Inspection on 23/07/07 for Tara`s Retreat Residential Care Home

This inspection was carried out on 23rd July 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 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

Tara`s Retreat Residential Care... 15/07/08

Tara`s Retreat Residential Care... 20/03/07

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Tara`s Retreat Residential Care Home High Street Sandridge St Albans Herts AL4 9DQ Lead Inspector Patricia Rogan Unannounced Inspection 23rd July 2007 13:00 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`s Retreat Residential Care Home DS0000068418.V346490.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`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tara`s Retreat Residential Care Home Address High Street Sandridge St Albans Herts AL4 9DQ 01727 850527 01727 853927 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) B & M Care Limited Mrs Annette Sudbury-Smith Care Home 46 Category(ies) of Dementia - over 65 years of age (46), Old age, registration, with number not falling within any other category (46) of places Tara`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th March 2007 Brief Description of the Service: Taras Retreat Care Home is a spacious, purpose built care home and was opened in 2006. Situated in the rural Hertfordshire village of Sandridge and surrounded by open countryside, it is near local amenities and close to the city of St Albans. The home can be reached by public transport or by road with a good sized car park in the grounds. The M1, M25 and A1 motorways are all approximately 15 minutes drive away. Taras Retreat has been designed with a choice of communal areas for the residents. All single bedrooms have ensuite shower facilities and there are also specially equipped bathrooms which are used when additional assistance is required. The home is wheelchair accessible throughout, with a lift to the first floor. The well-kept gardens have ample gazebos and seating areas for use by residents and their visitors. Care fees range from £610 to £700. Copies of the Service User Guide and the most recent report on the home published by the Commission are available in the home. Additional fees for such services as hairdressing and chiropody are explained in the individual service user contract. Tara`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection of all the key National Minimum Standards. Information was gathered from people who use this service and from people who work in the home. Other sources of information was from speaking with some family members and professionals involved with Taras Retreat. The manager of the home completed an Annual Quality Assurance Assessment (AQAA) document which provided comprehensive information about the service. During the visit to the home, time was spent speaking with some of the people who live in Taras Retreat, to hear their views about the care they receive and also observing how care and support was provided for people with dementia. Where there has been no change from the previous key inspection which took place in March 2007, this information has been brought forward. What the service does well: What has improved since the last inspection? The manager has addressed the requirement raised at the previous inspection and ensures that doors leading to the garden have the alarms turned off so that independent residents have easy access to the garden. People with dementia are to be moved to the ground floor so that they too can have access to the garden area and not be restrained by the keypad-locked doors at each end of the corridors on the first floor. The manager met with residents and families to explain why this decision was made. Those residents who will move upstairs were invited to choose which room they preferred. Residents who did not wish to move have been supported in this decision. It is evident that a great deal of work has gone into improving they way that information in each residents file is recorded. Those files which were inspected were in an accessible format and held relevant, recent information to ensure Tara`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 6 that staff were aware of the needs of the residents and of any changes which may have taken place. 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. Tara`s Retreat Residential Care Home DS0000068418.V346490.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`s Retreat Residential Care Home DS0000068418.V346490.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 is not applicable to this service.) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are involved in a full assessment prior to moving into the home and comprehensive information is provided to all prospective residents and their representatives. EVIDENCE: Any prospective resident or representative is provided with an information booklet and a Service User Guide. The manager invites the prospective resident to visit the home and spend time meeting residents and staff. One person who had visited the home when looking for a home for a relative said, The manager showed me round and asked some residents if they wanted to chat with me in private. I felt this showed she was confident that I would hear good things about the home, and I did. My mother has settled in beautifully. Senior members of staff carry out a comprehensive pre-admission assessment. An inspection of two recent comprehensive assessments had included the prospective residents views and had also involved relatives. Tara`s Retreat Residential Care Home DS0000068418.V346490.