Inspection on 23/11/05 for Tavistock Square (17)

This inspection was carried out on 23rd November 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tavistock Square (17) 18/11/08

Tavistock Square (17) 09/01/08

Tavistock Square (17) 07/12/06

Tavistock Square (17) 30/06/05

Tavistock Square (17) 25/01/05

Tavistock Square (17) 02/08/04

Tavistock Square (17) 17/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Tavistock Square (17) Silksworth Sunderland SR3 1DZ Lead Inspector Miss Andrea Goodall Announced Inspection 23rd November 2005 10:00 Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tavistock Square (17) Address Silksworth Sunderland SR3 1DZ 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) 0191 523 8250 0191 523 8250 Northgate & Prudhoe NHS Trust Mrs Maria Jane Rennoldson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th June 2005 Brief Description of the Service: The home at 17 Tavistock Square provides accommodation for 6 people with a learning disability, one of whom also has physical disabilities and uses a wheelchair. The home is a modern, purpose-built bungalow with level access at the 2 front entrances and good access around all areas for people with physical disabilities. It is sited in a cul-de-sac of similar modern housing and is set back with a large driveway and large back garden. The home provides personal care and is owned and operated by Northgate & Prudhoe NHS Trust. The bungalow provides 6 good-sized bedrooms, 2 lounges, 2 dining rooms, 2 bathrooms and an activities room.The home is within easy walking distance of various local shops, clubs, health centre and a church. It is also a short drive from main supermarkets and leisure clubs. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over one day in November 2005. Time was spent with the people who live here, having lunch with them and looking round the bungalow with them. Time was also spent with the Manager, talking about the service and looking at care records. Staff talked about their work and how they help the residents. Comment cards about the service were received from 4 relatives (on behalf of 2 residents). All said that they were satisfied with the care provided at this home. Their comments are in this report. Picture cards were sent to residents for their comments about the home, but they could not do this on their own. Instead time was spent with residents to see what they think of the home. What the service does well: Staff understand the different needs of the residents and know how to support them in the right way. Staff keep very good care records that show what residents can manage themselves and exactly how they need help with other things. There was a busy, friendly atmosphere in the house and people had different activities and trips out to enjoy. Residents and staff get on well together, and staff understand the different ways residents have of showing what they want. Relatives wrote on comment cards that they are very pleased with the help that residents get at the home. One relative said, Tavistock is a very nice and relaxed home with lovely staff. Another relative said, The overall standard of care and support provided by staff is excellent. My (relative) is very happy in the home. The bungalow is very well decorated and furnished. It is a bright, comfortable and modern place for the residents to live. It is spacious and has lots of lounges and sitting areas for the people who live here to choose from. It also has good access for people with a physical disability. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 6 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. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4&5 Prospective residents have opportunities to visit the home and have trial periods before deciding whether to move here. Each resident has a copy of a contract that outlines the terms and conditions of their residence. EVIDENCE: In the past couple of years 2 new residents have moved to the home. Both had several visits to the home to look around and meet the other residents. The Manager described the importance of giving new residents plenty of time to get used to the home before they move here. In this way new residents can make an informed decisions about whether they want to move to this home. New residents who do choose to move here have a 3-month trial period to make sure the home can meet their needs. All the residents have a copy of a Residents Agreement, which is kept in their own files. This describes the terms and conditions of their residence here. The agreement is written in plain English and pictorial symbols. However it is clear that, due to the severity of their disabilities, residents could not independently understand this contract. Some residents have signed the agreement, even though they do not understand the information. The Manager stated that the agreements had previously been sent to relative or representatives where these exist. However there was no demonstration of this. Also two residents have no representation at all. The Manager continues to seek out advocacy services, but there have been no advocates for those 2 people for many years. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 & 10 Clear support planning systems ensure that staff work consistently in support of residents individual goals and needs. Residents are supported to take risks as part of an independent lifestyle. There is information for residents about how they can access their own records. EVIDENCE: There are clear care plans in place for each of the people who live here. These provide staff with very good information about peoples individual specific needs and show exactly how staff should support them. The care plans now include some information in pictorial form to help residents understand their own records. Residents or their representatives have not signed support plans. However there is a note at the front of each persons files that states whether or not they are able to be involved in their own care plans. The Manager indicated that most people cannot tolerate sitting with staff and records for long. There are also risk assessments in place for activities that may involve and element of manageable risk. For example one person enjoys horse riding, and Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 10 one person enjoys helping in the kitchen but there are guidelines about how any risk can be minimised. However, the moving and assisting plan for one person who uses equipment to support their mobility was not completed. This does not protect against the risk to that person if the equipment is not used consistently by staff in the right way. There is now an Access to Information statement in each persons files. Due to their severe disabilities the people who live here could not understand it. There is also brief information at the front of their files that is in easy language and pictorial form that reminds staff that the files belong to the residents, and that residents can see their own file at any time. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 & 16. Residents are supported to use local community facilities. Residents rights and choices are respected. EVIDENCE: The people who live here are supported to use local community facilities such as shops, pubs and local transport. All the residents are registered with the local GP practice. In this way, residents are part of the local community. The bungalow is sited in a modern estate in a former mining village, and has been subject to some vandalism in the past. Residents right to lead their own lifestyle is respected. One person prefers his own company and expresses his choice, through behaviour, to spend much of his time in a quiet lounge. Staff support him to do this, whilst still offering alternative choices and activities. Other residents enjoy lots of activity, and there were several planned trips out today for the people who wanted to go. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 12 Residents are encouraged to be involved in daily domestic tasks, such as cleaning and laundry as part of an independent lifestyle. The people here tend to choose not to be involved in many household tasks, and this is accepted whilst they are still offering the opportunity. Residents can use their rooms when they wish for hobbies or private time. All bedroom doors are lockable from the inside so residents can choose to be private. Staff now support people to keep their bedroom doors closed when they are out of the home. