CARE HOME ADULTS 18-65
Tarrant House Perrancombe Perranporth Cornwall TR6 0JB Lead Inspector
Lynda Kirtland Unannounced Inspection 25th January 2006 2:00 Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 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 Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 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. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Tarrant House Address Perrancombe Perranporth Cornwall TR6 0JB 01872 572214 01326 375001 tarrant@belhay.aol.com 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) Mrs Maureen Joy Tarrant Mr Steven Jon Tarrant Mrs Christine Marie Tarrant Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 4th August 2005 Brief Description of the Service: Tarrant House is registered to provide care for 7 service users who have personal care needs by reason of a learning disability. The registered providers are Mr S Tarrant and Mrs M Tarrant who have many years experience in social care. The registered manager post is being advertised. In the interim Mrs S Taylor has been employed as the temporary manager of the home until a registered manager is appointed. Tarrant House is a modern purpose built property situated approximately a mile from the centre of Perranporth. Tarrant House provide transport to local activities in the community. Tarrant House presentation is in keeping with the local community and is not distinguishable, as a Care Home. The building is well maintained, comfortable and homely. All bedrooms are for single individuals and meet the space regulations. The majority of bedrooms plus the large communal living room, attractive dining area, patio and good size kitchen are on the first floor, therefore residents need to be able to negotiate stairs. Tarrant House is set in an acre plot and therefore has a large garden, which is well maintained and attractive. The garden has a dedicated area for the home to grow its own produce. There are currently 7 service users resident at the home. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspector visited Tarrant House Residential Home on the 25 January 2006 and spent three hours at the home. This was an unannounced visit. The purpose of the inspection was to gain an update on the progress of compliance to the requirements that were identified in the last inspection report dated 4 August 2005. As the majority of standards were inspected at the previous inspection on the 4 August 2005 and assessed as met, this inspection mainly focused on the environment, staffing and some management areas. On the day of inspection seven service users were resident in the home. The methods used to undertake the inspection are to meet with a number of residents, staff and the manager to gain their views on the services that Tarrant House offer. Tarrant House records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. What the service does well:
From observations of residents throughout the inspection it was evident that Tarrant House provides a relaxed atmosphere. Staff interacted with residents in a patient, friendly and professional manner. From a recent questionnaire completed by relatives this evidenced that they are satisfied with the care and accommodation that the residents receive from the staff at the home. The homes pre admission and care planning system have not changed since the last inspection. All residents have a care plan, which identified their care needs accurately and plans how to address them. Access to a variety of health professional occurs. All residents have a weekly programme of activities that can be based in the home, at college or work placement. It was observed during the inspection that residents participate in a number of activities provided by the home and local community. Visitors feel welcomed to the home. Residents or staff raised no issues or concerns during this inspection. Staff stated if they had any worries or anxieties they felt able to approach the manager at the home. The interim manager has ensured that she consults with residents, their representatives, staff and external agencies that use Tarrant house facilities to gain their views on the service that Tarrant House provides. Ideas for areas of improvement or developing services are readily accepted and considered by the management team as they wish to continue to improve on the service that Tarrant House provides. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection?
