CARE HOMES FOR OLDER PEOPLE
Tara 5 Avenue Road Brentwood Essex CM14 5EL Lead Inspector
Nicola Dowling Key Inspection 31st July 2006 09:30 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 Tara DS0000018045.V305785.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 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. Tara DS0000018045.V305785.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Tara Address 5 Avenue Road Brentwood Essex CM14 5EL 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) 01277 233679 01277 233679 dilan_sookarry@hotmail.com Mr Mohendas Karachand Sookarry Mrs Chandanee Sookarry Mrs Chandanee Sookarry Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places Tara DS0000018045.V305785.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15/12/05 Brief Description of the Service: Tara Care Home is a traditional semi-detached large house positioned near the corner of a busy main road leading to Brentwood railway station and town centre. There are shops, a pub and doctors surgery nearby. The cost of care at Tara is £426 per week. The home has a small front entrance. There is no passenger lift. The rear garden is compact but suitable for the needs of the service users who reside in the home. There is a strong family presence in the home with a number of experienced staff related to the registered provider and manager. This works well and the residents’ spoke positively of the care and support they receive. Residents’ on admission are still able to access the local community with staff support. Most residents’ have resided at Tara for a number of years. Given the age group of the service users, the registered provider and manager recognise that their care needs and dependency levels will increase. Leisure interests are encouraged and communal meals out are a common feature of life in the home. Tara DS0000018045.V305785.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day. The inspection consisted of a tour of the home, talking with staff and residents, observing the care given and reading of documents. Most of the residents were seen and two were spoken to. Information that was submitted to the Commission for Social Care Inspection before the home was inspected has also contributed to this report. The inspector would like to thank the staff and residents for their help and hospitality throughout the day. What the service does well: What has improved since the last inspection?
The requirements and recommendations from the last inspection have been met. There have also been a number of improvements to the environment. Air conditioning has been fitted to one sitting area that has benefited the residents during the very hot weather. Also areas of the home have been painted and double glazed windows have been fitted throughout. Improvements to the home’s environment are ongoing. Tara DS0000018045.V305785.R01.S.doc Version 5.2 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. Tara DS0000018045.V305785.R01.S.doc Version 5.2 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 Tara DS0000018045.V305785.R01.S.doc Version 5.2 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 and 5 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. Residents’ have their needs assessed before they enter the home and get the opportunity to view the home and meet the staff before they are admitted. EVIDENCE: Residents’ confirmed that they visited the home before they were admitted and that they had the opportunity to meet the staff. Also the manager of the home will go out to see a prospective new resident at their home. This enables the manager to meet the relatives and new resident in a relaxed environment. There is documentation to evidence that a needs assessment is carried out by the home and that the home work with key-workers before during and after admission. Tara DS0000018045.V305785.R01.S.doc Version 5.2 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, 8, 9 and 10 Quality in this outcome group is excellent. This judgement has been made using available evidence including a visit to this service. The residents are closely supervised and well cared for at this home and staff take a proactive approach to healthcare. EVIDENCE: All residents have a care plan identifying what their health needs are. The regular staff group provide continuity of care and were seen observing and interacting with the residents in a respectful way. Comments were received from district nurses, doctors, relatives and residents. They all described good care at the home with no evidence of neglect. A resident confirmed that he saw the doctor when he needed to and that a chiropodist called regularly. Residents receive their mail unopened however staff will support them to read it if required. Tara DS0000018045.V305785.R01.S.doc Version 5.2 Page 10 The home do not keep a record of resident’s weight at the home because this is recorded at the GP surgery. The manager agreed to keep a record of the resident’s weight on their care file. One resident has not had an annual review from their funding authority since 2002 and the manager agreed to follow this through. Medication in the home is well managed and is audited by a local pharmacist. For improved good practice a photograph of the resident should be attached to their MAR sheet. Below are some of the comments received about the care in this home: “Tara provides a caring and homely service” “Very happy with the standard of care” “The residents are happy and well cared for” “Residents never lack full care and attention” Tara DS0000018045.V305785.R01.S.doc Version 