Inspection on 29/11/05 for The Tamarind

This inspection was carried out on 29th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Tamarind 17/10/08

The Tamarind 02/11/06

The Tamarind 13/06/05

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 CO12 4RN Lead Inspector Andrea Carter Unannounced Inspection 29th November 2005 09:30 The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 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 The Tamarind DS0000017979.V268206.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 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. The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Tamarind Address 112 Ramsey Road Dovercourt Harwich Essex CO12 4RN 01255 507283 01255 507283 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) 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 DS0000017979.V268206.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th June 2005 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 DS0000017979.V268206.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a two week period, commencing with a site visit, which covered one day. During the inspection fieldwork involved discussions with the registered manager, staff and service users. Sampling of service users files and associated documentation was undertaken. A full tour of the premises and grounds supports the findings from this inspection. Five service users comment cards were received along with two visitors and one health and social care professional. Eleven standards were looked at in total with six standards being met, two with minor shortfalls and three with major shortfalls. What the service does well: What has improved since the last inspection? It is of concern that all of the previous requirements from the last inspection remain outstanding .The registered person must as a matter of priority produce and progress an action plan to address the shortfalls. The registered manager must ensure that all records of risk are kept under review and that any limitations agreed with the service users as to the service The Tamarind DS0000017979.V268206.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. The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 7 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 The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 1 Prospective service users do not generally have the information they need to make informed choices about where to live. EVIDENCE: This was an outstanding requirement form the previous inspection. There has to date been no progress in this area. The service must ensure that both the statement of purpose and the service user guide are made more accessible to current and prospective service users. The format of the documents requires amendment to enable the use of symbols and picture.The manager is planning to liaise with the local makaton coordinator to move this area forward. The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 7 and 9 Service users make decisions about their lives with assistance as needed. Service users are generally supported to take risks as part of an independent lifestyle. EVIDENCE: Two service users files were sampled and case tracked. They both provided clear evidence that the care plan was individualised to specific need. The care plans of both individuals; contained in depth documentary evidence. A clear audit trail from assessed need to specific service provision was evident. Individual records clearly reflected the individuals right to choice and make decision making. One individual despite the inability to communicate verbally has records that document clearly what his behaviours indicate. The individual profile sheets of service uses indicate a very in depth knowledge and understanding of the individuals who reside within the service. Activities could be expanded upon in respect of documentary evidence provided around individuals. Financial audit trails clearly evidenced how one individual takes responsibility for their own monies The remaining four service users have the proprietor or The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 10 service manager as their appointee. Individual files show authorisation and consent forms to reflect the same. The registered manger has the authorisation to sign and cash the homes cheques. Five service user survey cards indicated they were happy with the home and liked living there, felt well cared for and were treated with respect and their privacy was upheld. The current missing persons policy must be updated to reflect the procedure to contact identified individuals during this process. This should include the registered manager and the commission for social care inspection. Comprehensive risk assessments are in place around service users and the action required to minimise risk, is documented to the individuals care plan. The risk assessments should be reviewed to clearly state how these areas should be actioned. This should include the production of generic risk assessment in relation to the collective infringement of service users rights through the locking of the main door and side gates. . The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 13 and 16 Service users generally feel they are part of the community. Service users rights are respected and responsibilities recognised in their daily lives. EVIDENCE: The service enables individuals to access a variety of leisure pursuits within the community. These include one individual who attends a makaton communication course. Swimming and aqua springs are attended twice weekly and also a multi sensory group and environment is participated within. A local group is accessed in Dover court for individuals with specific needs. Recently one individual was christened into the local church; currently no other service users choose to attend religious services. One individual accesses the public library. The home has two vehicles one being a people carrier and the second an estate vehicle. One service user accesses public transport, which is readily available a short distance from the home. The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 12 The service should expand its current timetable to reflect all the needs and diversity of its current service user group, thus incorporating a wider range of opportunities to access community facilities for both educational and recreational purposes. Currently no individual choose to vote within the home. The individual care plans sampled reflected the daily routines of individuals. The risk assessments cover individual’s independence and associated risks within choices. Two service users have keys to their own rooms and frequent the community unsupervised. Housekeeping forms part of the weekly routine with individuals taking responsibility for their own rooms in terms of laundry and hovering and dusting. Support is given in line with individual ability levels. A new system of the identification of daily and