Inspection on 05/09/08 for Tendring Rest Home

This inspection was carried out on 5th September 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tendring Rest Home 11/09/07

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 23/11/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Tendring Rest Home Ringwood Road Netley Marsh Totton Hampshire SO40 7DY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Craig Willis     Date: 0 5 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Tendring Rest Home Ringwood Road Netley Marsh Totton Hampshire SO40 7DY 023 8086 4571 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Tendring Care Homes Ltd Mrs C P Lacey care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Service users in the category Dementia (DE) not to be admitted under the age of 60 years. 0 0 Over 65 0 0 Date of last inspection Brief description of the care home Tendring Rest Home is registered to provide care and accommodation twenty-three older people, who may also have dementia. There are two lounge rooms and a dining room that people living in the home can use. The home is approximately a mile from Totton town centre and is situated on a local bus route. The manager reported that the weekly fees for a place at the home range from 415 pounds to 685 pounds. Care Homes for Older People Page 4 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The evidence used to write this inspection report was gained from a review of the information the provider has sent us since the last visit and the previous inspection report. This information included incident reports and an annual quality assurance assessment. A site visit was made to the home on 5 September 2008. During the visit we spoke to people who live in the home, visiting relatives, the manager and staff on duty. The communal areas of the home were viewed and documents relating to the running of the home were inspected during the visit. Care Homes for Older People Page 5 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 6 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 7 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems to assess peoples needs before they move into the home. This helps to assure people that the home will be able to meet their needs. Evidence: Following the last inspection we made a requirement that people must not move into the home before their needs have been fully assessed. This requirement has been met. The manager reported in the annual quality assurance assessment for us that peoples needs are fully assessed before they move into the home. We looked at the files of five people who live in the home during the visit. Each person had an assessment of their needs that was completed before they moved into the home. This assessment included peoples mobility, personal care, health care, social, spiritual and cultural Care Homes for Older People Page 8 of 24 needs. People spoken with who live in the home said they were able to visit before they decided whether to move in and were reassured that the home would be able to meet their needs. Six people who live in the home completed a survey for us; all said they received enough information about the home before they moved in so they could decide whether it was the right place for them. Care Homes for Older People Page 9 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are set out in good care plans, which give staff the information they need to provide the right care. There are good systems to support people to take their medication, however, controlled drugs need to be stored more securely. Evidence: The files of five people who live in the home were inspected during the visit and all contained a care plan. The care plans had been developed from the initial needs assessments and set out how these needs should be met. The plans include an assessment of any risks identified, for example concerning peoples mobility and risk of falls or confusion as a result of dementia. The risk assessments contain action that should be taken to minimise the risks identified. All of the care plans seen had been reviewed each month, with amendments made where peoples needs had changed. A requirement was made following the last inspection that action must be taken to minimise the risk of harm from identified hazards. This requirement has been met. Care Homes for Older People Page 10 of 24 People had signed plans where possible to indicate that they had been consulted over the development of the plan. Staff spoken with said they found the information in the assessments and care plans to be accurate. Records inspected demonstrated that people have access to a range of health services including GP, district nurse, dentist, chiropodist and optician. Records of visits were kept in peoples file and included any advice from the practitioner. People spoken with said they were able to see their doctor when the need to. A requirement was made following the last inspection that accurate records must be kept of medication received into the home and administered to people. This requirement has been met. People who live in the home are able to control their own medication, following an assessment that this is safe. Where people are not able to, or dont want to control their medication, it is administered by staff who have completed training. Medication held by the home is stored in a locked trolley and cabinets and most tablets are provided in blister packs. The medication administration record for the current month was inspected and had been fully completed. This gives a record of medication that has been received into the home and when staff have supported people to take their medication. At the time of the visit one person was prescribed a controlled drug. These were separately recorded in a controlled drug register and stored in a separate cabinet, although this was not a specific controlled drug cabinet. The records were checked and the balance recorded matched the tablets held. The regulations regarding the storage of controlled drugs have recently changed and they now need to be stored in a specific cabinet, which the manager said would be arranged. One person spoken with was concerned that she had run out of her medication during the previous month. The manager reported that this was due to insufficient medication being prescribed and staff not taking action to order more medication. The manager has worked with the prescribing GP to ensure sufficient medication is prescribed for each month and said she would ensure staff take prompt action if anyone is running low on their medication. People spoken with said staff treat them well. During the visit staff were observed responding to people in a manner that maintained their privacy and dignity, for example waiting for a reply before entering a bedroom and talking to people in a friendly and respectful way. Care Homes for Older People Page 11 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a good range of activities to meet peoples different needs and provides a choice of food that people like. People are supported to keep in contact with their family and friends and visitors are made to feel welcome. Evidence: The home provides a variety of group activities, based on feedback about the ones people enjoy. On the week of the visit the planned activities included arts and craft, a quiz, interactive music, gardening and interactive games. As well as group activities time is set aside for one-to-one activities, for example playing cards or chatting. Most people spoken with said they liked the activities that are organised. The home has a well-stocked library with large print books and audiotapes. People spoken with during the visit said their relatives were always made to feel welcome. This was also reported by visiting relatives spoken with. People spoken with said