5.2 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, 13, 14, 15 Quality in this outcome group is excellent. This judgement has been made using available evidence including a visit to this service. Residents enjoy a relaxed and flexible lifestyle, with good food. EVIDENCE: Residents confirmed that they can choose when they get up or when they go to bed. Mealtimes can be flexible and residents can have their meal out if they choose. The food served was well presented in good quantity and looked appetizing. For those residents that are able they can manage their own affairs. Residents are also taken out to vote if they choose to. The home keep a daily record of residents’ individual activities that range from reading the paper to going out to a local garden centre. Because of distance some residents do not get as many visitors as others however visitors are welcome anytime of the day by friendly staff. Tara DS0000018045.V305785.R01.S.doc Version 5.2 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 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: The Commission for Social Care Inspection has not received any complaints or any incidents of adult abuse. The home has a clear complaints policy that is easily located in the home. The manager reported that no complaints have been received by the home. Most staff have completed protection of vulnerable adult training. For the two staff that have not had the training it has been cascaded down to them. Tara DS0000018045.V305785.R01.S.doc Version 5.2 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 25 and 26 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe environment that is comfortable for the residents’. EVIDENCE: The premises are warm, airy, clean and free from offensive odours. There is sufficient heating, lighting and ventilation. The accommodation is decorated to a comfortable standard that creates a homely environment for the residents. The proprietors are always making improvements to the premises and employ a maintenance man for the general upkeep of the home. Comments received from residents indicated that the home is generally well kept. Small areas of the home would benefit from better cleaning. This was discussed with the manager and dealt with straight away. Tara DS0000018045.V305785.R01.S.doc Version 5.2 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 28 29 and 30 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. Caring and trained staff are employed in sufficient numbers to meet the residents needs EVIDENCE: This is a family run home and many staff are related to the proprietor. Of the sixteen employees four are trained nurses and four have completed NVQ 2 or above, a further four hold a current first aid certificate. Staff undertake continuous training the most recent is a health and safety course. The home does not employ agency workers enabling a consistent staff team to care for the residents. The recruitment documentation was checked and this evidenced a through recruitment process. The duty rota evidences that there are two staff on each day shift and one staff at night. The proprietors are always available for the on call rota and take a hands-on approach to the residents’ care and the management of the home. Residents and others have reported how “friendly” the staff are as well as being “dedicated and courteous”. Tara DS0000018045.V305785.R01.S.doc Version 5.2 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 Quality in this outcome group is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interest of the residents. EVIDENCE: The registered manager is qualified, competent and has the necessary skills to run the home efficiently. Both the registered manager and provider are trained nurses and maintain their qualification. They have owned and run the home since 1990. The manager does undertake quality assurance monitoring and uses the information gained to inform care practice. This information will also be assimilated into the home’s annual report. Tara DS0000018045.V305785.R01.S.doc Version 5.2 Page 16 Residents’ money was checked with the manager and was correct. Money is held securely and accounted for properly. Safety certificates were checked and are up to date. There was evidence that the bath hoist had been serviced however the certificate for this had not been received. The manager agreed to follow this up Tara DS0000018045.V305785.R01.S.doc Version 5.2 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 Tara DS0000018045.V305785.R01.S.doc Version 5.2 Page 18 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Tara DS0000018045.V305785.R01.S.doc Version 5.2 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 2 Standard OP7 OP26 Regulation 14(2)(a) (b) 23(2)(d) Requirement The Registered person must ensure that residents have an annual review of their care All areas of the care home should be kept clean. This refers to the cleaning of: Light switches. Extractor fans. The Registered person must provide a copy of the homes quality assurance report to the Commission for Social Care Inspection. Timescale for action 03/10/06 19/09/06 3 OP33 24 15/12/06 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 2 3 Refer to Standard OP8 OP9 OP38 Good Practice Recommendations
The residents’ weight records should be kept in the care home A photograph of the residents should be kept with the care file/MAR sheet. The home should obtain the service certificate for the bath hoist. Tara DS0000018045.V305785.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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