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Inspection on 07/06/05 for Teesside Cheshire Home

Also see our care home review for Teesside Cheshire Home for more information

This inspection was carried out on 7th June 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a positive progressive atmosphere were residents rights, choice and independence are promoted. There are a range of educational and social activities that are available and residents are encouraged to participate in the management and philosophy of the home and organisation. Documentation within the plans of care includes information in the resident`s own words as to their care needs and how these are to be met. Evidence was seen that indicated that all care needs are discussed and agreed with the resident themselves where applicable or they`re representative, promoting the rights, choices and independence of the residents.

What has improved since the last inspection?

The home has acted on a recommendation from the previous inspection to ensure that the recording of all medication on Medication Administrations charts are accurate. Documentation within the resident`s plans of care has been developed and includes records of the residents agreement as to whom their care can be discussed with, their preference of gender of carer, and a personal evacuation plan, promoting choice, rights and individuality of residents. Staff files examined all contained appropriate documentation with regard to recruitment, including two written references as required at the previous inspection. A more robust staff recruitment procedure promotes the safety and well being of the residents.

CARE HOME ADULTS 18-65 Teesside Cheshire Home Marske Hall Redcar Road Marske-by-Sea, Redcar TS11 6AA Lead Inspector Jane Bassett Unannounced 7 June 2005 10:00 am 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Teesside Cheshire Home Address Marske Hall Redcar Road Marske-by-Sea Redcar TS11 6AA 01642 482672 01642 759973 info@london.leonard-cheshire.org.uk Leonard Cheshire 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) Mrs Susan OBrien Care Home 27 Category(ies) of PD Physical disability (27) registration, with number of places Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No conditions of registration. Date of last inspection 20th December 2004 Brief Description of the Service: Teesside Cheshire is a care home registered for 27 adults with a physical disability. Marske Hall is a grade 2 listed building situated in the the centre of the village and is close to all local amentities such as pubs, liesure facilities, churches and shops. Transport facilities provide by the home are available to all residents. All rooms are single accomodation with ensuite toilet facilities. There is a passenger lift giving access to the first floor. The home offers a range of communal areas including the atrium with fish pond, conservatory, lounge and dining room. There are extensive grounds which are accessible and include an aviary and chicken run. The home offers occupational therapy services in a large and well equipped room, and has a sensory room available. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection the inspector spoke to four residents, three staff and the manager. A tour of the building took place. Documentation including residents plans of care and staff records were examined. The inspector spent a total of five and a half hours at the home. What the service does well: What has improved since the last inspection? The home has acted on a recommendation from the previous inspection to ensure that the recording of all medication on Medication Administrations charts are accurate. Documentation within the resident’s plans of care has been developed and includes records of the residents agreement as to whom their care can be discussed with, their preference of gender of carer, and a personal evacuation plan, promoting choice, rights and individuality of residents. Staff files examined all contained appropriate documentation with regard to recruitment, including two written references as required at the previous inspection. A more robust staff recruitment procedure promotes the safety and well being of the residents. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 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. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 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 standard(s) 2 The homes pre admission assessment process ensures that residents needs can be met. EVIDENCE: The file of one service user recently admitted to the home was examined. This contained a pre admission assessment carried out by the manager and an assessment from the residents care manager. These were found to contain information with regard to the holistic needs of the resident. Both the manager and deputy manager described the process of information gathering and pre admission visits that the staff carry out prior to admission. Where possible the resident and relatives are encouraged to visit and spend time at the home. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 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 standard(s) 6, 7, & 9 Evidence seen indicates that the home meets individual’s needs and choices. Resident’s rights and independence are respected and promoted; residents are encouraged to undertake an independent lifestyle, whilst staff assistance is available when necessary. EVIDENCE: Three residents files were examined these were found to contain assessments; risk assessments and plans of care which contained information of need and how these are to be met. Files also contained personal profiles of residents that gave a life history and personal support records written in the resident’s own words as to what their needs are and how they wished these to be met. Evidence, including regular reviews, was seen that indicated that plans of care had been discussed and agreed with residents or representatives. Documentation included agreements with residents as to whom care needs can be discussed with. Further documentation recorded resident’s preferences as to gender of carer meeting their needs. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 10 All documentation in relation to individual residents is kept discreetly within their own rooms. All staff who spoke to the inspector had a good knowledge of individual residents needs, preferences, choices and how these are met. The home uses a key worker system that promotes individual care of residents. Residents who spoke to the inspector confirmed that their choices were respected and their independence was promoted. They confirmed that staff discuss their needs with them and their rights were respected. One service user spoke of going out unescorted to do their own shopping. Another said ‘staff carried out their care to a high standard’ and staff were ‘ respectful and friendly’. Whilst discussing care with one resident they told the inspector that staff gave them ‘support with all areas of their daily life’. One resident spoke of attending regional resident meetings where the management and organisation of the homes and charity are discussed. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14, 15, & 16 The home provides and encourages appropriate leisure activities, holidays and community contacts. Appropriate personal relationships are supported. EVIDENCE: The home employs staff who provide occupational therapy. As well as an occupational health room the home provides a sensory room. The manager told the inspector that the home is currently raising funds for the purchase of appropriate equipment such as a passive movement table and parallel bars that will assist with physiotherapy. Two residents who spoke to the inspector talked of a recent holiday to Kielder. The inspector was also told that four residents were on holiday in Scotland at the time of the inspection. A number of resident’s rooms were seen to contain computers, and other equipment that assisted with communication. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 12 Both residents and staff spoke of contact with the local community, including outings to the pub, shop, day centres, theatres, entertainment within the home etc. One resident spoke of the one to one time that he has to assist him with his poetry and other writings. Another spoke of individual time with supporter speaking German. The attached day centre continues to be used by local community groups, which residents can join if they so wish. The manager told the inspector that this facility was to be used by the home for training purposes, but would remain available for community activities and entertainments. Residents confirmed that visitors are encouraged and family and friends contacts are supported. One resident told the inspector that visitors were always made to feel welcome. Staff told the inspector that the library visits regularly and there are links with local churches if residents wish to participate. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 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 standard(s) 18, 19 & 20 Residents receive care that offers personal support with both physical and emotional health. Medications were seen to be handled appropriately. EVIDENCE: During the inspection it was seen that medications are stored and recorded appropriately. The Medication administration sheets where found to contain labels issued by the pharmacist, instead of unconfirmed hand written entries for additional medication or changes as recommended at the previous inspection. Evidence in the resident’s files indicated that they have access to GP’s and other health professionals such as dietician, speech therapist, chiropodist and physiotherapist as necessary. Residents who spoke to the inspector confirmed this. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 14 Residents files contained information supplied by the resident themselves as to how they wish their needs met. Staff who spoke to the inspector confirmed that they had access to and read the information contained in these files. The home operates a key worker system, promoting the individual needs of the residents. Staff were able to describe a good knowledge of the individual needs of the residents that they were key worker for. Residents who spoke to the inspector confirmed that they received personal support as preferred by themselves. One resident spoke of the ‘caring staff’. Another resident spoke of the time spent with him as an individual assisting him with his interests as well as his care needs. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 15 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 standard(s) These standards were not assessed on this occasion. EVIDENCE: Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 16 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 standard(s) 24,25, 26, & 30 The home provides a homely, comfortable environment that promotes individuality and independence. EVIDENCE: On the day of the inspection the home was found to be clean, tidy and odour free. It was seen that the home offers a ‘homely’ and comfortable environment for residents. Resident’s bedrooms seen were found to be personalised to taste. During the inspection it was seen that a number of residents bedrooms have recently or are currently been decorated. Residents confirmed that the decoration was their choice. Resident’s rooms were seen to include personal items of their choice including computers, stereos, activities, pictures, ornaments and furniture. Equipment such as overhead hoists are provided in a number of bedrooms if required by the resident. All bedrooms have ensuite toilet facilities. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 17 It was also seen that redecoration was taking place in corridors. One resident who spoke to the inspector confirmed that the choice of decoration had been her own, another spoke of the pleasure she had from having her own possessions around her. The home has an alarm call system that allows residents to summon assistance; this has been augmented by the staff carrying mobile phones allowing then direct contact between themselves and the ability to speak to the GP from the resident’s own room. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 & 35 Evidence seen indicates the home provides sufficient staff to meet the needs of the residents. The recruitment process promotes the protection of vulnerable adults from abuse. EVIDENCE: Residents who spoke to the inspector confirmed that there was sufficient staff to meet the needs and were happy with how this care was delivered. A staffing rota was seen. Staff confirmed that they could meet the needs of the residents but were ‘busy at times’ and would welcome additional hours to provide more one to one time with their key residents especially those who had limited communication. Staff who spent time with the inspector spoke of the induction and training that they receive which promotes the residents care. They all said that training was encouraged by the home and there were a wide variety of courses offered, including the NVQ, health and safety, first aid, fire safety, and moving and handling. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 19 Three staff files of staff recently recruited were found to contain all the appropriate information including two references as required at the previous inspection. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 & 42 The home is managed in such a way that promotes resident’s welfare, rights and choices. Health and safety within the home is promoted. EVIDENCE: All residents and staff who spoke to the inspector said that the manager of the home was open and approachable; they felt that the home was well run and they were supported. Issues raised were listened to and acted upon appropriately. One resident spoke of attending a regular regional meeting for residents enabling them to raise issues. She also spoke of the Regulation 26 visits that take place and her opinion being sought as part of this process. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 21 Another resident confirmed that their care is reviewed on a regular basis with their involvement in decisions. Care plans seen at the time of the inspection contained evidence of reviews, containing the views and opinions of residents and representatives. Evidence was seen that residents opinions of the service were sought, staff who spoke to the inspector expressed that this was difficult with those residents with little or no communication. Documentation seen indicated that the home and equipment are maintained as required, fire alarms are tested weekly, and hot water temperatures are checked and recorded. A first level nurse employed by the home has 7 hours allocated weekly to monitor and promote health and safety issues within the home. She is currently developing individual evacuation plans for service users, taking into account their abilities and mobility in the event of a fire. Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 22 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 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 3 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 4 3 3 x Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Teesside Cheshire Home Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 23 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 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. 1. Refer to Standard Good Practice Recommendations Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale, Stockton-on-Tees TS17 6QX 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 Teesside Cheshire Home B51-B01 S210 Teesside Cheshire V231319 070605 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!