Inspection on 13/06/05 for The Tamarind

This inspection was carried out on 13th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Tamarind 17/10/08

The Tamarind 02/11/06

The Tamarind 29/11/05

The Tamarind 01/02/05

The Tamarind 03/09/04

The Tamarind 03/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 The Tamarind 112 Ramsey Road Dovercourt Harwich Essex C012 4RN Lead Inspector Ray Burwood Announced 13 June 2005 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Tamarind Address 112 Ramsey Road, Dovercourt, Harwich, Essex CO12 4RN 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) 01255 507283 01255 507283 A G L Care Limited Mr Steven Brian Lingley Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 01/02/05 Brief Description of the Service: The Tamarind is owned by AGL Care Limited and provides accommodation and care for five people with learning disabilities. The home is a detached house situated on the main road into Harwich and offers single accommodation on two levels. All communal areas are situated on the ground floor, and include a lounge, dining area and a kitchen that includes laundry facilities. The dining room has access to the enclosed garden to the rear of the premises. Tamarind is situated on the main bus route and leads to local amenities. Parking is available to the front of the house. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection of Tamarind was undertaken on the 13th June 2005 with the assistance of the manager, staff and service users living in the home. The inspection was carried out between the hours of 10.00 am and 3.00 pm. Service users and staff were spoken with as part of the inspection process, with additional feedback received via Comment Cards sent to service users, their relative and visitors to the home. Comments received, praised the care and affection offered by staff and expressed satisfaction with the service provision. Service users and staff also commented on the relaxed, happy and homely environment they lived and worked in. Management support and training was discussed with staff and found to be a positive experience. A tour of the premises was undertaken and a sample of both care and staff files were inspected. Documentation relating to the running of the home and safety checks was also inspected as part of the inspection process. A total of 15 standards were inspected, with 12 meeting the National Minimum Standards (NMS). What the service does well: The service provides a well-organised key-worker system, with back up from assistant key-workers to cover holidays and sickness. The home offers more intensive care to two service users, with one receiving one to one care and another receiving additional staff support during appointments and activity sessions. Records relating to service users healthcare needs are comprehensive, appropriately maintained, with good records kept. The home supports those service users who wish to be independent within a risk management framework, whilst at the same time recognising individual needs and lifestyles. Service users spoken with commented on how their views, wishes and aspirations were respected by staff, one in particular was looking forward to starting college to enable her to improve her job opportunities. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 6 Feedback from relatives and friends confirmed the good working relationship with the home and their satisfaction of the service provided. What has improved since the last inspection? What they could do better: The home’s quality assurance and monitoring system should be further progressed by seeking the views of all stakeholders in order to develop the service. Following discussions with the manager it was agreed that he would consider a number of options regarding the home’s Statement of Purpose and Service User Guide format. Although some service users may be able to read and understand these documents, others may benefit from a pictorial or other suitable format. Policies and procedures relating to ageing and illness should be further developed. Please contact the provider for advice of actions taken in response to this The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 2. The home provides the required information for some of the service users living in the home, which clearly links service users needs and aspirations to the services offered. A pictorial format linked to service users capabilities was discussed with the manager. EVIDENCE: The home’s Statement of Purpose had been updated to reflect the managers qualifications, and his ongoing training undertaken in relation to the National Vocational Qualification (NVQ) Level 4 in Management and Care. The service Users Guide sets out the required information in terms of what the home offers to current and prospective service users, but like the home’s Statement of Purpose, is not in a suitable format for all of the service users for whom the home is intended. The manager confirmed that service users relatives were aware of the services the home was offering, but agreed that some further work, using a pictorial form or other, would be investigated. (See recommendations). The initial assessment documentation inspected is used across all of the company’s homes and covers all the sub sections of the National Minimum Standard (NMS). Service users’ files contained additional information via Community Care Assessments provided by Social Service Departments. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 10 The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 8. Care plans are clearly detailed and contains evidence of service users needs and wishes, together with appropriate information to enable care staff to carry out their duties. Service users, who have the capacity, are able to contribute and participate in the daily routine of the home. EVIDENCE: Three care plans sampled were seen to contain comprehensive detail regarding the assessed needs of service users, and were reviewed on a regular basis. Staff spoken with during the inspection evidenced their knowledge in relation to the care planning process and the maintenance of such documents. Risk assessments were seen to be included in service users files inspected, with clear guidelines for staff on the actions to be followed to minimise the likelihood of the identified risk presenting. All care plans contained the required information in respect of healthcare needs, with referrals well documented. Visits to or from healthcare professionals were documented and outcomes recorded. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 12 Service users spoken with confirmed that they are involved in the daily running of the home through planning daily activities, contributing to menus and shopping for food. Evidence was submitted showing the frequency of service user’s meetings and the signatures of those attending. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 15 and 17. The home supported those service users who were able to work in the community and offered a range of appropriate activities, both in the home and the community. Family links are supported and maintained by the home. Service users are offered the choice of a well balanced diet to meet their needs and lifestyles. EVIDENCE: From discussions with the manager and one service user, the employment of this particular individual had ended because of the early start she had to make. This employment, delivering newspapers was therefore curtailed. Since then, the individual concerned has made enquiries about a college course in decorating and car valetting. The daily activities records seen, included college courses in music and movement together with multi-sensory sessions. Two male service users’ spoken to said their daily programme of activities included going into town The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 14 shopping, and being more independent in terms of organising their own time and interests. From discussions with staff and service users, family links were strong with weekends spent together at home for some service users’. Also, family holidays were a feature of the year. Those who did not have the opportunity to engage in this way were involved in a holiday with staff from the home. One service user who had no family was supported by his Social Worker who was in regular contact. Advocacy services were not in use at the time of the inspection, although the manager would ensure that if an advocate should be required, he would access and support the service. The manager explained the homes involvement with Mencap in setting up a pen pal register for service users to access, if they were interested in corresponding with other people who had learning disabilities. The home operated a seasonal menu system with those service users who were able, contributing to the different choices available. Kitchen facilities were domestic in nature and allowed the space for service users to be involved in food preparation work and making snacks and drinks. Food storage, records of refrigerators and freezer temperatures, and service users choices of alternative meals were in order. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 and 21. The home’s medication systems and procedures ensure the protection and wellbeing of service users. Policies, procedures and arrangements are in place should a service user die, but further information and procedures should be included to take account of service users who ageing or ill. EVIDENCE: The home’s medication system was seen to meet the requirements. Medication id dispensed via Boots ‘Measured Dosage System’ (MDS) and named boxes/bottles and included Homely Remedies by prescription. The home operated a weekly audit of PRN medication, with dispensed and stocks of medication checks in place and records kept. The manager confirmed that all staff had received accredited training from Boots. In addition, Ms Amy Beeharry, the Responsible Individual, was accredited to provide medication training for staff. The home did not maintain any controlled drugs. The home has a policy on death and dying (expected or sudden). Care plans seen included the wishes of service users or their next of kin, in the event of death, however, this policy should be updated to include service users who are The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 16 ageing or may require nursing in the home, and the impact on other service users. (See requirements) The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23. The home’s Adult Protection and Whistle Blowing policies and procedures, including training, were adequate to help ensure service users were protected from harm or abuse. EVIDENCE: The home’s Adult Protection and Whistle Blowing policies were both comprehensively detailed and followed the Essex County Council’s guidelines for reporting incidents of abuse. Staff spoken to confirmed that they had received training in recognising and responding to abuse. Further training had been booked for staff to attend courses in July and September 2005. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24. The home provides a well maintained environment that is safe, homely and meets the individual lifestyles of service users’ EVIDENCE: During the inspection process, a tour of the premises was undertaken with the manager and two service users. Service users rooms, communal areas were seen to meet individual needs and lifestyles. The home was homely, decorated to a good standard, being safe accessible, and suitable for its stated purpose. One service user spoken with said she was about to change the décor of her room, something that she likes to do. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 35. The home’s recruitment policies and procedures were robust and ensured the protection of service users. Service users needs were supported by trained and qualified members of staff. EVIDENCE: Three staff files were sampled in respect of the home’s recruitment process. All files contained the required documentary evidence under Regulations. The manager confirmed that staff did not commence their duties until all checks were in place. Staff had been given a copy of the General Social Care Council’s (GSCC) code of conduct guidelines. Six members of staff are qualified to National Vocational Qualification (NVQ) Level 2 or above. Staff spoken with discussed their training programme that had been agreed at formal supervision sessions, and confirmed their progression through induction and foundation training. In-house training is undertaken by the home’s Registered Individual, who is accredited to provide some areas of training. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42. The manager should progress the home’s quality assurance, (repeated requirement), to ensure that service users and other stake holders views are known. The home’s records, for the protection of service users and staff are well documented and maintained. EVIDENCE: The manager provided evidence in relation to service users survey documentation with these ready to distribute. Additional documentation relating to relatives, professionals and any other stakeholders feedback, are yet to be developed and distributed. (See requirements). The manager of the home was aware of his responsibilities regarding the health and safety of service users’ and staff. Training had taken place in relation to health and safety and safe working practices (12 week course) and the testing of equipment had been undertaken on a regular basis. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 21 Records required by regulation for the protection of service users and staff were inspected and found to be correct, these included certificates and tests carried out for the following: • Gas and electricity, including portable appliance’s and emergency lighting, • Water temperatures, • Fire equipment and fire alarm system, • Fire drills and instruction. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 x x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Tamarind Score x x 3 2 Standard No 37 38 39 40 41 42 43 Score x x 1 x x 3 x v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 23 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 1 Regulation 4,5 Requirement The registered person must produce a Statement of Purpose and Service User Guide, which is in a format that is compatible with the needs of all service users. (Previous timescale of 30/04/05 not met). The registered person must maintain and develop records in relation to the needs of service users who may be ageing or dying. (Previous timescale of 30/04/05 not met). The registered person must develop a process for revewing and keeping under reveiw, the quality of the homes service provision.(Previous timescale of 30/04/05 not met). Timescale for action 30/09/05 2. 21 17 30/09/05 3. 39 24 30/09/05 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. The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 24 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection Fairfax House Causton Road Colchester Essex CO1 2RJ 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 The Tamarind v222664 i56-i05 the tamarind s17979 v222664 ai 130605 stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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