Inspection on 24/01/06 for Tegfield House

This inspection was carried out on 24th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tegfield House 20/04/06

Tegfield House 08/08/05

Tegfield House 07/12/04

Tegfield House 01/07/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Tegfield House 24 Chilbolton Avenue Winchester Hampshire SO22 5HD Lead Inspector Tracey Box Unannounced Inspection 24th January 2006 10:00 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 Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tegfield House Address 24 Chilbolton Avenue Winchester Hampshire SO22 5HD 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) 01962 854600 Hartford Care Ltd Terry John Whayman Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 08/08/05 Brief Description of the Service: Tegfield House is a care home registered to provide accommodation and support for up to twenty four older people. Hartford Care Limited own the home. Mr Terry Whayman is registered manager. Tegfield house is situated in a quiet residential area of Winchester, within easy reach of local ameneties. The home comprises of twenty four single bedrooms, most of which are en-suite, a large lounge, dining room and a room which is used for the haridresser when she visits. The accommodation is located over two floors, access can be gained by two staircases and a pasinger lift. The home has a large, secluded well maintained garden. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five hours. The people living at Tegfield prefer to be referred to as residents, therefore will be referred to as this throughout the report. At the time of the inspection twenty four residents lived at the home (two residents were in hospital, the inspector was aware of this as the home had sent the required notification to the CSCI, as required in regulation 37 of the Care Standards Act (CSA) 2000). The manager showed the inspector the layout within and surrounding the home, including communal areas and a few bedrooms, all areas appeared clean and comfortable, providing a pleasant environment for residents. Records were seen and the inspector asked residents and staff for their views and experiences of living and working at Tegfield. The inspector spoke with one relative who visited the home. The inspector witnessed lunch being prepared, fresh produce was used, resulting in a nutritious, home cooked meal. Three residents agreed that meals are always very good, and are home made as apposed to pre packed. What the service does well: What has improved since the last inspection? Care plans and risk assessments have been revised and are reviewed on a regular basis. The doorbell has been incorporated to the ‘aid call’ system, this ensures staff are notified of visitors. The complaints log has been revised, each page is numbered consecutively to show a true record of complaints received. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 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. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 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 Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 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): 3,6. A comprehensive procedure for assessing the needs of a potential new resident is in place to ensure the resident’s and the home’s needs are met prior to admission. Tegfield provides short term intermediate care to residents who have been assessed. EVIDENCE: The manager explained the home advertises any vacancies they have, people phone to make enquiries, a pre-assessment form is filled out with the details of the prospective resident, at this stage the caller is invited to look around the home if they wish, then the manager visits the prospective resident in their own environment to assess their needs, with a social worker, carer (if appropriate) with family / representative present. The prospective resident is invited to spend time at the home if the home can meet their needs, if the individual wishes to move into the home, the home confirm by means of a contract that the home is able to meet the individuals needs, the resident has a one month trial period to see. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 9 One resident recalled she visited the home prior to their admission, and that she liked it and wanted to live at Tegfield. The inspector saw one resident’s files that included a pre-assessment form completed by the manager prior to the resident’s admission to the home. The information included likes and dislikes, medical and family history and other relevant information to ensure the home is able to provide the care the individual requires. Family/representatives are invited to participate in the completion of the assessment to obtain as much information as possible. The inspector saw a letter that confirmed the home can meet the individuals needs. The manager explained the process he follows if someone wishes to stay at Tegfield for intermediate care. The inspector saw the homes policy on intermediate care, this is only provided if a bedroom is available to accommodate the stay. Residents confirmed they are consulted prior to a resident staying for short term care The registered person must produce a ‘Service Users Guide’ to ensure prospective residents are aware of the service the home provides. