Inspection on 04/06/07 for The Tidings

This inspection was carried out on 4th June 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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

CARE HOME ADULTS 18-65 The Tidings The Tidings 9 Brewery Drive Halstead Essex CO9 1BS Lead Inspector Neal Cranmer Key Unannounced Inspection 4th June 2007 09:30 The Tidings DS0000068483.V344287.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 The Tidings DS0000068483.V344287.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. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Tidings Address The Tidings 9 Brewery Drive Halstead Essex CO9 1BS 01787 473198 F/P 01787 473198 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) Mrs Isabel Mabhena Mrs Ayshea Jannette Hutchison Care Home 2 Category(ies) of Learning disability (2) registration, with number of places The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection First inspection since registration in 2006. Brief Description of the Service: The Tidings is a small house situated in the heart of Halstead in Essex, close to local amenities. The home accommodates two ladies, who are supported by a small staff team to live as independently as possible. The property comprises of three bedrooms, a small communal lounge, kitchen dinning room, patio doors lead from the lounge to a small-enclosed garden area, laid mostly to lawn. Fees for staying in the home are between £750.00-£1.800.00 per week, there was no mention of any additional charges being made, this information was provided on the day of the inspection by the proprietor. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection of the home, its first since registration in 2006, which took place over one day in June 2007. During the course of the inspection the inspector was accompanied by the proprietor and the registered manager, both of whom were spoken with at length. At the time of our arrival the two people living in the home were going out to attend day activities and one was spoken with prior to their leaving. During the course of the inspection a wide range of documentary evidence was sampled, most of which was found to be in order. A tour of the premises took place which included viewing of one person’s bedroom (with their consent) communal living areas and garden. Twenty-five of the forty-three standards were inspected, of these twenty-one were met, two were exceeded, and two were minor shortfalls. What the service does well: What has improved since the last inspection? This was the s first inspection of the service since their registration in 2006. Therefore at this point in time there is nothing to comment on in this section of the summary. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 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 Tidings DS0000068483.V344287.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People looking to move into the home can be assured that they will be provided with the necessary information to enable them to make an informed choice about the homes ability to meet their needs. Admission to the home will be based upon a detailed assessment of the individuals needs. EVIDENCE: The home’s Statement of Purpose and Service users Guide were both developed in December 2006, and detailed the aims and objectives of the service, services and facilities provided, arrangements for meeting people’s healthcare needs, accommodation and the fee range for staying in the home. All people admitted to the home are fully assessed prior to their admission, to ensure that the home is able to fully meet their needs. Assessments sampled during the inspection were seen to be well detailed, including the following information: • • Clinical diagnosis Dietary preferences DS0000068483.V344287.R01.S.doc Version 5.2 Page 9 The Tidings • Religious needs • Personal care needs • Educational needs • Self care needs. • The outcome of assessments was used as a basis for the development of the individual’s plan of care. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 10 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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs and personal goals are reflected in their plans of care, which are developed in consultation with the person, and recognise and take account of the need for individuals to take risks as part of developing an independent lifestyle. EVIDENCE: Both care plans of the people living in the home were sampled, each was written in the first person, and were very clear and concisely written with respect to the individual’s support needs, identifying what level of support they required, and if relevant if specialist aids or adaptations were required to assist in the identified need being met, daily records were kept clearly and concisely. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 11 There was evidence within the care plans that people had been consulted with about their plans of care, and this was further confirmed during discussion with one person. Each of the care plans sampled were seen to have review dates set. Risk assessments were very detailed and included a description of the nature of the risk, people who were likely to be at risk, and the measures in place to minimise any impact, all of the risk assessments were regularly kept under review, and each member of the care team had signed an attached sheet confirming that they had read and understood the information in the risk assessment. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 12 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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that they will be supported to take part in community based activities of their choosing, which will be age and peer appropriate they will be supported to maintain links with those important to them. People living in the home can be assured that they will be provided with a diet that is healthy, and about which they will have been fully consulted about, and had input into deciding. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 13 EVIDENCE: Discussion with people living in the home, the registered manager, and the proprietor provided evidence that people regularly attend college, where they take part in courses for ‘Skills for Living and Developing Independent Living Skills.’ These courses focus on helping people to develop skills in cooking, literacy, and numeracy. In addition to the time people spend in college activity plans that were sampled as part of the inspection indicated that people were taking part in the following community based activities: • • • • • • Attending Aqua Springs Going for walks Shopping Attending Church Going for meals out Using the local library. Planners were available in pictorial format, and copies of individual’s planners were seen in their rooms. One person spoken with during the inspection spoke of being aware of their activity plan and of their involvement in having agreed and set it up. The same person spoken with spoke of being supported by the home’s staff to maintain contact with their family, through visits, letters and occasional phone contact. Meals at the home are provided three times daily, at least one of which is a cooked. Meals are provided flexibly to facilitate people’s activities and a record of all meals consumed is maintained. To facilitate people’s choice a pictorial folder is kept. The menus seen were varied and nutritious, and there was evidence of fresh fruit being available in fruit bowls around the home and a supper snack is available to people should they wish it. