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Inspection on 23/06/05 for Tenlands Care Home

Also see our care home review for Tenlands Care Home for more information

This inspection was carried out on 23rd 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

Feedback from service users and relatives indicated that people felt very satisfied with the care provided at Tenlands. Staff were described as being `friendly` and `caring`. Comments from relatives included ` the quality of service is outstanding. When my mother recently required urgent medical attention this was dealt with promptly and efficiently.` `On another occasion I pressed the call button and staff attended within 35 seconds.` Another relative commented that `staff don`t just look after the service users, they also look after the family`.

What has improved since the last inspection?

A redecoration programme has commenced. Those areas completed were noted to be bright and cheerful.

What the care home could do better:

Care planning within the home should be more consistent to ensure that all staff are aware of how to look after all of the people in the home. The recording of medication needs to be monitored to ensure they are safely managed and administered. Care planning within the home should be more consistent to ensure that all staff are aware of how to look after all of the people in the home.

CARE HOMES FOR OLDER PEOPLE Tenlands Care Home Woodlane Ferryhill County Durham DL17 8GD Lead Inspector Susan Lowther Announced 23 June 2005 rd 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 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. Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Tenlands Care Home Address Woodlane Ferryhill County Durham DL17 8GD 01740 657200 01740 656262 tenlands@btconnect.com Highfield Hiome Properties Limited 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) Janet Brown CRH 42 Category(ies) of OP - 42 registration, with number TI - 5 of places Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: TI: Up to 5 persons with a terminal illness over the age of 55 years may be accommodated commensurate with the homes Statement of Purpose. Date of last inspection 18th November 2005 Brief Description of the Service: Tenlands Care Home is purpose built. The home can accommodate up to 42 people in single or double, personalised bedrooms provided on two floors catering for service users who require general nursing and residential care There are a number of communal lounge / dining areas available for residents’ use. There is a social and recreational programme for those who wish to participate. Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. CSCI has a statutory duty to inspect all care homes at least twice a year. This announced inspection was carried out in accordance with this duty. The inspection took place on the 23rd June 2005 between the hors of 09:30am and 4pm. During the inspection of the home, time was spent talking to service users, staff and relatives. Records were examined and a tour of the building took place. The requirements in the previous inspection report of the home were the main focus of this inspection. In line with current CSCI policy on Proportionality, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion will be raised during the next inspection of the home. What the service does well: What has improved since the last inspection? Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 6 A redecoration programme has commenced. Those areas completed were noted to be bright and cheerful. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 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 standard(s) 1,2,3,&5 Sufficient information is given to prospective service users within the Statement of Purpose and Service User Guide to help them make an informed decision about moving into Tenlands Care Home. Appropriate assessment procedures are in place. EVIDENCE: Copies of the Statement of Purpose and Service User Guide were available within the reception area of Tenlands Care Home along with a copy of the home’s most recent inspection reports. Examination of an assessment of a person who had recently been admitted to the home, confirmed that comprehensive assessments are undertaken and it was confirmed that she had been invited to visit the home prior to admission. Assessments form the basis from which the individual plan of care will be written and demonstrate how the home will meet an individuals needs. The information provided within assessments must cover all areas of physical, social, emotional and psychological needs. Some of the care plans reviewed demonstrated that all areas are not entirely covered. Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9,10 &11 Individual care plans are in place, some progress has been made since the last inspection about the requirement that these should reflect all of the information obtained during the assessment process, however these still require further development. At the time of this inspection medication was not always being managed correctly, with some practices considered to be unsafe. EVIDENCE: The care plans examined demonstrated that all of the needs identified in the assessment are not always followed with a plan of care. This results in staff not always having the written information they need to meet all of the needs of service users. The plans contained written evidence of input from other professionals and each service user is registered with a local General Practitioner. During the inspection it became evident that the recording and administration of drugs was not always being managed correctly and was therefore a Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 10 potential risk to the health and wellbeing of service users. On several occasions medications had not been signed as given. On one of these occasions this involved insulin which was drawn up from a bottle and therefore it would not have been possible to establish whether that particular dose had been given or not. Several staff have undertaken specialist training in the area palliative care. Company policies are available for staff to consult and specialist services are utilised when required. No concerns were raised during interviews with service users, staff or visitors and no adverse observations were made during the inspection process. Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 &14 Service users are encouraged and assisted to make a choice about their care and how they wish to spend their day. EVIDENCE: Discussion with the manager, staff and service users demonstrated that activities are frequent and tailored as far as possible to meet individual need. Observation during the inspection demonstrated that service users communicate well during group activities. One of the organisers was seen to use the activity as a way of settling in a new service user who had been admitted a few hours earlier. Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 12 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 standard(s) These standards/outcomes area were not assessed during the course of this inspection. They will be examined at the next inspection EVIDENCE: Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 13 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 standard(s) These standards/outcomes area were not assessed during the course of this inspection. They will be examined at the next inspection EVIDENCE: Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards/outcomes area were not assessed during the course of this inspection. They will be examined at the next inspection EVIDENCE: Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35&36 The manager has a clear development plan, which she communicates effectively to staff. She is positive towards enhancing her skills and abilities to provide a good standard of care to service users. Robust procedures are in place for the safe keeping of service users money. EVIDENCE: The Registered manager has completed an appropriate management qualification. . Feedback from service users, staff and relatives confirmed that the manager is approachable and friendly. Personnel records examined confirmed that staff are supervised on a regular basis. The manager provided evidence to ensure that procedures have been reviewed with regard to service users financial interests and a more robust system has now been implemented. Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 16 Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 3 x 3 3 x x Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 18 YES 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 OP 7 Regulation 15 & Schedule 3 13 & 17 Requirement Timescale for action 30/09/05 2. OP 9 Care plans must at all times reflect the information obtained during the assessment process.(Previous timescale of 31/01/05 not met.) The Medication Administration 31/08/05 Record must be completed at the actual time of administration. 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 Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 19 Commission for Social Care Inspection Darlington Area Office No 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Tenlands Care Home B54 S758 Tenlands V220288 230605 Stage 4.doc Version 1.20 Page 20 - 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. 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