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are generally well written and individualised. Daily records are relevant and informative. All service users have full access to health professionals. Medication administration is correct and is overseen by a pharmaceutical organisation. Service users are treated with respect. EVIDENCE: The care plan reflects the initial assessment and had been updated on a regular basis and as care needs changed. There had been a marked improvement in the way that information is written and this means that staff coming on duty have up to date knowledge of any changes to care needs and how best to provide care and support. Feedback from health and social care professionals was positive. During the inspection, staff were seen to knock and wait before entering residents rooms and were discrete when speaking about personal matters. Several residents said they found the staff soon understood their likes and dislikes and this helped them to feel settled. Tara`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are varied activities in the home and garden and in the village and families are encouraged to be involved. People with dementia have limited access to varied and meaningful occupation. The menu is varied with a choice offered and the dining rooms are pleasantly set out. EVIDENCE: Some of the people who use this service take part in events and activities in the home and in the wider community. Many people commented about this and felt pleased with what was available. Several felt that the large communal dining area and lounge is under-used and suggested this would be suitable as a place to try out new crafts or continue with hobbies they had prior to moving into the home. The activities co-ordinator works well and spends part of her time with the residents who have dementia. However, feedback from discussion and questionnaires is these activities are not often continued when the co-ordinator is not there. This is an area which still needs to be developed to ensure that people with dementia, who cannot initiate activities for themselves, benefit from daily, meaningful occupation. Meals are nutritious and plentiful and enjoyed by residents who said, Meals are always tasty. and Theres a good choice on the menu. Tara`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a confidence that complaints would be treated with respect and that the appropriate action would be taken. The policies are stringent and staff training is ongoing to ensure service users are protected from abuse. EVIDENCE: The manager invites people who use the service and their family members to air their views at residents relatives meetings. Sometimes, residents do not have confidence to speak at such meetings and one to one discussions are encouraged. The service has an open approach and readily reports to appropriate authorities any concern that has arisen and will also respond to the concern in order to find an amicable solution. The staff have training in safeguarding adults and there are stringent policies and procedures in place regarding reporting and action to be taken if there was an incident of poor practice. Tara`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is maintained to a high standard and changes to where residents rooms are will be mean that all people who use the service have access to safe outdoor areas. All areas of the home and grounds were in very good order. EVIDENCE: The maintenance and repair programme is ongoing to ensure that people who use the service live in a home that is of good quality. Residents with dementia have had no access to the garden unless a member of staff was available to escort the residents downstairs. This is being addressed and people with dementia are moving to ground floor rooms after discussions and meetings with everyone involved. People moving to the first floor have chosen their new rooms and several said they liked the smaller lounges and views over the fields. The cleaning and laundry service is of a high standard and a resident commented, Everywhere you look, its lovely and clean. Tara`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are good. The recruitment policies are robust. Staff training is wide-ranging and relevant to the service being provided. Not all staff put into practice the training they have had in dementia care. EVIDENCE: Almost always, there are sufficient staff on duty. Concern was expressed because there was no management on site at weekends. Senior staff are in charge at weekends and a member of the management team is on call at all times. Response by staff towards residents during the time of the inspection was kind and helpful. This approach is continued at any time and is evidenced by the many positive comments that were received, They always listen to me. I dont have to explain myself, they know when I feel a bit fed up and they soon make me feel wanted. The recruitment policies and procedures are efficient and robust. There is an induction programme for all staff and new members of staff work alongside another member of staff until they are considered competent to work alone. Training in person centred care is ongoing so that care and support for people with dementia becomes effective and of a very high standard and all staff need to put this training into practice. Tara`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is proficient and caring and takes her responsibilities seriously, running the home in the best interests of the service users. Financial management, policies and procedures and record keeping is good. EVIDENCE: The manager is highly regarded by the residents and families and has the respect of the team and the people who are involved with the home. She is managing the changes to the service in a sensitive manner whilst being proactive by trying to improve the lives of people with dementia. All required policies and procedures are in place and are up to date. One-to-one staff supervision takes place and observation of practice is continuous. The health and safety of residents and staff is regarded seriously and the policies and record keeping reflect this. Quality assurance reviews are regular and ongoing. Tara`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 15 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 n/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 x x x x x 3 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`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 16 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. Standard Regulation Requirement Timescale for action 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 OP12 Good Practice Recommendations People with dementia should have practical help to enjoy meaningful occupation which reflects their life history and interests, at all times in the day when the activities coordinator is not available to provide this support. Ways in which the communal areas can be more fully used should be discussed with the people who use the service and their families because several felt this would develop a greater sense of community in the home. 2 OP14 Tara`s Retreat Residential Care Home DS0000068418.V346490.R01.S.doc Version 5.2 Page 17 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 - 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. 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