Inspection on 20/02/06 for Tarry Hill

This inspection was carried out on 20th February 2006.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tarry Hill 01/10/08

Tarry Hill 04/10/06

Tarry Hill 29/09/05

Tarry Hill 09/03/05

Tarry Hill 06/10/04

Tarry Hill 17/03/04

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

CARE HOME ADULTS 18-65 Tarry Hill 3/7 Cale Road The Flat New Mills Derbyshire SK12 4LW Lead Inspector Susan Richards Unannounced Inspection 20th February 2006 10:00 Tarry Hill DS0000055430.V275246.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 Tarry Hill DS0000055430.V275246.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. Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tarry Hill Address 3/7 Cale Road The Flat New Mills Derbyshire SK12 4LW 01663 746440 01663 744915 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) Active Care Partnerships Ltd Mrs Lisa-Marie Joan Lovatt Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th September 2005 Brief Description of the Service: Tarry Hill provides personal care for younger adults with learning disabilities. The home was initially registered by Derbyshire County Council Social Services under the Registered Homes Act 1984, transferring under the Care Standards Act 2000 in 2002. It comprises of no 3 Cale Road, which is a three bedroom semi-detached house, no 7 Cale Road, which is a ten bedded house and The Flat, which is located on the first floor buildings extension of no 10. All are located on the same site, with a central office, which is a prefabricated building located within the grounds. There are separate garden areas with seating provided for each house. The home lies on the northeast outskirts of New Mills in the High Peak close to a main bus route and within easy access of local shops and amenities. Each house has its own dedicated lounge and dining space for service users together with bathroom and toilet facilities. No 3 and the Flat have domestic type kitchen each have a domestic washing machine for laundry items. No 7 has a large central kitchen, which some service users can access under supervision and a small separate laundry room. There is a separate bedroom in the Flat and also in No 3 for the purposes of staff sleep-in facilities. However, there is no dedicated staff room or separate washing facility for those staff. The registered manager has the support of a team of care and hotel services staff and also receives external management support via Active care Partnerships Ltd. Activities are organised for service users in accordance with their individually assessed educational, social and occupational activity needs. Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection was on the personal and social care and support provided for residents, the arrangements for their health care, including that relating to the management and administration of medicines residents and the arrangements of resident admissions to the home. Case tracking was undertaken for two residents. This involved the examination of their recorded care needs assessment information and care plans and associated records. Discussions were held the manager and staff regarding those individual’s care needs and also the needs of others, together the arrangements for the organisation and delivery of their care. The inspector was not able to hold meaningful discussions with one of the service users case tracked due to their limited mental capacity. The second service user case tracked was not present during the inspection. The Inspector met with other service users. Communication with them was in accordance with their given capacities. What the service does well: What has improved since the last inspection? A review of the pre-admission assessment process has been undertaken, as has the approach to the formulation of individual’s care needs assessment and care planning information, with positive results. A review of night staffing working arrangements has been undertaken and roles and responsibilities in relation to the use of sleep-in staff clarified with staff concerned. Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 6 A review of the arrangements for laundry services has been undertaken. 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. Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 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 Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 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 & 5 Residents were generally well supported and provided with the information they needed to make decisions about their lives and their continued accommodation in the home in accordance with their assessed needs and given capacities. However, the continued accommodation of one service user case tracked was not in accordance with their terms and conditions with the home or the home’s service aims and philosophy. EVIDENCE: There had been no resident admissions to the home since the previous inspection. Case tracking was undertaken in respect of two residents, both of who have lived at the home for considerable time periods. One of those was out at college at the time of the inspection. The Inspector was unable to enter into sustained discussions with the other resident due to their capacity and presenting needs. Discussions were held with staff about the needs and care of those persons case tracked and other residents accommodated and the Inspector also met with some residents. The recorded needs assessment information of those residents case tracked was examined, together with other information relevant to their admission and ongoing placements. These were comprehensive, and provided information in accordance with recognised practise, including that relating to the assessment of risk, individual capacities, potential and capabilities and their rehabilitation and therapeutic and/or specialist needs. Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 9 Discussions were also held with the manager and staff about their training and experience related to the care of those residents case tracked. The statement of purpose for the home and its service user guide were also examined. These had been reviewed and updated since the previous inspection, to reflect a number of changes mainly in respect of staff employed and staffing arrangements and also the home’s assessment and admissions criteria, which were discussed with the manager and deputy manager. Individual terms and conditions for placement were examined for those residents case tracked, together with their contracts for placement from the placing authority. Tarry Hill DS0000055430.V275246.