weekly goals is implemented with the support of the key worker system and inliaison with the service users. This can be a simple task to achieve for example sweeping the leaves in the garden and is the choice of the individual service users. The manager is currently exploring ways of expanding the weekly goals. . The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 18 19 and 21 Service users receive personal support in the way they prefer and require. Service uses physical and emotional health needs are met. The ageing, illness and death of a service user must be reflected in a policy and procedure to help ensure it is handled with respect and the wishes of the individual are adhered to. EVIDENCE: The care plans sampled indicated the positive way the service responds to the personal care given to individuals. Specific information is contained documenting exactly how an individual prefers all aspects of his care and the level of support required to achieve this. Waking and retiring times within the home are dependant on personal choice and meal times offer a degree of flexibility dependant ton daily activities and schedules. There is currently a key worker system in place that supports individual with shopping for a variety of personal items, clothing and toiletries included. Service users shop locally independently or with support. Previous input from outside professional services included Speech and Language Therapy. Currently this is not accessed, but one individual attends a makaton communication course. An annual review o individual need takes The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 14 place with funding authorities and key workers support the manager in compiling relevant review documentation. Input from parents and relatives is regular and phone calls and visits to the family home and the residential unit are supported and encouraged by the home. The previous requirement to produce an updated policy and procedure around the specific areas of ageing illness and death has not been met. The service must update its present documentation to reflect the wishes of individuals around this area, and a policy around the associated care that would be required if and when an individual becomes ill, through the ageing process, how the service would support the individual; and the impact on the other individuals they reside alongside. The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 22 Service users feel their views are listened to and acted on. EVIDENCE: Individual letters have been sent to all family members with a copy of the homes complaints procedure and the most recent inspection report. The policy clearly outlines how to contact the home or commission and associated timescales with the process. Regular house meetings enable service users to voice their views and concerns. Support is given through the key worker system, one to one with staff or the manger is also available to facilitate communication around areas of concern. The manger is currently exploring ways to better support the least communicative of the service users group. There have been twocomplaints received by the service this yesr. The home compliments file contains numerous sentiments of thanks from family and friends. Two relative survey cards indicated they are happy with the service and have not to date had to make a complaint to the service A social worker, who completed the survey form, identified that the service communicates clearly and works in partnership with the organisation. The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 30 The home is clean and hygienic. EVIDENCE: The home presented as clean, tidy and free from odours. The laundry room facilities were appropriate for the needs of the service. Procedures were in place to sort soiled laundry and washing machines washed at 65’c to help ensure the risk of cross infection is eliminated. The infection control policy clearly documents the procedures to follow to reduce infection. Staff when dealing with specific areas wear appropriate clothing. The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not looked at during this inspection. EVIDENCE: The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 The service is looking to develop a quality assurance system that will enable self monitoring, review and development of the home, but as yet this is not inplace EVIDENCE: This area was a requirement form the previous inspection. The service have not progressed this area any further. The service has developed a questionnaire to distribute to service users, although this needs to be formatted in a way that, will help individuals understand its content. There is currently a plan to liaise with the service head office to discuss and compile a stakeholder’s questionnaire in preparation for implementation. This will in turn enable the service to review and develop its current service provision through a system of self-monitoring. The current systems indicates that polices and procedures are updated intermittingly. The regularity of this process should be addressed. The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 19 The Tamarind DS0000017979.V268206.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 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 1 x x x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x 3 x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 2 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Tamarind Score 3 3 x 1 Standard No 37 38 39 40 41 42 43 Score x x 1 x x x x DS0000017979.V268206.R01.S.doc Version 5.0 Page 21 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 YA1 Regulation 4,5 Requirement Timescale for action 31/03/06 2 YA9 3 YA13 4 YA21 3. YA39 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 service users. (Previous timescales of 30/04/05 and the 30/09/05 not met). The registered manager must 14(2)(a) ensure that all records of risk 17(1)(a)(q) are kept under review, and that any limitations agreed with the service user as to the service users freedom of choice and liberty of movement is recorded. 16(2)(m)(n) The registered manager should ensure that individual timetables are expanded to reflect community access to recreational and educational facilities. 17 The registered person must maintain and develop records in relation to the process of ageing , illness or dying. (Previous timescales of 30/04/05 and 30/09/05 not met). 24 The registered person must DS0000017979.V268206.R01.S.doc 31/03/06 31/03/06 30/03/06 30/04/06 Page 22 The Tamarind Version 5.0 develop a process for reviewing and monitering, the quality of the homes service provision.(Previous timescale of 30/04/05 and 30/09/05 not met). 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 The Tamarind DS0000017979.V268206.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 DS0000017979.V268206.R01.S.doc Version 5.0 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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