Inspection on 24/01/07 for Tewin Road (1)

This inspection was carried out on 24th January 2007.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tewin Road (1) 19/01/09

Tewin Road (1) 25/01/06

Tewin Road (1) 02/06/05

Tewin Road (1) 14/03/05

Tewin Road (1) 18/11/04

Tewin Road (1) 11/03/04

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Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

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Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Tewin Road (1) 1 Tewin Road Leverstock Green Hemel Hempstead Hertfordshire HP2 4NU Lead Inspector Mrs Judith Kent Unannounced Inspection 24th January & 6 February 2007 11:00 th Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 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 Tewin Road (1) DS0000019564.V328420.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 Adults 18-65. 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. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tewin Road (1) Address 1 Tewin Road Leverstock Green Hemel Hempstead Hertfordshire HP2 4NU 01442 214796 01442 244250 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) www.caretech-uk.com Caretech Community Service Limited Manager post vacant Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate 6 people with learning disability or physical disability (when associated with learning disability). 25th January 2006 Date of last inspection Brief Description of the Service: Tewin Road is a respite care unit for up to six people with a learning disability and associated physical disabilities. In addition, up to two further clients may receive day care at any one time. Service users have an allotted numbers of nights per year (specified by Adult Care Services) and therefore come for repeated short stays, becoming familiar with the home and the staff. There are approximately sixty-five clients that currently use the service. There are two shared care beds for service users with a physical disability. The building is an ordinary detached two-storey house in a residential neighbourhood, adjacent to parkland. Accommodation comprises of a lounge, dining room, small office, laundry room and kitchen. There are two bedrooms on the ground floor for use the use of shared care clients with physical disabilities and an assisted shower room. There are four bedrooms on the first floor and two bathrooms. Fees at the home are negotiated on an individual basis. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on two days as the inspector returned to the home to be able to talk to service users who were not there during the first visit. There were four people staying at the home at the time of the inspection – three were staying for short periods and one was on a day visit. All those who chose or were able to talk to the inspector indicated that they enjoyed their stays in the home and felt that the staff looked after them well. The atmosphere in the home was relaxed and warm and the support staff clearly had a good rapport with the service users. What the service does well: What has improved since the last inspection? 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. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures through rigorous assessment that it will be able to meet the needs of service users who stay at the home. EVIDENCE: Full and comprehensive assessments are completed for each prospective service user before they are offered a place in the home. The assessments are carried out with everyone concerned with the welfare of the person and are used to write the care plan to be used during the person’s stay in the home. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users care plans reflect individual care needs. The home’s support staff help service users to maintain and further develop independence as far as possible during their stays in the home. EVIDENCE: Each service user has contributed to the development of their care plan which sets out their individual needs and includes risk assessments for their stay in the home. The care plans are reviewed monthly for regular service users; less often for those whose visits are less frequent. Everyone has a designated key worker and records are maintained to give a picture of their daily activities during their stay. The emphasis is on helping service users to be as independent as possible and care plans and risk assessments are written to reflect this. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are helped to maintain and further develop their independence while they are staying at the home and are encouraged to take full advantage of the leisure facilities available to them. EVIDENCE: Service users continue to attend day centre, college and work during their stays at Tewin Road. The staff in the home help them to maintain and further develop their daily living skills – people help to cook their own meals and other tasks they need to be as independent as possible. Use of community facilities is encouraged and service users are helped to take advantage of them so as to make their stays in the home enjoyable. The staff meet with everyone involved in service users’ care to find out what they like to do while they are staying at the home. There are outings at the weekend, all of which are already planned for the year, and there are ad hoc activities during the week, and although most service users attend day centre or go to work during the day, cinema, bowling or pub trips are arranged for evening times. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 10 Mealtimes are communal and service users help to prepare and cook their meals as far as they are able. Special diets are catered for, for instance diabetic and Halal meals are prepared for those who need them. