Inspection on 24/11/05 for Tenlands Care Home

This inspection was carried out on 24th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Tenlands Care Home 17/02/09

Tenlands Care Home 27/03/08

Tenlands Care Home 22/11/06

Tenlands Care Home 23/06/05

Tenlands Care Home 18/11/04

Tenlands Care Home 25/05/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Tenlands Care Home Wood lane Ferryhill Durham DL17 8JD Lead Inspector Mrs Sue Lowther Unannounced Inspection 24th November 2005 09:30 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 Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 DS0000000758.V266046.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tenlands Care Home Address Wood lane Ferryhill Durham DL17 8JD 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) 01740 657200 01740 656262 Southern Cross Home Properties Limited Mrs Janet Brown Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42), Terminally ill (5) of places Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Convalescence. Persons over the age of 55 requiring convalescent care may be accommodated commensurate with the home`s statement of purpose and function. Terminal Illness. Up to 5 persons with a terminal illness (palliative care) over the age of 55 may be accommodated commensurate with the home`s statement of purpose and function. 23rd June 2005 2. Date of last inspection 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 DS0000000758.V266046.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. By law we have to inspect all care homes at least twice a year. This unannounced inspection was carried out in accordance with this obligation. The inspection took place over 7 hours, on the morning and afternoon of 24th November 2005. 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 were assessed during the last inspection of the home. The inspector looked around the building and a number of records were examined. 7 service users, 6 visitors, the manager and 6 members of staff were spoken to. What the service does well: What has improved since the last inspection? Although some care plans require further development, the work that has been undertaken to improve care planning arrangements in the home is acknowledged. The manager now carries out a monthly audit to monitor the administration and recording of medications. A programme of redecoration was ongoing at the time of the inspection. Those area completed were found to be bright and cheerful. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 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. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 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 Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 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&4 Admissions to the home are well managed. Service users receive appropriate information about the home and their needs are assessed prior to admission. EVIDENCE: All service users are assessed prior to coming into the home. In addition to care manager assessments the registered manager normally visits the service user in their current place of residence. She advised the inspector that she would sometimes take another person with her if she feels this is needed. If she is on holiday this would be done by one of the qualified nurse and care where appropriate. The file of one service user recently admitted to the home was found to contain comprehensive information and the family confirmed that they had looked around the home and had been supplied with all of the information they required to make a decision about whether or not their relative would like to live there. The home does not provide intermediate care and therefore assessment of Standard 6 is not required. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 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 the following standard(s): 7, 8 & 9 Individual care plans are in place, but some require more comprehensive information to ensure that all care needs are appropriately met. At the time of this inspection medication was not always being managed correctly, with some practices considered to be unsafe. EVIDENCE: The inspector spent time in the company of service users and saw that people living at Tenlands Care Home are well cared for and comfortable in their home. Management and staff ensure that service users’ assessed health care needs are met. Where specialist intervention is required it is sought. Records confirm that contact with GPs and other health professionals are maintained. The inspector observed, through the actions and responses of staff, that staff respect service users’ privacy and dignity. Service users spoken to expressed their general satisfaction with the manner and attitude of the people employed at Tenlands. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 10 A service user plan has been developed for each service user that identifies needs associated with health and personal care. The care plans of five service users were examined. These were found to identify basic needs but they are not always evaluated on a monthly basis. The manager advised the inspector that as the ownership of the home had recently changed, care plans were being updated using the preferred paperwork used by the new company. Some of the information required by the inspector had been filed before the new paperwork was in place. It is recommended that the old paperwork remain in place for reference purposes until the new paperwork has been completed. The home’s systems relating to medication were checked. The home’s policies, procedures and systems in place relating to the receipt, recording, storage, handling, administration and disposal of medicines are generally adequate. Of the medications audited, the recording sheet of one service user was not completed in accordance with the prescribrer’s instruction, indicating a potential drug error. This was brought to the attention of the manager who began an immediate investigation into the issue. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 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 the following standard(s): 12, 13,14 &15 Social needs are recognised and provided for. The home has open visiting arrangements. Service users’ rights are respected and choice is provided. Meals are of a good standard. EVIDENCE: An activities co-ordinator is employed and a volunteer who was the previous organiser who has now retired assists her. On the afternoon of the inspection the activities co-ordinator had arranged a ‘clothes party’. Service users, relatives and staff had the opportunity to purchase items. Other events are also arranged on a daily basis. A number of people spoken to said how much they enjoy these events. Social stimulation is considered within care planning arrangements and records are kept of events organised. It is also acknowledged that care staff provide activities wherever possible. Staff were seen to engage with service users in social interaction. Tenlands has open visiting arrangements. The inspector spoke to 6 visitors who provided positive feedback. Service users were asked about the choices they were given. One person spoke about being asked if they preferred to be called by their first name or more formally by their surname. Staff were seen Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 12 to treat people with respect. For example, by knocking on the door before entering a bedroom. All of the service users spoken to said that the food was good. One said ‘I have just had a lovely meal.’ Another who had only been in the home for a short time said ‘I have heard that Christmas is really good, I am going to stay here rather than go home with my relatives.’ The lunchtime meal was observed and service users were sat at tables enjoying a relaxed lunch. Staff were available to assist service users should they require help over the lunchtime period. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 13 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): 16 & 18 Complaints and adult protection systems in the home serve to safeguard service users. EVIDENCE: Information about complaints, how and who to make them to, is made available to service users and their families through information displayed on the home’s notice boards and in the home’s ‘Service Users Guide’. Service users’ and families’ views are obtained through regular contact and an ‘open door policy’. Residents Meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. ‘Resident Surveys’ have also been carried out within the home. The survey results have been published and are made available. The home, through its parent company has detailed complaints and adult protection procedures. Copies of these were seen to be available for staff use. Staff interviewed voiced a commitment to the service users they work with and to upholding service users’ rights. Two family members of one service user said that they sometimes have problems but can approach the staff who attend to them speedily and with courtesy. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 14 Policy and procedure documents relating to adult protection provide information and guidance to staff. A copy of Durham and Darlington Adult Protection Committees policy and procedures on adult protection matters is held in the home. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 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, 21,24 & 26 The home was clean, comfortable and well maintained providing service users with a safe and pleasant environment. EVIDENCE: A programme of redecoration was ongoing at the time of the inspection. Those areas completed were found to be bright and cheerful and were in a style liked by people living there. Service users spoken to said they liked being able to bring into the home small items of furniture along with photographs to make their own room more pleasant and homely. However during the tour of the building the inspector noted that some of the commodes require replacement. Consideration should be given to replacing these with a type, which are more domestic in nature to fit in with the homely environment. The communal areas of the home were clean and service users confirmed that their bedrooms were also cleaned to a good standard. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 16 The inspector also noted during the tour of the building that one bathroom had been converted to a shower room. The manager and staff confirmed that due to the layout this facility it use was limited to service users who require either no or very little assistance. It could not be used for people who require the help of two members of staff. In addition no hand washing facilities were available within the room to provide protection for staff and service users. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 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 & 30 Sufficient staff are currently employed. The home has a settled, well-trained and well-led staff team. EVIDENCE: From discussions with management and staff, and from an examination of duty rosters, sufficient staff are employed within the home. There is a settled staff team. Service users spoken to confirmed that staff respond quickly to requests for assistance. The home had staff files in place, which provided evidence that that the appointment of a new member of staff is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. The Manager told the inspector that due to staff leaving there are currently 9 care staff currently trained to NVQ Level two or three in care. A further 11 have almost completed this training. Staff spoken to said that they found thus training useful and helped them to improve their day-to-day practice. Recent training had included ‘Care of the Dying’, fire safety, moving and handling and wound care. All new staff receive an induction and this was documented in the staff files examined. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 18 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 & 38 Service users can be confident that the home is well managed. Systems and safeguards are in place to ensure the health, safety and welfare of service users and staff is protected. EVIDENCE: The registered manager is very experienced in managing a care service. She is a registered general nurse who also has completed an appropriate management course. There was an open and friendly culture between the management team and the staff at the home. Staff said that they felt well supported in their work and evidence in staff files confirmed that regular supervision of staff takes place and that staff are appraised. Service users and relatives confirmed that the manager was approachable and that they would go to her if they had any concerns. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 19 The homes health and safety file was examined. All equipment in the home is regularly checked with certificates available to confirm this. There are no outstanding issues from the environmental health or fire and rescue service inspections. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 20 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 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 3 Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7OP8 Regulation 15 & Schedule 3 13 Requirement Current care plans must contain all of the information to ensure that each resident gets the assistance that is needed for them to live safely. The Registered manager must ensure that all prescribed medication is administered in line with the company policy and procedure and according to the instruction of the prescriber. A hand washbasin must be provided in the bathroom on the ground floor, which has recently been converted to a shower room. An audit must be undertaken of current bathing facilities to ensure that there are sufficient assisted facilities available following the recent conversion of one bathroom. Timescale for action 31/01/06 2. OP9 24/11/05 3 OP21 13(3) 31/01/06 4 OP21 23(2)(j) 31/01/06 Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 22 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 OP24 Good Practice Recommendations Consideration should be given to replacement of commodes with a type, which are more domestic in nature to fit in with the homely environment. Tenlands Care Home DS0000000758.V266046.R01.S.doc Version 5.0 Page 23 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. 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