The registered providers have been approved to register a second care home in Cornwall. This altered the management arrangements of Tarrant House as the registered manager, Mrs Tarrant resigned from her post at this home in August 2005. Since that time Mrs Taylor has acted as interim manager at Tarrant House. The registered providers have attempted to recruit to this post since then but with no success. In the last two weeks Mrs Taylor has stated her intention to apply for the registered manager post and CSCI are awaiting her application. Staff are pleased that Mrs Taylor has made this decision and were satisfied with the changes that she has made since she has been in post. These are in the main in relation to the staffing rotas, increase in staffing levels and feel that she is approachable to ideas. Since the previous inspection a application to convert the activities room which was on the ground floor into an additional bedroom so that Tarrant House can provide care from 6 to 7 residents has been approved. This has allowed Tarrant House to expand its service. The registered providers have architect plans drawn up to install a new conservatory area to be attached to the lounge area, which will be more accessible to residents, and is intending to use this as a activity room. It is aimed that work on this project will commence in a couple of months. The expansion of an additional bedroom has had minimal effect on the service that Tarrant House provides. The pre admission, assessment and care planning process were considered carefully as was the moving in period to the home. Mrs Taylor also ensured that staffing levels were initially increased to enable the new admission to the home to be as smooth as possible for all who live, visit or work at the home. Due to the increase in staffing levels this has meant that the manager can now have supernumerary hours and so is no longer part of the rota. This has allowed greater focus on the administration systems in the home. The manager has purchased a portable loop system to be used in staff meetings and training. This can be used for anyone in the home who has use of a hearing aid. Staff have access to numerous training courses that assists them in their work. 60 of staff has achieved a minimum of NVQ level 2, with two others commencing this course. Four staff is near completion of the LDAF course and again others are booked to commence this course. Some staff has attended a communication course in the method of Makaton that greatly benefits communication with residents. Since the previous inspection the adult protection policy has been reviewed and is satisfactory. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 7 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. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 8 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 Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 9 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 Tarrant House have informative documents that explain the services that the home provides, admission processes and expectations of the placement so that service users and their representatives can make a informed choice about living at the home. EVIDENCE: Tarrant House have an informative statement of purpose / service users guide which accurately details the services that the home provides. This is presented in pictorial and written manner so that a wider audience can understand it. With the exception of a recent admission to the home due to the expansion of the service, Tarrant House residents are long-term placements. Due to the homes numbers of residents and issues of confidentiality the inspector did not inspect the file of the recent admission to the home as it may identify the resident in this report. The homes statement of purpose details the admission process and the manager was able to verbalise how Tarrant House undertook the pre assessment and admission process in an appropriate manner. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 10 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): Not inspected EVIDENCE: This section was inspected in detail at the previous inspection and all standards were assessed as met. The manager stated the processes remain as at the last inspection. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 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): Not inspected EVIDENCE: This section was inspected at the previous inspection and was assessed as met. It was evident during the inspection that some residents were at college, day placements or were participating in social activities within the home with staff. Therefore it was observed that this section is still met. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 12 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): Not inspected EVIDENCE: This section was inspected at the previous inspection and all standards were assessed as met. It was evident during conversations with staff, and observations, that health needs are still being monitored and addressed as appropriate. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 13 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): 22,23 The home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. Tarrant House has a satisfactory adult protection policy that all staff is aware of. EVIDENCE: Tarrant House has a complaints policy, which explains how the home will investigate any concerns raised. From observations during the inspection it was evident that residents had a positive relationship with staff. The manager is keen to encourage residents and their representatives to raise any concerns so that she can then look into them and take appropriate action, as she is with staff. Quality assurance surveys and residents meetings, plus staff meetings are venues were views could be expressed on Tarrant House as well as on an individual bases. CSCI have not received any complaints. Since the previous inspection the adult protection policy has been amended. This was discussed with the manager and it was agreed that the policy is now satisfactory. Copies of the DOH ‘No Secrets’ guidance were shown to the inspector. The manager is attempting to get training places on the Cornwall Multi disciplinary Adult Protection Training for all her staff. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 14 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 Tarrant House provides a comfortable, safe environment for all those who live, visit or work at the home. EVIDENCE: Tarrant House is a modern purpose built property situated approximately 2 miles from the centre of Perranporth. The building is however in keeping with the local community and does not ‘stand out’ as a ‘care home’. The building is well maintained, comfortable and homely. The gardens are also well maintained and attractive. The home is clean and free from offensive odours. The home is airy and has sufficient and suitable light, heat and ventilation. The building is not wheelchair accessible as the majority of the communal areas are on the first floor and the main entrance is on the ground floor. Furnishings and fittings are to a high standard and are replaced when necessary. Maintenance and renewal for the fabric and decoration of the premises are carried out as required. One member of staff has been designated to audit the premises and check that the home remains decorated and maintained to a high standard. Documentation of this was seen.
Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 15 Residents are involved in making choices about the colours of their bedrooms and are able to bring their own furniture and can decorate and personalise their rooms. All bedrooms are well decorated and furnished to a high standard. Bedrooms also reflect individual residents personalities and tastes. There was adequate heating, lighting and ventilation. Restrictors are fitted on all windows. Radiators are unguarded but are thermostatically controlled. The previous registered manager gained advice from the health and safety executive in respect of thermostatically controlled radiators and lack of radiator covers and undertaken risk assessments in this area and have taken appropriate actions to ensure that health and safety of all service users in the home. Two bedrooms have a ensuite facilitity. From inspection of the bathroom areas these were seen to be clean, and decorated to a good standard. There are an adequate number of bathrooms and toilets in the home. These are well decorated and easily accessible for residents. The bathrooms have no adaptations, as currently residents are fully mobile. There is no identified need to have specialist aids and adaptations present in the home. The home has a large communal lounge, and a dining room, which is also used as a quiet space outside of meal times. Communal spaces meet space standards and are decorated to a high standard. Visitors can be received either in resident’s bedrooms or in the dining room. The kitchen and laundry facilities are on a domestic scale are clean and appropriately equipped. Staffs are provided with adequate facilities including an en-suite shower. There is a sleep-in room which is furnished to a good standard includes a safe space to store personal belongings. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 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): 32,34,35 Tarrant House ensure that suitable trained staffs are employed in sufficient numbers at all times. Robust recruitment systems are in place. EVIDENCE: At all times there is a minimum of three carers on duty during waking hours for seven residents. At night there are two members of staff who sleep in. A manager is on call at all times. In addition the home employs a domestic three days a week. Maintenance work is contracted out as the need arises. From discussion with staff they commented that they felt that there is sufficient staff on duty. The registered manager stated that the home has not needed to employ agency workers. From observations it was evident that staff have formed positive relationships with the residents and that they were competent in their work. From inspection of staff files this evidence that staff are recruited appropriately and satisfactory checks are made prior to commencing work at the home. Sixty percent of staff have achieved ta minimum of NVQ at level 2. Four staff members are in the process of completing the LDAF course with a further 2 staff commencing this in the near future. All staff are trained in the safe handling of medication, first aid, moving and handling, food hygiene, COSHH, adult protection and health and safety. Some staff are trained in the communication method of Makaton. Ms Taylor stated that she aims for all staff to attend a refresher course in infection control.
Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 17 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, 38,39 The registered providers have advertised for a registered manager post at Tarrant house. The interim manager provides a structure, which creates an open, positive and inclusive atmosphere. Continuous review of the homes policies is ongoing to ensure that it reflects work practices within the homes to promote residents’ safety and rights. EVIDENCE: Since the resignation of Christine Tarrant, as registered manager of Tarrant House, Shirley Taylor has taken on the responsibility of interim manager at the home whilst the registered manager post has been advertised. This post remains vacant. However after discussions with the registered provider and Ms Taylor, it is now likely that Ms Taylor will apply for this post. Ms Taylor is near completion of the Registered Managers Award, is experienced in managing care homes and has ensured that the running of Tarrant House has been managed efficiently and smoothly. Staff spoke positively of her management skills and hopes that she will apply for the post. A requirement has been identified for a registered manager to be appointed to the home.
Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 18 It is evident that the interim manager ensures that residents, relatives and staff are consulted about how they view the service that Tarrant House provides. Tarrant House are in the process of completing their quality assurance survey. The questionnaires and documentation used were viewed as satisfactory. Ms Taylor agreed to forward the findings of this survey once completed. Ms Taylor is currently reviewing the homes policies and therefore this was not inspected. Records are kept up to date, accurate and stored in a confidential manner. Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 X 3 X 4 X 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 2 3 3 3 X X X Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 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 8 (1) (2) 9 (1)(2) Requirement A registered manager must be appointed who has the skills and expertise as set out in the national minimum standards Timescale for action 30/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 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 Tarrant House DS0000009093.V268182.R01.S.doc Version 5.1 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