they were able to decide how they spent their time and what activities they took part in. People are able to practise their religion, with spiritual Care Homes for Older People Page 12 of 24 leaders made welcome in the home, for example so that people can receive communion. Support is also provided for people to travel to places of worship if they wish. The home has a menu that provides a choice of two meals. People spoken with said the food is very good and confirmed that alternatives are available if they want. Details of peoples specific dietary needs are included in the care plans and are made available to kitchen staff. The home has recently introduced room service menu, with people able to order meals and snacks to be served in their room. Care Homes for Older People Page 13 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has good systems to deal with complaints and respond to allegations of abuse. This gives people confidence that any complaints they make will be taken seriously and investigated. Evidence: The home has a complaints procedure, which is included in the service users guide and displayed in the home. The home has received two complaints in the last year. These concerned the care provided to one person and an administrative error. The complaints were investigated and records were available of the findings. The people who made the complaints were written to with the findings of the investigations and the action that the home was going to take. People spoken with during the visit said they were confident any complaints they made would be taken seriously and investigated. Six people who live in the home completed a survey for us. Five said they were aware of the homes complaints procedures and one said they were not sure. The home has procedures in place to respond to allegations of abuse and staff have received training in the safeguarding adults procedures. Staff spoken with demonstrated a good understanding of different types of abuse, signs that someone may be being abused and what to do if abuse is witnessed, reported or suspected. Care Homes for Older People Page 14 of 24 Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and provides a homely, comfortable and safe environment that meets peoples different needs. Evidence: All of the homes communal areas were inspected during the visit. All areas were clean and well maintained. There are two large lounge areas, a dining room and a quiet seating area at the edge of the dining room. People said the home is kept clean all of the time and their bedrooms were comfortable and had all that they need in them. All six people who live in the home that completed a survey for us said the home was always or usually fresh and clean. The home has a maintenance person and staff reported maintenance is completed quickly when required. There is a garden, with areas that are accessible to people with greater mobility needs. Since the last inspection a private area of the home has been converted into an additional four bedrooms, which has reduced the number of double rooms used. There are plans to build an extension to add a number of other rooms. The manager and provider are aware of the need to apply to us for these rooms to be registered before they are used. The home has a separate laundry room, with machines capable of washing soiled clothes if necessary. There are infection control procedures in place and hand washing Care Homes for Older People Page 16 of 24 facilities in the laundry room, kitchen, toilets and bathrooms. Staff are provided with protective clothing, for example gloves and aprons, and were seen using them during the visit. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are thoroughly checked, well trained and employed in sufficient numbers to meet peoples needs. Evidence: The home has three care staff between 8am and 2pm and two care staff in the afternoon and overnight. In addition to the care staff there are cleaners and kitchen staff. Most people spoken with said they thought there were enough staff to meet their needs, although one person thought it would be better with an additional carer in the early evening. The manager reported that this was something they are currently looking at to see whether it would improve the service they provide. Of the six people who live in the home that completed a survey for us, two said staff were always available when they need them and four said staff were usually available when they need them. Staff spoken with said they thought there were sufficient staff on all shifts. A requirement was made following the last inspection that staff must have a Criminal Records Bureau (CRB) disclosure before they start work. This requirement has been met. The manager reported that all staff working in the home have had suitable preemployment checks. The records of four staff employed in the last year were inspected and contained confirmation that a CRB disclosure had been obtained, Care Homes for Older People Page 18 of 24 confirmation that the person was not on the protection of vulnerable adults list as unsuitable to work in a care home and two written references. Staff complete a twelve-week induction when they start work. Seven of the twelve permanent care staff have completed the National Vocational Qualification (NVQ) in care at level 2 or above and two are currently completing the award. The home has a training programme in place with courses including first aid, food hygiene, fire safety, infection control, moving and handling, safeguarding, medication and dementia. Staff spoken with said they thought the training was relevant to their role and gave them skills and knowledge to meet peoples needs. People spoken with said staff had the right skills to meet their needs. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and staff are supported to do their job effectively. There are good systems to assess the quality of the service provided and plan improvements. Evidence: The manager reported she has almost completed the registered managers award and expects to have achieved it by October 2008. During the visit the manager demonstrated her knowledge of the service and a commitment to ensure that the service continues to improve. Staff spoken with said they receive good support from the manager. A senior manager from the company visits the home each month to assess the quality Care Homes for Older People Page 20 of 24 of the service provided. Reports are made of these visits and sent to the manager. The reports contain details of any actions that are needed and these are followed up at the next visit. People who live in the home and their relatives are regularly consulted about the quality of the service provided, through both meetings and surveys. The results of these consultations and regular audits are used to create a development plan to improve the service. The manager reported that they do not hold money or act as an appointee for anyone who lives in the home. The manager reported that all equipment in the home is regularly serviced and checked to ensure it is safe. During the visit we sampled servicing records for the fire alarm and extinguishers, hoists and the lift, which had all been serviced regularly. The record of weekly tests of the fire alarm had not been completed since June 2008. The manager reported that the maintenance person tests the alarms weekly but they are not always recorded as the book is locked away. The manager agreed to ensure the book is completed in future. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person must ensure controlled medication, including Temazepam, is stored in a controlled drugs cabinet. The cabinet must comply with the misuse of drugs (safe custody) regulations 1973. 31/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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