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 14 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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that their physical and emotional healthcare needs will be met in such a way that preserves and respects their dignity. The home’s policies and procedures for the administering of medicines are sufficiently robust to ensure that people are protected. EVIDENCE: Both of the people living in the home are registered with local General Practitioners, and evidence was seen of a range of healthcare professionals providing input to the home, these included: • • • • • Dentists Chiropodists Opticians Community nurses Epilepsy nurse DS0000068483.V344287.R01.S.doc Version 5.2 Page 15 The Tidings The home operates a key worker system, and discussion with people living in the home indicated that they had been involved in choosing whom they wished to be their key worker. People’s medication is stored in individual cabinets, and all staff administering medicines have received training from a local pharmacy. Medication records sampled were detailed and included photographs of all members of staff administering medicines, as well as a sample signature. A medication information sheet is maintained in respect of each person and included a photograph, their name, date of birth and General Practitioner. The information sheet also recorded who the medication is supplied by including the suppliers contact name and telephone number, type of medicine, including its strength, direction for administration, and times to be taken. All of this information was in addition to the Medication Administration Record (MAR Sheet). As part of all staff induction a medication awareness pack is provided. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 16 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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that any concerns or complaints about the home will be listened too and acted upon, and that procedures for protecting them are robust. EVIDENCE: There have been no complaints or adult protection referrals in respect of the home since its registration in 2006. People spoken with said they were aware of how and who to complain to if they were unhappy with any aspect of the care provided by the home. All of the care staff with the exception of the newest recruit have received training in adult protection, a date has been scheduled for the newest member of staff to receive the said training, arrangements for protecting people are robust. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that the home is generally safe and well maintained, and kept clean and hygienic. EVIDENCE: The environment is generally homely and comfortable, albeit in places a little sparse of homely knick-knacks. This was discussed with the registered manager and the proprietor at the time of the inspection. Overall the home is safe, although there is a strip that needs fitting to the carpet between the kitchen and the hallway, which is currently posing a possible trip hazard. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 18 Storage in the home is limited, and currently the downstairs toilet is doubling as a storage area. However there are plans in place for the area under the stairs to have a sliding door fitted, which would ensure that items of storage would be kept separate from the toilet area, this work is scheduled to take place in the near future. The laundry arrangements in the home are domestic in nature, but are adequate to meet the needs of the number of people in residence. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured that they are supported by a competent staff team who are closely supervised and have the appropriate training to meet their assessed needs, and are further protected by the home’s recruitment practice. EVIDENCE: People living in the home are supported by a small team of staff who are competent and well trained for their roles. Interactions seen and heard between staff and people living in the home were positive and respectful. Staff were seen to be approachable, and were clearly interested in the views of individuals. The home does not employ any care staff under the age of eighteen. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 20 During the course of the inspection the home’s recruitment records were sampled, no gaps were found in respect of the documentary evidence that is required to be maintained under the Care Homes Regulations, and the recruitment practice seemed to be sufficiently robust enough to ensure the protection of people living in the home. Samples of training records evidenced that staff have received training in the following areas: adult protection, moving and handling, fire safety, and food hygiene. The home employs three care staff, two of who are qualified at N.V.Q level 2 in care. Discussion with the registered manager and one member of the care team indicated that individual 1 to 1 staff supervision is provided every one to two monthly, in addition group supervisions are held periodically. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 21 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, 38,39, 40 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home can be assured of being supported in a home that is well lead and run, and which seeks the views and opinions of others. The home’s policies and procedures are robust and ensure that people’s rights are safeguarded. EVIDENCE: The registered manager of the home also manages its sister home Meadowview which is situated nearby. The manager has significant previous experience of working in the care sector and is qualified at N.V.Q level 4 in both Management and Care. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 22 Discussion with one member of the care team indicated that the management ethos within the home is good, stating that the manager provides a clear sense of leadership and direction, and is always readily available to speak to about any issues of concern. The member of staff spoke of regular staff meetings and formal supervisions being provided, in addition to both of these bi-weekly key worker meetings are held with the people living in the home. The home reviews the quality of its service provision through the use of questionnaires which are disseminated to both relatives and visiting professionals. The home maintains a comprehensively detailed policies and procedures file, which is broken down into care related policies and staff related policies, which the registered manager had signed off, and further all had been signed by each member of the staff team. The policies and procedures file was kept in the home’s office, which is accessible to staff at all times. The home’s safe working practices were sampled and appeared to be in order, the following safety checks were regularly undertaken, emergency lighting, weekly fire alarm checks, monthly checks of the building and its grounds, weekly water temperature checks, portable appliance testing. A copy of the home’s Gas safety certificate was seen; the home’s electrical installation certificate was not available for viewing at the time of the inspection. The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 23 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 3 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 2 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 3 35 3 36 3 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 4 x 3 3 3 4 X 3 x The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 YA23 Regulation 18 (1 ci) Requirement All staff must be provided with the appropriate training relevant to the work they are to perform, this relates specifically to the need for all staff to be trained in adult protection, to ensure that risk to people living in the home is minimised. The home must be kept in a good state of repair both internally and externally, to ensure that people’s health and welfare is safeguarded. Timescale for action 30/09/07 2. YA24 23 (2b) 31/07/07 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 Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 The Tidings DS0000068483.V344287.R01.S.doc Version 5.2 Page 26 - 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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