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 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 the following standard(s): 7,10. Residents health, personal and social needs are set out in individual’s care plans ensuring the individual’s needs are fully met. Personal support within the home is offered in such a way as to promote and protect residents’ privacy and dignity. EVIDENCE: The inspector sampled five care plans which provide staff with easily accessible information they need to meet residents’ needs. The care plans are comprehensive and include information about the individual’s health, medication, abilities, speech, personal care needs, mobility, religion and family details and any special requirements. Care plans included records of visits to the individual by their doctor, chiropodist, district nurse and other entries such as flu jab and admittance to hospital and sleep pattern. One resident said “staff care for me as I wish, all I have to do is ask”. The manager explained care plans are reviewed on a monthly basis, unless the individual’s needs change sooner. The inspector witnessed this procedure. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 11 The inspector witnessed staff address individuals in their preferred manner, as stated in individuals care plans. Staff were observed knocking bedroom doors and waiting for a reply before entering, three residents said that they felt staff respected their privacy and dignity. Two residents commented on how polite, helpful and friendly the staff are, and how they feel staff respect their privacy and dignity. One relative said they are very happy with the care and support their father receives. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 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 the following standard(s): 13,14,15. Contact with family/friends/representatives and local community is encouraged as the individual wishes. Practices in the home demonstrate that the home promotes individual choices and encourages residents to have control over their lives. Dietary needs of residents are well catered for with a balance and varied selection of food available that meets residents taste, dietary requirements and choices. EVIDENCE: Individuals care plans explore contact with family, friends, representatives and social workers, so to are individuals wishes to attend activities outside the home, although residents prefer to participate in activities within the home, unless it involves going out with family. A record of visitors to the home was seen, which showed family visits, the inspector talked to one visitor who expressed their happiness with the care and support their relative receives, and with the homes “Nice welcoming environment” they also stated that they are welcome at the home at any time. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 13 The manager confirmed staff use a variety of ways to enable residents to make choices, for example, when choosing which clothes to wear, the staff member will arranging the options in front of the resident to enable them to choose. One resident said “I choose what I want to wear and staff help me to get dressed.” The manager said residents choose colours schemes when areas of the home are being redecorated or refurbished. The inspector asked some of the residents what sort of activities they enjoy participating in, all explained how much they enjoy spending time perusing their own interests/hobbies, which included reading, playing card games, watching television, bingo, chair exercises, sing along songs and spending time with their visitors. The manager explained the home employ an ‘activities co-ordinator’ to ensure regular activities take place. One resident said “I would prefer it if there were more activities designed to stimulation of the body and mind, like quizzes, discussing news stories etc”. The manager said they would discuss this with the activities co-ordinator. The inspector witnessed lunch being prepared, served and eaten. The main meal was home cooked using fresh vegetables and fresh fruit was used for one of the deserts on offer. The food areas were well stocked to provide a wide variety of foods. Staff gave each resident the choice between two options, an alternative to these is always available, residents confirmed this. Staff asked residents what they preferred for their tea and supper, residents confirmed this is usual practice. One resident said “I prefer soup at tea time, which is always available. Residents confirmed the meal served was nutritious and appealed to their tastes, one resident said “The food is always very good and freshly prepared, if I prefer something else to the dish on the menu, the cook will prepare something else.” Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 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 the following standard(s): These standards were assessed at the previous inspection. EVIDENCE: These standards were assessed at the previous inspection. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 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 the following standard(s): 19,26. Residents live in a safe environment, which is well maintained. The home is clean and hygienic, providing a pleasant environment for residents. EVIDENCE: The manager showed the inspector around the home, which appeared well maintained. The inspector saw records within the homes maintenance file, details included the fault and the action taken, all records are signed and dated to monitor progress. One resident said their room was very pleasant, clean and warm, they were encouraged to bring their own personal belongings, furniture and pictures to make it feel like home. “if I want anything fixing or putting up on my wall, all I have to do is ask and it’s as good as done.” A random selection of bedrooms were seen, all were found to be clean, warm and furnished with personal items. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 16 One resident said “I feel safe here, as well as being free to come and go as I please”. The home’s radiators and pipe work are safe ensuring that all potential hot surfaces are kept to low temperature. The garden is very well maintained, the patio area had recently been cleaned to remove moss to prevent anyone slipping. The inspector witnessed the homes procedures to ensure hygiene is maintained, staff were seen to use protective clothing whilst completing their duties of personal care and cleaning. The residents stated that the home is always clean, warm. The inspector detected no offensive odours. The inspector saw an up to date food hygiene certificate of the staff member who was cooking, however all other staff require Infection control and food hygiene training. THIS IS A REPEAT REQUIREMENT FROM 09/09/05 Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 17 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. The number of staff meet the residents’ needs, however staff must obtain training to ensure their skills meet the residents’ needs. Residents appear to be in safe hands, however records do not show any formal training to support this. There are good recruitment procedures in place that ensure residents are not put at risk, however induction training needs formalising. EVIDENCE: At the time of the inspection, appropriate numbers of experienced staff were on duty, however they had not receive adequate training to fully ensure the residents safety. Four staff files were sampled. The files contained photographs of the individual, along with other evidence of the individual’s identification. The inspector saw evidence that appropriate checks had been completed against the Protection Of Vulnerable Adults (POVA) list and Criminal Records Bureau (CRB) disclosures had been completed. The files contained application forms that included previous experience of the individual. One senior staff said she had recently completed her National Vocational Qualification (NVQ) level 3 in care and was waiting for her certificate. The manager over 50 of staff are working towards or have achieved an NVQ in care. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 18 The inspector saw one valid food hygiene certificate. No other certificates were available, staff confirmed they had not received any training to keep updated with mandatory training. Staff files and the homes training records showed that staff were in need of the following mandatory training: manual handling, food hygeine, first aid, infection control and induction and foundation, therefore the manager must ensure all staff receive the appropriate mandatory training. THIS IS A REPEAT REQUIREMENT FROM 09/09/05 Individual staff training plan must also be revised to enable the manager to track training needs. The manager said new staff complete induction training whilst working at the home, no formal records of this training were available, therefore the manager is required to ensure all new staff receive an adequate induction and foundation programme that has been assessed against the Skills for Care Council induction standards. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 19 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. The home has a registered manager. Formal practices would ensure the home is run in the best interests of the service users. The home ensures resident’s financial interests are safeguarded. EVIDENCE: The registered manager is registered with The Commission for Social Care Inspection (CSCI) and is working towards completing his NVQ level 4 in management and Registered Managers Award (RMA). The manager confirmed he gets feedback on the running of the home on a daily basis by talking to residents, their families and staff. One visitor said “” I often see the manager on a regular basis, he informs me of how my relative is. I let him know how very happy I am with the care and support my relative receives.” The home operates a keyworker system, which means each service user has a named member of staff who has specific responsibilities for the service user. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 20 The manager confirmed the home ensures the residents are consulted, in a very informal way, about issues surrounding the running of the home, the residents respond well to this, therefore no formal documents have been completed. The home would benefit from developing a more formal way of recording the outcomes of these consultations, to show that the home is run in the best interests of the residents. The CSCI receives copies of the provider’s monthly unannounced visits to the home, this report includes residents feedback about the home. The home follows policies regarding service users finances. The inspector sampled three residents money which was held in a locked safe in the office which is locked when not in use. Receipts were in order for all moneys received and spent, all three balances tallied up with the balances stated in the records. Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 21 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 2 X X 2 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 2 Standard OP03 OP06 OP29OP28 OP27 Regulation 4,5.1,2,3 Sch.1 Sch.2,4 Requirement The registered person must produce a ‘Service Users Guide’ and statement of purpose. The registered person must ensure staff receive manual handling, food hygeine, first aid, infection controland induction and foundation training and maintain training plans for each staff to monitor training needs. THIS IS A REPEAT REQUIREMENT FROM 09/09/05 Timescale for action 24/02/06 24/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Tegfield House DS0000060876.V280136.R01.S.doc Version 5.1 Page 24 - 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!