page 18 Are there any outstanding requirements from the last inspection? yes 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 7 Regulation 15 Requirement Each service user must have a care plan which sets out the health, personal and social care needs. This must include the action to be taken by staff to meet service users needs and must be kept under review. All parts of the care home must be clean and reasonably decorated. Furniture and furnishings must be maintained in a good state of repair. radiator gaurds must be refixed to the walls, and the drainpipe repaired. staff files must include all the informaation required by schedules2 and 4. All staff must recive regulaar formal supervision. Timescale for action 10/8/05 Previous timescale of 30/4/05 not met. 10/10/05 2. 19 23 3. 4. 19 29 13 18 10/8/05 10/8/05 previous timescale 30/5/05 not met. 30/8/05 Previous timesaale of 1/10/04 not met. 20/5/05 As required on the day of the inspection.
Page 19 5. 36 18 6. 38 13 A risk assessment must be completed regaurding hot water, and action taken to ensure service users are protected from the risk of scalding. Water at hot water outlets must be monitored
J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Taptonholme Version 1.40 7. 38 13 8. 38 13 9. 38 23 to ensure they are maintained at close to 43 degrees centigrade. To control the water temperature and reduce the risk of scalding valves must be fitted to outlets where full body immersion takes place. There must be an up to date certificate in place confirming that the electrical systems in the home are safe. The fire door must be ajusted to ensure it can be opened with ease in the event of a fire. A risk assessment must be completed regarding the fire exits that are not alarmed during the day, and action taken to respond to any identified risk. 30/10/05 1/1/06 10. 38 23 21/5/05 As required on the day of the inspection. 10/8/05 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 Good Practice Recommendations Taptonholme J55 S3021 Taptonholme V237924 19.07.05 UI Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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