Inspection on 27/03/08 for Tenlands Care Home

This inspection was carried out on 27th March 2008.

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

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 22/11/06

Tenlands Care Home 24/11/05

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 Key Unannounced Inspection 27th March 2008 09:00 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 Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 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.V361493.R01.S.doc Version 5.2 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 tenlands@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Home Properties Limited Mrs Janet Brown Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following category of service only: Care home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places 40. The maximum number of service users who may be accommodated is 40. 22nd November 2006 2. Date of last inspection Brief Description of the Service: Tenlands Care Home is purpose built. The home can accommodate up to 40 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. Fees charged are between £390:50p and £600. Hairdressing, chiropody, newspapers and toiletries are not included. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This unannounced inspection of Tenlands Care Home took place on the 27th march 2008. Records were examined and a tour of the building took place. Time was spent talking to staff, the people who live in the home and their relatives. The manager supplied some written information to the CSCI before the inspection. The inspection focussed on key standard outcomes for people who live in the homes and to check whether requirements from the previous report had been met. Management arrangements within the home were also checked as a result of some concerns being raised by other professionals about this. What the service does well: What has improved since the last inspection? The administrator said that all of the people who live in the home now have a contract so that they understand the service they are entitled to receive. Since the last inspection a new nurse call system has been installed. The manager said that all areas, including en suite facilities, now have an accessible nurse call for people to use. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 6 Many of the commodes have been replaced as recommended in the last inspection report and wheelchairs are only stored in individual bedrooms. 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. The summary of this inspection report can be made available in other formats on request. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 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.V361493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3. The home does not provide intermediate care. Therefore assessment of standard 6 is not required. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions are well managed and people are provided with information about the home before moving in. EVIDENCE: The administrator said that all of the people who live in the home now have a contract so that they understand the service they are entitled to receive. Everyone is assessed prior to living in the home. In addition to social service care manager assessments the manager normally visits the person in their Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 9 current place of residence. of the nurses. If she were on holiday this would be done by one The files of two people recently admitted to the home were found to contain comprehensive information. The family confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. One person said, “I came to look around the home. Staff gave me all of the information I needed to make the decision about coming to live here”. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s health care needs are well managed by the home. Systems to administer medication are safe and people living at the home say that they are treated well and that the standard of care is good. EVIDENCE: The manager said that all of the people who live in the home have care plans so that staff know how to look after people on an individual basis. Those looked at contained most of the information staff need to look after people well. Although the religious needs of people are addressed in the main, where people have specific cultural needs these should also be set out in the plan of care. This was discussed with the manager at the time of the inspection. People spoken to during the inspection said that they are happy with the care received and the level of information given. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 11 Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. One person who lives in the home said, “The manager makes sure that I see the doctor and the chiropodist when I need to”. Medication is administered by qualified nurses or carers who have been appropriately trained.. The home has a comprehensive medication policy. Records of all medicines received, administered and those leaving the home are maintained. On checking the medications it was found that a bottle which had a limited shelf life once opened did not have the date of opening identified. Whilst it is accepted that this medication could not be out of date due to the date it was dispensed, there is a potential for out of date medication to be given. The date of opening medications of this nature must be identified on the bottle. People spoken to said that staff always treat them with dignity and respect. One of the relatives said “ The staff are really good, they are lovely and speak to people nicely”. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the 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 range of activities with input from the people that live there. Relatives are made welcome and encouraged to visit the home. People living at the home said that they were able to make choices within all aspects of daily living. There is a varied menu and people likes and dislikes are well catered for. EVIDENCE: The home have an activities coordinator. Routines of daily living and activities are flexible and varied to suit individual expectations, preferences and capabilities. Personal choice is promoted at all times. People’s interests are recorded, there is a daily activity programme which is flexible. People can have visitors at any time and private visiting areas are available. People’s spiritual needs are respected. Recent activities have included bus trips, outside entertainers, board games, crafts and filmshows. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 13 People are encouraged to make choices and decisions wherever possible and this was observed throughout the day. One person said “I can get up and go to bed when I want. I can also have a bath or shower when I want”. There are two choices of meal. Special dietary needs are catered for and people are assisted to eat if necessary. One person who lives in the home said “The food has improved. We get a choice and there is plenty”. Another said “I think the food could be improved on”. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service’. Complaints and adult protection matters are supported by clear guidance and training. EVIDENCE: The home has a complaints procedure in place, which is displayed throughout the home. One person said, “I have never had any problems but if I did I would ask to see the manager”. A record is kept in the home of all complaints. Those recorded since the last inspection have been investigated within the home. Staff are trained to recognise and prevent abuse of the people who live in the home. The home has a clear adult protection procedure which links with the local authority procedure for safeguarding adults. The home also has an active whistleblowing policy. All staff spoken with said that they would have no hesitation in telling someone if there was a problem. One member of staff said “I would speak to the manager straight away. If she were not available or if it involved her I would speak to the area manager”. Recent training has taken place with regard to the Mental Capacity Act and the law, which links into Safeguarding Adults policies and procedures. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26. People who use the 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 in the main clean, well maintained, furnished and decorated to a good standard. EVIDENCE: The communal areas were bright and nicely decorated. Since the last inspection a new nurse call system has been installed. The manager said that all areas, including en suite facilities, now have an accessible nurse call for people to use. Many of the commodes have been replaced as recommended in the last inspection report and wheelchairs are only stored in individual bedrooms. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 16 Many of the rooms are decorated to the person’s own taste and there was evidence to confirm that people can take in some personal items when they go to live there. This includes pieces of furniture as well as photographs and ornaments. On the day of inspection the premises were found to be clean, hygenic and free from any odours. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing numbers support people’s health needs. The home has a commitment to staff training and recruitment practices protect people living in the home. EVIDENCE: From the rota supplied at the inspection there was sufficient care staff on duty to meet the assessed care needs of the people who were using the service. People said that staff were usually around and answered the call bells quickly. One person said “Staff are sometimes busy when I need help and take a little longer than I would like. This is usually during the morning time”. Another said, “The staff are always around. I like to spend time in my room. Even though they are busy they often pop in for a chat or to check if I need anything”. The home had staff files in place, which provided evidence that the appointment of new members of staff is made through proper recruitment processes. The files of three people were checked. Recruitment includes the vetting of staff through the use of Criminal Record Bureau (CRB) checks, Protection of Vulnerable Adult checks (POVA) and written references. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 18 Training has recently taken place in fire safety, moving and handling, infection control and dementia awareness. A large number of care staff are trained to NVQ level 2. Certificates to confirm this were seen in staff files. Staff spoken to confirmed that there is plenty of training available. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the 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 relatives and people using the service are regularly consulted about the service they receive. Financial arrangements are good and health and safety systems and practices protect people. EVIDENCE: The manager is a qualified nurse and has several years experience in working with older people. She has been spending some of her time at another home within the company and several professionals have raised concerns about this. However staff, the people who live in the home and visitors were extremely complimentary about the manager. One member of staff said “The manager is very approachable and I would not hesitate to approach her if I had a problem. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 20 We know where she is and how to get in contact with her if we need to”. Another said, “We always know where the manager is and can contact her at any time”. The mangement arrangements should be kept under constant review to ensure they are appropriate. There are clear lines of accountability within the home. Staff, relatives and those living at the home are actively involved in the decision making process of the home. The home has an annual plan for quality assurance which includes meetings staff. These are held monthly and information from these are included in quality monitoring. Relatives and the people who live in the home can approach the manager at any time as she operates an open door policy. The area manager completes a regulation 26 visit monthly. This is an audit which covers all aspects of the environment and the care delivered. The manager said that during this audit the area manager speaks to staff, the people who live in the home and visitors about their views. Any suggestions made are considered and improvements made where possible. Personal finances are kept in the home for people who request this. Two signatures are obtained and receipts are kept to ensure peoples’ financial interests are safeguarded. Health and safety systems were looked at. Safe working practices are maintained in line with current regulations and appropriate risk assessments are available. All safety checks for maintenance are carried out by external contractors as designated by law. All accidents are recorded and reported appropriately. The manager said that all of the requirements made following a recent visit by the environmental health officer had been implemented. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 X 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 3 X 3 X X 3 Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13(2) Requirement Where medications have a limited shelf life once opened, the date of opening must be identified on the label. Timescale for action 31/03/08 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. 2. Refer to Standard OP7 OP31 Good Practice Recommendations Where people have specific cultural needs these should be set out in the plan of care. The mangement arrangements within the home should be kept under constant review to ensure they are appropriate. Tenlands Care Home DS0000000758.V361493.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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 © 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 DS0000000758.V361493.R01.S.doc Version 5.2 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. 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