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): 6, 7 & 9. The care, support and assistance required and provided for residents were well documented in accordance with their risk-assessed needs and staff was conversant with these. Residents were effectively supported to make decisions about their lives, and individual’s independence was well promoted in accordance with their wishes, lifestyle preferences and individual capabilities. EVIDENCE: The written care plans of those residents case tracked were examined and discussed. These were comprehensive and formulated in accordance with their recorded needs assessment information, within a framework of risk management. Residents’ individual capacities and capabilities were accounted for in terms of their involvement in their care planning. The needs and interests of significant others, such as family and representatives were also identified. Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 11 Care plans included specialist directives as appropriate, for example from external healthcare professionals and were periodically reviewed in accordance with recognised guidance. Records of all reviews were in place. One of the residents case tracked was in the process of a planned move to supported living type accommodation. This was in accordance with their wishes, lifestyle preferences and assessed needs. Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 12 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 There were satisfactory arrangements aiming to further develop residents’ access to educational, social and occupational activities. Residents were well supported to maintain their friendships and family links. Residents were provided with a satisfactory diet, although some views expressed indicated that the variety and choice of food could be improved. EVIDENCE: The organisation of occupational, educational and social activities and access to these for by individual residents (both in and outside the home) was discussed with the manager and staff and to some extent with residents. An activities co-ordinator had recently been appointed to post and a review of activities was being undertaken with the aim of developing a greater increased structure to the organisation of individual activities, which was felt to be a positive. Approaches to ensuring the promotion of individual’s rights and responsibilities, whilst ensuring their safety and the safety of others were also Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 13 discussed and care records examined in respect of these. For example, individual’s responsibility for housekeeping tasks. Menus were examined and meal provision discussed. Views expressed indicated that the choice of meals provided could be improved. Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 14 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 Staff was fully conversant with the personal support needs and preferences of individual residents, however some service users did not always receive their one to one support in accordance with their assessed needs. There were suitable systems and arrangements in place to ensure that residents’ were effectively enabled to access outside health care professionals for the purposes of monitoring and treatment and routine healthcare screening. There were satisfactory systems, arrangements and practises in the management and administration of residents’ medicines. EVIDENCE: Discussions were held with key staff about the organisation and delivery of personal care and support for residents, including those case tracked. The documented needs assessments and care plans of those residents case tracked were examined. These were comprehensive and included details of individual’s lifestyle preferences and clear care interventions, which were in accordance with the assessed needs. Staff was conversant with these. The arrangements for the monitoring of health and access to outside health care professionals were also discussed generally and specifically for those residents case tracked and their associated care records were examined. Clear Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 15 records were kept of individual’s health care referrals and interventions in for both specialist and routine health care screening. Systems for the management and administration of residents’ medicines were discussed and examined, with a focus on those residents case tracked. These were satisfactory. Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 16 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 standards in this section were not assessed on this occasion. EVIDENCE: Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 17 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): The standards in this section were not assessed on this occasion. EVIDENCE: Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 18 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): 33 Some residents did not always receive their one to one support from staff in accordance with their assessed needs and placement arrangements. EVIDENCE: The personal support and care needs of residents case tracked, together with the personal support needs of other identified residents were discussed and examined - including the one to one care and support of named residents in accordance with their needs assessments and contractual arrangements. Staff duty rotas were examined and the organisation and deployment of staff on a shift-to-shift basis was also discussed with the manager and staff. Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 19 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): EVIDENCE: Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 20 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 3 3 2 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 2 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X X X X X X X X Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 21 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 YA3 Regulation 4, 5 & 14 Requirement The (continued) placement of any service user must be in accordance with their terms and conditions with the home and the stated service aims and philosophy. The home must not continue to accommodate any resident whose needs it cannot meet. (NMS 33 also applies here). The registered person shall, having regard to the size of the home, the statement of purpose and the number and needs of residents – ensure that at all times that staff are provided in such numbers (suitably qualified, experienced and competent) as are appropriate for the health and welfare of residents. The registered persons must review the variety and choice of food for residents and ensure that this is promoted. Timescale for action 31/03/06 2 YA18 18 31/03/06 3 YA17 16 30/04/06 Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 22 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 Tarry Hill DS0000055430.V275246.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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