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18. Residents receive personal support in the way that they require. EVIDENCE: All of the people who live here need some support with personal care to varying degrees. One person has a severe physical disability and needs full physical support of staff. The home provides suitable equipment for this and there is a comprehensive moving & assisting plan for staff to follow. Other resident need support with bathing or dressing, and prompts for personal grooming. All support is carried out in the privacy of a residents own bedrooms or bathrooms. There is a good mix of gender amongst the staff team so that there is always both male and female staff on duty throughout 24 hours to ensure the correct support is available to each resident. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22. Residents have information about how to make a complaint. EVIDENCE: The Trust has a booklet, Tell Us, for people who use its services. This describes the complaints procedure in easy language for people with a learning disability. Due to their communication needs, most of the people who live here use gestures, noises and behaviourisms to show their dissatisfaction. Staff have built up a very good understanding of different residents likes, dislikes and communication needs. In this way they are able to recognise if a resident is unhappy with a situation. Staff were able to describe such occasions and how they accepted this as a complaint by the residents. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27 & 28. Residents live in a homely, comfortable and safe environment. Bathrooms and toilets meet residents needs. There is a good range of different lounge areas for the residents. EVIDENCE: There have been significant and much-needed improvements to the quality of decoration and furnishings within the home over the past couple of years, and the home now offers a good standard of accommodation for the people who live here. Overall, the home is modern, bright, well furnished, contemporary and cheerful. The bungalow is well maintained and is accessible for residents or visitors with a physical disability. Since the last inspection one bedroom has been redecorated to the chosen colour schemes of the newest resident. All the bedrooms are decorated differently and reflect the different personal styles of the residents. The home provides 2 bathrooms for the 6 people who live here. One has overhead tracking for hoist equipment, and a wheel-in shower. The other has a Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 16 specialist bath with chair lift. Both bathrooms have a toilet and there is also a separate WC. At the time of this visit there was no shower curtain, which does not protect the dignity and privacy of the residents. Both bathrooms are showing wear and tear and are now ready for redecoration. The alarm call cord in one bathroom was tied up so staff or residents could not reach it if they needed help. There was a cotton towel in the communal WC that could present a risk of risk of cross-infection if shared by different people. There are already paper towels in place in this WC, so it is not needed. The home has a very good range of lounges and sitting places for the 6 people who live here. There are 2 dining rooms, and a garden room that is used for activities. There are 2 family sized TV lounges. This means that one person can spend time on his own in one lounge without being disturbed by others. The home also has a good-sized back garden and this is well used by residents in better weather. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 17 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 & 35. There are sufficient staff to meet the needs of the people who live here. Residents are supported by well-trained staff. EVIDENCE: The minimum staffing provided at Tavistock Square is 3 support staff on duty from 8am-8pm, and 2 night–time staff (one of whom is on waking duty). However staff are flexible and will provide extra time to help residents go to special events, such as evening parties and concerts. There is also a full-time Enabler on duty for 5 days per week so there are more opportunities for residents to have 1:1 support with their individually preferred activities. There has been only 1 change to the staff team since the last inspection and 2 new staff have started working here. The continuity of the staff team has helped staff and resident to build up good levels of communication, and allowed staff to learn about the different needs of the people who live here. More than half of the staff team have attained the NVQ level 2 (or above) care qualifications, specifically for working with people with a learning disability. It is anticipated that the remaining staff will also train towards this in the future. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 18 There is an individual learning plan for each member of staff that identifies any training that they need. The home also has a record of all training courses attended by each staff. The home uses a number of different training agencies, including Trusts own training department and local colleges. From discussions it is clear that the Manager is committed to staff training so that residents receive support from a well-trained, competent staff group. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 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): 39 & 42 The views of residents are not currently sought to review and develop their home. The health and safety of residents are promoted and protected by the homes practices. EVIDENCE: The Trust has a quality assurance system (Total Quality Management) to monitor and review the services it provides, including the home at Tavistock Square. The Trust wants to include residents views in reviewing the home, so has designed a questionnaire that uses pictures and easy language to support the communication needs of the people who live here. However the questionnaires have not yet been used and the Manager stated that residents would not be able to complete them without support. Relatives and independent advocates have not been requested to help residents to complete the questionnaires. In this way residents views have not been formally sought in order to review the service. There are house meetings but due to their disabilities residents find it difficult to take part in these. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 20 Staff receive mandatory training in health & safety matters on an annual basis through the Trust. Staff carry out sleep-in duties overnight and in-house fire instruction is carried out and recorded every 3 months. There were no health and safety issues noted at this time of this visit. Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X 3 2 Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 X X 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 2 4 X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tavistock Square (17) Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 3 X DS0000015736.V253002.R01.S.doc Version 5.0 Page 22 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. 1 Standard YA5 Regulation 12(2) Requirement There must be independent advocacy or representation (for those residents without relatives) for support when drawing up agreements. Moving & Assisting plans must be completed so that staff know exactly how to support people with their individual mobility needs. Timescale for action 01/02/06 2 YA9 13(5) 01/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA5 Good Practice Recommendations The home should demonstrate whether residents understand the Residents Agreement, and demonstrate that relatives or representatives have been sent a copy of the agreements. Residents should be supported by relatives or independent advocates to complete the Trusts questionnaires that are intended to review the service. 2 YA39 Tavistock Square (17) DS0000015736.V253002.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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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