Inspection on 24/08/06 for Tate House - RNIB

This inspection was carried out on 24th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tate House - RNIB 18/09/07

Tate House - RNIB 09/02/06

Tate House - RNIB 01/12/05

Tate House - RNIB 21/03/05

Tate House - RNIB 08/02/05

Tate House - RNIB 06/02/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Tate House - RNIB Tate House 28 Wetherby Road Harrogate North Yorkshire HG2 7SA Lead Inspector Chris Taylor Key Unannounced Inspection 24th August 2006 09:30 X10015.doc Version 1.40 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 Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tate House - RNIB Address Tate House 28 Wetherby Road Harrogate North Yorkshire HG2 7SA 01423 886927 01423 885192 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) Royal National Institute for the Blind Mrs Deborah Anne Lynch Care Home 39 Category(ies) of Sensory impairment (39), Sensory Impairment registration, with number over 65 years of age (39) of places Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th February 2006 Brief Description of the Service: Tate House is a care home that is run by the Royal National Institute of Blind People. The home is registered to provide personal care for up to thirty-nine service users all of which have a visual impairment. The home is situated on Wetherby Road, which is one of the main roads leading into Harrogate, and therefore is close to the local amenities of Harrogate town centre. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what was used to write this report. • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called a Pre Inspection Questionnaire. A visit to the home that was unannounced. This lasted seven hours and included talking to staff and manager’s about their jobs and the training they have completed. Also spending time with service users whilst they were having lunch and talking to service users on their own. And checking some of the records polices and procedures the agency has to keep. What the service does well: What has improved since the last inspection? The way that meals are served has changed, this means mealtimes are a pleasant and enjoyable time for service users. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 6 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. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. Service users care needs are properly assessed prior to a service user being admitted. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The case records checked confirmed good practice. They all contained information about the help and support individuals would need. Particular attention was made to areas of potential risk such as moving and handling and falls. Relatives are always involved where possible to find out more information that the service users may not be able to provide. The assessment provides clear evidence where the home would be able to meet the service users’ needs and where other agencies would need to be involved. Two service users who were recently admitted both said they were made to feel welcome and staff spent time with them helping them to settle in. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is excellent. Service users’ health and personal care needs are met. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Four people were identified for the case tracking exercise. All have a service user plan which contained information about all aspects of their lives what support is needed and how that support should be provided. It was clear from observations that the document is used as a daily working tool and staff were seen referring to service plans throughout the day. Although the format for service user plans is the same each plan looked at was very individual and specific sections were only completed where appropriate, for instance, nutritional screening. Good practice to be noted was the detail of information about individual preferences for the routines of the day and to what extent relatives and family members are to be involved in planning and reviewing for care. The service user or their representative signed service user plans. Also Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 10 present were risk assessments that supported service users to live as independently as possible with safeguards in place, these were reviewed regularly. Whilst staff were helping service users with lunch and the afternoon’s activities it was clear that staff knew individuals’ needs and they were able to reassure and assist service users in a kind and supportive manner. Service users said that they talked to staff about what help they needed and said that staff are polite and always knock on bedroom doors before entering. The policy for the storage and administration of medication provides good instruction to staff. All staff receives accredited training. Medication is stored securely. If service users take responsibility for administering their medication service users sign an agreement form and an appropriate risk assessment completed. Lunchtime medication administration was observed and this was carried out safely and in manner that ensured service users dignity was maintained. One service plan looked at noted the service user did not wish to take medication in the presence of others and this was respected. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. Service users are supported to pursue their own interests and participate in community activities. Meals provided are nutritious and prepared well. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Tate House is a busy home with plenty going on. An activity’s organiser is employed and she arranges a variety of activities in the home according to peoples’ interests. Many of the activities support and are specific for service users with sight impairments. Every morning a member of staff reads the newspaper and other activities include computer classes, keep fit, reminiscence and discussion groups, foot massage and gardening. Service users are supported and encouraged to participate in community activities and specialist day centres where service users attend Spanish, painting and pottery classes. As well as going to the theatre, trips to country houses, the seaside and out for meals. Service users said they enjoyed the variety of activities on offer but there is no pressure to join in. A hairdresser visits the home regularly as does Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 12 the local vicar to provide Holy Communion. There is a large accessible garden with railed pathways to guide service users independently. There are three main meals per day and a choice is provided at each. Special dietary needs such as low sugar diets are catered for and special requests can usually be met. Where appropriate nutritional assessments are carried out and these were seen in case records. Service users spoke positively about the quality of meals provided and service users clearly enjoyed their lunch. Staff supported those people who needed assistance respectfully and discreetly. Menus were looked at and these were varied. Hot and cold drinks are available throughout the day and a hot drink and snack is provided prior to bed. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 16 and 18 Quality in this outcome area is good. Service users have access to an effective complaints procedure and are protected from harm. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A complaints procedure is provided to service users and is included in the Statement of Purpose. Service users said that they felt able to talk to staff and the manager of the home if they had complaints and that these would be dealt with properly. The Commission has received one complaint about the home that was investigated by RNIB. Some aspects of which were substantiated. Those areas have been addressed through additional staff training. The home has received three complaints, all of which were investigated thoroughly and resolved effectively. One complaint resulted in a change in the dining arrangements, these changes were commented favourably on by more than one service user. There is a comprehensive policy and procedure with regard to adult protection and staff have a good awareness of this. Staff receive training in adult protection issues during induction and foundation training and as part of NVQ level 2 and 3. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 19 and 26 Quality in this outcome area is excellent. Service users live in a safe clean and comfortable environment. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A tour of the premises was made. The building has recently been totally refurbished and is equipped with good quality furniture, fittings, aids and equipment to meet the needs of service users. Specialist techniques and equipment have been utilised to meet the needs of the service users, including the use of colour contrasting along corridors, wardrobes and drawers. Tactile surfaces indicated the use of individual rooms and talking guides have been installed to assist with orientation and geographical location around the home. All bedrooms are en suite and there are sufficient bathrooms with adapted bathing facilities. There are a number of lounges and seating areas and there Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 15 are two dining areas. The grounds are well kept and accessible. Planting is colourful and highly scented. There was evidence of ample protective gloves and aprons available for staff use. The home had an infection control policy and on the day of the inspection the home was spotlessly clean. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Staff are properly vetted and trained to ensure service receive the care and support they need. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Records confirmed staff training completed and included a rolling programme to ensure staff complete mandatory health and safety training. Staff completed specialist training with regard to sight impairment and have recently completed training with regard to dementia, this is in preparation for a variation in the service user categories which the home is proposing. Staff said that training opportunities were good. The home meets the requirement that 50 of staff are qualified to NVQ level 2 and above. Records of those staff most recently recruited were checked; all had completed an application form, had CRB check and two written references. Staff complete a comprehensive induction based on achieving competence and these records were seen. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 17 The manager and senior staff work alongside staff and as such monitors their practice. At every shift change there is a handover where specific issues relating to service users are discussed. Polices and procedure are discussed at regular staff meetings. Staff receive formal recorded supervision and an annual appraisal. The rota indicates that there are enough staff hours provided and more staff are on duty at key times during the day. There have been some difficulties with staffing due to staff vacancies and long-term sickness; staff and service users commented this on. However it was also confirmed by staff and service users that this has improved of late and that wherever possible the same agency staff were used to maintain some consistency for service users. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. The home is managed in such a way that promotes the best interests of service users. Staff take proper precautions to ensure the health and safety of service users. EVIDENCE: The acting manager has worked at the home for many years and took over the manger’s role 6 months ago. She is well supported by the Responsible Individual and there was evidence through discussions with staff and service users that the home is managed in an open and positive manner. The home employs an independent organisation to complete annual quality assurance. Surveys are completed by service users and other interested Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 19 parties and the results published. From this the management team produce an action plan to address issues raised and make any improvements. Service users’ views are also obtained via residents’ meetings and residents’ reviews. Service users said that residents meetings were effect and their views are listened too and acted upon. Records were seen which confirmed that equipment is maintained; electricity supplies in the home are safe and serviced appropriately. Fire detection and fire fighting equipment is tested and maintained regularly. Accidents are recorded and analysed. Staff receive training with regard to all health and safety matters. Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tate House - RNIB DS0000035128.V309552.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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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