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are offered personal care in a way which meets their individual needs. The home looks after service users’ heath and their medication is managed safely while they are staying at the home. EVIDENCE: The level of care needed by service users is set out in detail in their care plans which are based on a comprehensive assessment of their needs and are reviewed regularly to reflect any changes since their previous stay. Service users’ health care needs are met during their stays in the home, when the community nurse or GP may be involved if urgent treatment is needed, but since service users normally stay in the home for short periods most of their health care is generally dealt with by their main carers. About half of the service users who stay in the home bring medication with them; of these a few manage their own medication after a risk assessment has been completed. Medication records, storage and administration were looked at during the inspection and were found to be managed well. There is a rigorous method of checking medication in and out of the home when people Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 12 stay or if it is sent to day centre with them. Only staff members who have had appropriate training deal with medication. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families can be confident that the home will protect their welfare and that complaints will be listened to. EVIDENCE: The home’s complaints procedure is produced in user-friendly format and is given to each service user who stays at the home. There have been no formal complaints since the last inspection, but there is good evidence from previous inspections that complaints are dealt with appropriately and within the required timescale. Service users are protected by the home’s safeguarding adults procedure and staff understand the process for reporting any suspicions or allegations of abuse. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a clean, comfortable, safe place for service users to visit and stay, although some areas are in a poor state of repair. EVIDENCE: Tewin Road provides homely surroundings for the people who stay there, with space where they can be alone or mix with other people in the house. The lounge and dining room are well furnished and equipped and bedrooms in the home are roomy and give a private space for service users. Each is decorated by the staff group in a different style and colour and many service users have their favourite where they like to stay during their visits. People are able to bring their own personal bits and pieces with them, but due to the short stay nature of the home rooms are not personalised in the way that they would be for permanent residents. The manager said that she plans to ask relatives for photos that can be put in rooms when service users stay. A look around the home revealed that there are several areas which are shabby and need attention, some due to the nearby Buncefield explosion last year, which seems to have caused several cracks in walls and ceilings. In Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 15 addition there are areas in bathrooms, kitchen and staff sleeping-in room, which need attention. These were discussed with the home’s manager who said that they had been noted. A new front door and frame has been ordered. The garden is to be altered and refurbished with paved areas and new fencing. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are recruited safely; the staff group is well trained and is able to meet the assessed needs of the service users who visit the home. EVIDENCE: Several staff files were looked at during the inspection and showed that staff are recruited safely and that the appropriate security checks take place. Two files did not have an identifying photograph of the staff member – these need to be put in place. The home is fully staffed at present and rarely uses agency staff, gaps in the rota being covered by the regular staff or bank workers; this arrangement provides consistency for service users. New staff are given an induction into the home and the company and are offered the opportunity to take up further training including National Vocational Qualifications (NVQs). Records of training were seen at the inspection. There are regular staff meetings and supervision, and annual appraisals are completed. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their families can be confident that the home is generally a safe place to live and that it is run in the interests of the people who use it. EVIDENCE: The manager has been in post since March 2006 and has completed both the NVQ Level 4 and the Registered Managers Award for which she is awaiting assessment. She has several years experience in working with people with a learning disability. There is a robust quality assurance system operating in the home; there are fully documented monthly audits by a senior manager of the company and a twice-yearly audit by an independent auditor. Every aspect of the home is looked at during these audits and service users, family members and care managers are asked to comment on the quality of the service provided by the home. Audit records were seen during the inspection - they showed that the Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 18 home has a good record of compliance with both National Minimum Standards and Caretech’s own requirements. Risk assessments and health and safety checks are completed and fire drills and equipment checks are carried out. The user-friendly fire safety instruction poster should be in each room, although the manager said that there have been problems in the past with service users removing them. It is suggested that they be framed and placed on the wall. Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 2 x Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 20 no 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 2 3 Standard YA24 YA34 YA43 Regulation 23(2)(b) Requirement Timescale for action 30/04/07 30/04/07 30/04/07 A maintenance programme must be developed to manage the repairs required in the home. 19(1)(b)(i) Staff files must hold an Schedule identifying photograph of the 2 staff member 23(4)(e) Fire safety and evacuation procedures must be placed in each room. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Hertfordshire Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Tewin Road (1) DS0000019564.V328420.R01.S.doc Version 5.2 Page 22 - 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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