Inspection on 16/08/05 for Tasker House

This inspection was carried out on 16th August 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tasker House 23/04/07

Tasker House 09/02/06

Tasker House 17/03/05

Tasker House 04/01/05

Tasker House 15/12/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Tasker House 160 Westfield Road Wellingborough Northants NN8 3HX Lead Inspector Judith Sansom Unannounced 16 August 2005 2005 at 10.00am th 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 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. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tasker House Address 160 Westfield Road Wellingborough Northants NN8 3HX 01933 276447 01933 383377 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Monolace Limited Mrs Helen Rogers Care Home 22 Category(ies) of Old Age (OP) 22 registration, with number Dementia - over 65 (DE)(E) 10 of places Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The Home will limit it`s services to the following service user categories: No person falling within the category Older Persons (OP) can be admitted where there are already 22 persons of category OP already in the home. No person falling with the category DE(E) can be admitted where there are 10 persons in the category DE(E) already in the home. Total number of service users in the Home must not exceed 22. Date of last inspection 17.03.05 Brief Description of the Service: Tasker House is a care home providing personal care and accomodation for up to 22 ser vi cce users who are over the age of 65 years. The home is registered to provide personal care for up to 10 persons, within the total of 22, with dementia related care needs. The home is owned by Monolace Ltd with Mr Balendra as the Responsible Individual. The home is a large detached house and is located near to the town centre of Wellingborough. The home currently has bedrooms on two floors wth a passenger lift to the first floor with some bedroom accommodation on the ground floor. Twenty of the bedrooms are single, and eighteen bedrooms have ensuite facilities. There is a large lounge and dining room for the residents to use. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for residents and their views of the service provided. The methodology of case tracking is used to find out if the care being provided to the residents is of an acceptable standard and meets their individual needs. ‘Case tracking’ involves the review of resident’s records, meeting with them and talking with the care staff that provides the personal care to the selected residents. The inspection also includes a review of the homes’ procedures and processes to ensure that all practices carried out by the staff protect the residents. The inspection process includes the collation of information from residents, relatives and visitors to the home. The manager submits a completed preinspection questionnaire. From these information sources an inspection plan is developed. The inspection in the home was carried out on an unannounced basis during mid morning and early afternoon. The inspection process that included the preparation and inspection took approximately six hours. Compliance by the registered manager to action previous requirements placed at the inspection of 17th March 2005 was reviewed as part of the inspection process. The primary method of inspection used was ‘case tracking’ which involved selecting 3 residents and tracking the care they receive through review of their records, discussion with the residents, the care staff and observation of care practices. The home is currently undergoing extensive building works to extend the overall size of the residents. At the time of the inspection the building works is not adversely impacting upon the residents. What the service does well: There is a strong commitment from the registered manger to promote training opportunities for all staff. Over 90 of staff have achieved a NVQ (National Vocational Qualification). Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 6 The interaction between residents and staff was constant, warm and friendly. The atmosphere in the home was relaxed and welcoming from staff and residents. A wide variety of activities are offered that involves relatives of the residents. In House and out of house activities are designed to meet the interests of the residents. Residents were very positive in their comments about the staff in the home, and felt that they couldn’t receive better care. 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 3. Standard 6 does not apply to Tasker House. Although the home has an admission process the collation of additional information is not always undertaken. The inclusion of these assessments ensures that any decision made is based on whether the home can meet the individual needs of the resident. Without this there is no assurance that the potential resident’s individual care needs can be met. EVIDENCE: One newly admitted resident explained that she had not been involved in her admission to the home as she lived too far away. She was happy that her daughter managed the admission, and was very happy in how she had been welcomed to the home. The pre-admission documentation to ascertain if the potential resident’s individual needs can be met is not detailed enough. Additional assessments from involved health care professionals should be included as part of the preadmission assessment. From this information an initial care plan should be developed, and in place prior to the resident moving into the home. This initial care plan lays a solid foundation for the development of a more detailed full Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 9 care plan that can be developed as the needs of the resident become more apparent. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 Although care records require some additional development the current practices in the home ensures that health care needs of the residents are being met. EVIDENCE: One service user was walking around the home with his care plan and a pen in his hand. He affirmed that he had been involved in the development of this document and that it was changed regularly. Each service user has a précised care plan and risk assessment placed in their bedroom. Service users are encouraged to take ownership of this document and are involved in the development of their care plan. These précised documents are reviewed on a monthly basis. The more detailed care plan, stored in the office, is reviewed on a six-monthly basis to which other health care professionals and relatives are invited. The information in both documents cross-references to ensure that staff are aware of the identified needs and changes of the service user. However these care plans do not detail how the resident wants their care to be delivered. There are no additional assessments to identify nutrional needs, dependency levels, water-low scores. The care plans are at risk of becoming task orientated documents rather then service user’s needs-led plans of care. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 11 These shortfalls have been identified in the two previous inspections and requirements had been placed. These requirements remain unmet. At the last inspection the timescale of the requirement was extended as the home was in the process of introducing a new care planning system. The home was advised to introduce this system gradually and to prioritize those residents who would initially benefit from a more detailed care plan. The new system has yet to be implemented. The manager showed the Inspector the new care plan formats that are due to be implemented at the resident’s 6 monthly review that are due to commence the last week of August. On advice from the Inspector these reviews are to be delayed by a week to enable a small selection of care record books to be completed to ensure that these systems meet the needs of the residents and are in line with the way in which the manager wants to take the care home. Any identified risk that relates to the environment has in place a detailed risk assessment. However life style risks that relate directly to the resident are not consistently identified and recorded and the accompanying risk assessments have not been developed. Staff must receive sufficient instruction in how to manage and minimise any identified risks. One service user self medicates a prescribed fortified drink. There is currently no formal risk assessment and monitoring system in place to ensure that the resident continues to safely self-administer. The staff assured the Inspector that as the care plans are reviewed on a monthly basis any concerns would be identified at that time. The home are currently experiencing problems with their contracted pharmacist having made a recent change in supplier. Further issues were identified in the administration instructions recorded on the MAR (Medication Administration Record) Sheets. The deputy manager, who has overall responsibility for the medication system, is responding to the shortfalls to ensure that the pharmacist is offering a proficient service. Service users were very positive in their comments about the way in which the staff show respect to them. Observations of the staff’s care practices confirmed the comments made by the residents. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 & 15 Group social activities are managed well and provide variation and interest for people living in the home. There is a lack of promoting individual past and present hobbies and interests to provide holistic care. EVIDENCE: Residents and a relative talked about the way in which the home provided a number of activities that they can join in with if they want, and how varied and interesting they are. Lists of activities and dates are displayed around the home as a reminder to any body who may be interested in taking part in the activities. The activities are designed to meet the interests of the residents on a group and singular basis. However there was no indication that personal interests and hobbies are being maintained or introduced. One resident told the Inspector that she used to do a lot of oil painting but had lost her confidence in being able to do it. The resident’s mid-day meal was a relaxed occasion that all residents seemed to enjoy. Staff talked to the residents and discreetly offered help to those Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 13 residents who needed it. Meals were taken to residents who chose to eat in their rooms. The cook walked through the dining room offering seconds, and one resident requested two boiled eggs and toast instead of the toad-in-thehole that was the main meal. Menus were placed on each table and a vegetarian alternative was available for any one who preferred this to a meatbased meal. The cook and manager may like to explore the introduction of residents being able to serve themselves from dishes placed on the individual dining tables. This practice would promote independence and choice for the residents in that the residents are able to choose the individual components of their meal and the quantity desired. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The complaints process and procedure in the home is robust and provides any complainant with the confidence that their complaint will be acted upon. EVIDENCE: Displayed in prominent places around the home are the home’s complaint procedures for any complainant to follow. The commission has received no complaints since the last inspection. One resident told the Inspector that she had nothing to moan or grumble about, but if she did she knows her daughter would talk to the manager who would get it sorted. The home has a copy of the Northamptonshire’s guidance in the protection of vulnerable adults. However this information is not current. The home must develop further the homes policies and procedures that instruct staff in the actions to take in the event of an allegation of abuse is made. This is especially important for the senior staff that may have to take the appropriate action in the absence of the registered manager. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These standards were not assessed during this inspection. There is major building works currently being undertaken at the home. These building works are not currently having any impact on the residents. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 Staff are enthusiastic and positive in their approach to their work and work together as a team to improve the quality of life for the residents. EVIDENCE: All staff are expected to attend the training that is provided by the home. Over 90 of the staff have achieved a National Vocational Qualification, including the registered manager who has recently achieved the Registered Managers Award. These figures are well above the expected level of 50 and have been reflected in the score given. The registered manager has developed a training matrix for all staff and is exploring the introduction of more training that is specific to the needs of the residents. The care practices observed by the Inspector demonstrated and confirmed the home’s commitment in ensuring that all staff are expected to work to a high standard. The registered manager is in consultation with a representative from TOPPS (now referred to as Skills for Care) to establish the recent changes in training to ensure that the staff group receive all appropriate training. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 & 38 There is good leadership, guidance and direction to staff from the Registered Manager that ensures the residents receive consistent quality care. EVIDENCE: The registered manager is continuing with developing her knowledge base and has achieved becoming an NVQ assessor. Her manner of managing is open and transparent and one which treats staff and residents with respect. Managerial tasks are delegated to trained members of staff and are used as personal development of the staff. The registered manager continues to provide hands-on-care when necessary and feels that this is essential to understand the needs of the staff and residents. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 18 The manager undertakes spot checks on the staff’s practices and their record keeping. Environmental checks are undertaken on a frequent basis to ensure that there are no health and safety issues outstanding. The manager records all checks to enable her to follow through any identified issues. Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 3 x x x x x x 3 Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 20 yes 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 7 Regulation 12 Requirement All care plans must contain sufficient information that instructs and guides staff in the delivery of personal care. Timescale for action 30.09.05 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 3 8 Good Practice Recommendations Detailed pre-admission assessments must be undertaken that inclued the collation of other health care professionals assessments prior to any admission to the home. Residents life style risk assessments should be developed further to ensure that they contain consistent information that instructs and guides staff in the mangement and minimisation of risk. Consideration should be made into maintaining and introducing interests and hobbies for the residents to ensure that the residents receive holistic care. Consideration should be made to introducethe practice of residents being enabled to serve themselves at meal times. The curent POVA policy and procedure should be further developed to ensure that all staff are aware of the action to take in the event of an allegation of abuse being made. C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 Page 21 3. 4. 5. 12 15 18 Tasker House Commission for Social Care Inspection Newland House Campbell Square Northampton NN1 3EB 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 Tasker House C51.C08.S12937.Tasker House.V224003.16.08.05.Stage 4.doc Version 1.30 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. 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