Inspection on 24/11/05 for Tarn House

This inspection was carried out on 24th November 2005.

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

Tarn House 02/06/09

Tarn House 30/06/08

Tarn House 30/08/07

Tarn House 26/06/06

Tarn House 23/06/05

Tarn House 05/01/05

Tarn House 13/09/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 Tarn House Mill Lane Walney Barrow in Furness Cumbria LA14 3XX Lead Inspector Ray Mowat Announced Inspection 24th November 2005 08:30 Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 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 Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 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. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tarn House Address Mill Lane Walney Barrow in Furness Cumbria LA14 3XX 01229 471798 01229 470125 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) Cumbria Care Mrs Bernadette Eileen Calldine Care Home 14 Category(ies) of Learning disability (14), Learning disability over registration, with number 65 years of age (1), Physical disability (3) of places Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 14 service users in the learning Disability (LD) category to include: Up to three service users in the category Physical Disability (PD) 1 service user in the category Learning Disability (Elderly) (LD(E) Maximum number registered 14 The staffing levels for the home must meet the Residential Forum Care Staffing Formula for Younger Adults. When single rooms of less than 12 sqm become available they must not be used to accommodate wheelchair users and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 23/06/05 2. 3. 4. Date of last inspection Brief Description of the Service: Tarn House is a care home providing personal care and accommodation for fourteen adults with learning and or physical disabilities. The home is owned by Cumbria County Council and managed by Cumbria Care, an independent business unit of the County Council. It is situated in a residential area of Walney Island and is close to local amenities and a local bus route that services the island and the nearby town of Barrow-in-Furness. The Home is on two storeys and is divided into four distinct units. These are called hill view, sea view, Greenland’s and Beachwood. Three of the rooms are used for short-term respite care. Each of the units has a lounge and a separate kitchen with dining area. All the bedrooms are single occupancy, some of which are fully accessible for people with physical disabilities. To the rear of the building are two fenced garden areas with seating. To the front of the building are open plan garden areas and a large car park, which is shared with the adjoining day service. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 24/11/05 from 8.30 am. I met with all the residents during the course of the inspection, either before they left for day service or when they returned in the afternoon. I also met with care staff and the supervisory and administrative staff on duty. Resident’s comments cards were also returned and confirmed a high level of satisfaction with life in the home. What the service does well: 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. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 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 Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4. The home has good systems in place to ensure prospective new residents are provided with appropriate information and their individual needs are assessed. EVIDENCE: As there have been no new permanent admissions to the home since the last inspection, this inspection focussed on the admissions procedure for respite care. By providing respite care many of the permanent residents had an opportunity to “test drive” the home prior to a permanent admission. When a respite stay is planned the home will complete a detailed assessment, including manual handling needs and risk assessment. This enables an initial care plan to be compiled and ensures the home is able to meet individual needs and appropriate staff are on duty. In the week before the planned stay the home will contact the resident or their relative/representative, to confirm all the relevant details including medication arrangements. At this point staff rotas are checked and confirmed, to ensure the staffing levels, skills and experience in the home, reflect the needs of the residents. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. The home is now responding to individual needs and preferences and is providing and promoting an independent lifestyle. EVIDENCE: All the residents have a detailed care plan file in place, which details all personal and social care needs. These provide staff with sufficient information to maintain a good continuity of care, based on individual needs and preferences. They contain informative pen pictures, which give staff a valuable insight to a person’s social history, relationships, personal preferences and what is important in their lives. The care plans emphasised the need for staff to take on an enabling role, by encouraging independence, maintaining existing skills and identifying opportunities to learn new skills. Prior to a review meeting a consultation form was completed, this identified current issues, what was working well and areas for improvement and action. The minutes from a recent review confirmed that relevant people attended the meeting and pertinent issues were discussed. One resident took great pride in his care plan and helped to write it up and update it. This level of ownership is good practice. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 10 Some of the files examined contained old records and out of date information, which causes confusion and should now be archived. Also it is recommended care plans for people using the respite unit are reviewed and updated on a regular basis. The home was in the process of introducing person centred care plans, with staff completing appropriate training. These had already proved effective and produced some positive outcomes for residents. One resident who has very limited verbal communication had an excellent “communication passport”, which documents the meaning of gestures and behaviours particular to that individual. These are very informative and invaluable to new staff and people who are not familiar with the person, to help with understanding each other. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. The home is providing appropriate activities and supporting residents, to pursue their interests and participate in community life. EVIDENCE: Based on discussions with residents and staff they have been enjoying a more active social life, now the home was operating with a full compliment of staff. One resident spoke enthusiastically about a recent trip to Blackpool lights they had enjoyed with their fellow residents. They also explained that they were planning future trips with their key worker. All the residents apart from one attend the local day service Monday to Friday. This provides them with opportunities to participate in a range of educational, leisure and vocational activities. They also access a range of community activities on a regular basis with support from staff from the home. These include visits to the shops, pubs, cinema, shows and social clubs. One resident who is more independent attends a local work experience scheme for joinery skills and is a volunteer at the church. Supporting residents to take on positive roles and integrate in the community in this way is good practice. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 12 Individual needs and preferences in relation to interests and hobbies were recorded in care plans. Also when residents participate in an activity it is recorded, so that all staff are aware of what has been taking place. The home had organised a series of holidays for different residents during the summer months. Residents were consulted about the type of holiday they preferred and who they wanted to go with, to ensure compatible groups were identified. Residents are actively encouraged to participate in all aspects of home life, one resident talked to me about how they are becoming more independent with washing, ironing and cleaning and that they have plans to learn how to cook. Staff support residents to keep in touch with both relatives and friends, by arranging and supporting visits or helping with phone calls. Menus are planned on a weekly basis in each unit, with residents making the choices and then shopping for the groceries. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 On the whole personal and healthcare needs are well documented and individual needs are met. EVIDENCE: Information contained within the care plans is sufficiently detailed to guide staff in meeting personal and healthcare needs. A record of all health related interventions were maintained on a personal file thus ensuring a good continuity of care is maintained and regular health checks completed. The home is in the process of introducing health action plans, with one of the supervisory team taking a lead responsibility for training staff and completing the plans. During a conversation with one resident they expressed some concern with a forthcoming flu jab. The staff reassured them about the process and arrangements and agreed to talk to them again. This was dealt with sensitively and honestly and had the desired effect. There was a comprehensive risk assessment on file for one resident, to support them with self-administration of medication. This was waiting to be agreed at a multi-disciplinary meeting before being used, which is good practice. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The policies, procedures and practice within the home safeguard both residents and staff. EVIDENCE: These standards were assessed at the previous inspection and met. There have been no recorded complaints since the last inspection. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. The home has made good progress with the refurbishment and re-decoration programme. EVIDENCE: Since the last inspection the outstanding work has been completed as required, including the refurbishment of two kitchens and the fitting of a new fully accessible bathroom. This contains a high/low bath and changing bench, with an overhead-tracking hoist accessing all areas. A programme of redecoration was underway on the resident’s bedrooms. Based on discussions with them they said “we chose the colours and the furniture for our rooms”. Rooms had been personalised and some residents had chosen to replace the home’s furniture with their own. Suitable aids and adaptations were provided, based on advice from relevant professionals, to meet the varied needs of residents. The home was in the process of improving the access to the rear garden and patio, with the construction of a ramp from the doorway, which will make the garden and patio accessible to people who use a wheelchair. All areas of the home were found to be clean and hygienic with the home having dedicated domestic staff to maintain a clean environment. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36. The staffing levels in the home have improved as required, with appropriate numbers of suitably trained staff on duty at all times. EVIDENCE: I met with several staff during the course of the inspection, in both informal discussions and formal interviews. Some of them were newly appointed since the last inspection. They had all completed a thorough induction course and were working through the foundation elements. (LDAF, Learning Disability Award Framework). They had also spent time in the home shadowing experienced members of staff and getting to know the residents and the routines of the home. Based on discussions with staff, the recruitment procedure was robust and followed good practice. They had been issued with contracts of employment and job descriptions and were aware of their role and responsibilities. With the appointment of new staff, all vacant posts have been filled and the staffing levels in the home were appropriate. It was evident staff had developed good relationships with residents and showed a good awareness of individual needs and desires. Staff were observed to offer choices to people and respected their wishes. In the absence of the manager the supervisors were managing the home on a day-to-day basis but had liaised with other service managers for advice, as Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 17 and when required. Written notification of the continued absence and interim arrangements in line with regulation 38 is required. Although the frequency of supervision had improved since the last inspection, due to this increased workload, supervision dates with some care staff were now overdue. CRB disclosures were checked and were all up to date, with the home now having appropriate checks for domestic staff in place. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 42, 43. In the absence of the registered manager the supervisory team were maintaining a consistent quality of care. EVIDENCE: As described previously the supervisors have been taking a lead role in the day-to-day management of the home, working closely with the administrative staff and liaising with the operations manager and day service manager. Staff felt they had been well supported in the home, with one of them describing the supervisory support as “excellent and always someone there for us”. The home’s health and safety policies and procedures, support and guide staff to maintain a safe environment. Appropriate risk assessments have been completed and there were no obvious hazards noted during the inspection. Tarn House DS0000036626.V248948.R01.S.doc Version 5.0 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tarn House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 2 3 X X X 3 3 DS0000036626.V248948.R01.S.doc Version 5.0 Page 20 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 YA37 Regulation 38 Requirement The home is required to notify the commission of any absence of the registered manager that is for a continuous period of 28 days or more, in line with regulation 38. Timescale for action 08/12/05 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 2 Refer to Standard YA10 YA6 Good Practice Recommendations It is recommended the content of care plan files be reduced to contain relevant and current information. It is recommended care plans for people on respite care are reviewed on a regular basis. 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