Inspection on 23/10/07 for The Tynings

This inspection was carried out on 23rd October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Tynings 26/11/08

The Tynings 20/04/06

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 The Tynings The Tynings Walmore Hill Minsterworth Gloucestershire GL2 8LA Lead Inspector Mr Tim Cotterell Unannounced Inspection 23 and 25 October 2007 10:00 rd th Beeches (The) (Seven Kings) DS0000065788.V350081.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 Beeches (The) (Seven Kings) DS0000065788.V350081.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. Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Tynings Address The Tynings Walmore Hill Minsterworth Gloucestershire GL2 8LA 01452 751037 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) grapevinecareadmin@gmail.com Grapevine Care Ltd vacant post Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide care and accommodation for up to 5 service users with a learning disability, but may also accommodate service users with minor associated physical disabilities provided that their primary needs relate to learning disability. The policies and procedures must be fully reviewed by 31/07/06 such that each one provides full, up to date guidance based on current law and best practice. 25th January 2007 2. Date of last inspection Brief Description of the Service: The Tynings opened in 2005, and is registered to provide care for up to five people with a learning disability. It is located in a rural area near the village of Minsterworth and is about 10 miles from Gloucester. The home is set in seven acres of land and various animals are kept including sheep, horses, chickens and pigs. Residents have single rooms. Four bedrooms have en-suite facilities and the fifth has access to a nearby bathroom. There is a large dining and living area on the ground floor, as well as a conservatory with views over the countryside. Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The inspection was undertaken by one inspector and consisted of three visits to the home. During the inspection all residents and staff on duty were seen, together with the acting manager, one of the providers and two relatives. All of the accommodation was seen (with the exception of one bedroom). A number of records were inspected and they included care plans, risk assessments, medication and personal monies. Three completed surveys were returned from relatives, and one from staff. What the service does well: What has improved since the last inspection? The home has continued to introduce ‘personal centred care planning’ and this provides a clear picture of what action (if any) staff need to do in order to meet the aims of the plan. Beeches (The) (Seven Kings) DS0000065788.V350081.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. Beeches (The) (Seven Kings) DS0000065788.V350081.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 Beeches (The) (Seven Kings) DS0000065788.V350081.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): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Whilst the home is taking care to only admit residents whose needs can be met. A fuller assessment may be achieved if the assessor received some formal training in this process. EVIDENCE: The deputy manager, with support from the provider will now undertake any assessment of need. The procedure was explained to the inspector and it was evident that considerable time is given to this important exercise. The home was clearly making great efforts to ensure any new resident would have sufficient opportunity to make a decision about any long term move to the home. It is recommended that anyone undertaking assessments have some formal training in view of the importance of the assessment of need prior to any admission. Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 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. 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. Residents are supported and their views are obtained over all aspects of their lives and the care plans clearly indicate needs and wishes of the individual. EVIDENCE: A number of care plans were looked at. The home has now introduced person centred care planning and they were seen as clear, relevant and comprehensive. The plans seen included the issues, which clearly described the things to be addressed and the views, wherever possible of the residents. The actions then followed and this gave a good description of what was expected from the staff in the home. The plan was then reviewed and if necessary changes made and recorded. If more specialist help was required the plans provided evidence that other health care professionals had been consulted. The Community Learning Disability Team had advised and supported the home on a number of occasions. Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 10 Where a plan refers to a specific task or goal. e.g. independence training, it is recommended that specific and wherever possible measurable aims are in included in the plan. This would enable the home to determine if the aims are met. The question of a social/sexual relationships policy was discussed with the deputy manager and it may be helpful to review the need for one after discussing the matter with the Community Learning Disability Team and or obtaining a copy of the local authorities policy (Gloucestershire County Council). There was evidence that specific risk assessments had been considered and if possible, the risks reduced by the joint efforts of staff and residents. The home encourages responsible risk taking and ensures that residents have sufficient information on which they can base their decisions. Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is making great efforts to ensure that residents have a lifestyle that is safe, stimulating and comfortable and one that is chosen by them. EVIDENCE: A number of residents attend a local church and as well as the religious services the church also provides a number of social activities which residents told the inspector they enjoyed. The outbuildings have been adapted and residents are now able to take part in various craft activities. One resident was pleased to show the inspector some finished ceramic work. The home has provided bicycles for residents who had expressed an interest they also provided some staff with bicycles as well and this has meant that staff and residents can take part in the rides. Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 12 In view of the main road the home has decided that all cycling will be restricted to what it considers to be safe areas. Some of the residents told the inspector that they were able to do things they enjoyed and this included activities in the Community. They also said that they were supported in different ways to take account of their abilities and individual wishes. The kitchen was clean with plenty of food available. The home has a three-week menu and residents are encouraged to tell staff what they like at the residents meetings. Breakfast and lunch consists of a variety of options and whilst the main evening meal is set, staff would prepare an alternative if requested. Each care plan included the likes and dislikes of the individual. On the first visit there was a birthday party and staff had made great efforts to provide a pleasant meal for the residents and relatives. Where family relationships are seen as important the home encourages and supports contact and relatives who were spoken to said that “staff are easy to contact” and that “they were always available at short notice”. Other comments included in the completed surveys were “in constant touch with the home and regular meetings to discuss any problems” “the home is very caring” and “there is good communication between us and the home”. One comment however asked for better communication and more information about planning. It is therefore recommended that all relatives are contacted to discuss the questions raised. It is appreciated that the question of sharing information is one that must be carefully considered and made after discussions with other interested health care professionals. It is also suggested that all relatives have a copy of the homes Statement of Purpose and Service Users guide. (it is appreciated that this has been done before). Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 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. 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. Staff provide adequate support and information in respect of health care, which ensures all residents can have access to all of the services in the community. EVIDENCE: The home respects the wishes of the individual and they were seen to be supported in a personal manner, and one, which provided dignity and respect. There is a record of the healthcare received and the local Community Learning Disability Team is often consulted over health care issues. At the time of the inspection a resident was receiving counselling from a visiting psychologist from the team. With staff support all residents were receiving appropriate health care from health care professionals. The home manages all medication and there was a record of the receipt, administration and disposal of all medicines. The medicines are reviewed annually and where appropriate a review is undertaken by the consultant psychiatrist. Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 14 A number of staff have received medication training. In view of the number of courses and the different types it is essential that the staff who administer medicines are competent to do so. The inspector discussed accredited training with the acting manager although it must be appreciated that this may not be the only route towards competency. Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 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. 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. Residents live in a home, which ís staffed by competent carers and they are safeguarded from abuse. EVIDENCE: Residents are able to give their views to staff and the residents meetings provide an opportunity for comment and or criticism. The inspector also noted how staff and residents discussed matters, which affected resident’s day-today lives, the staff were seen as patient giving as much time as was required. The residents /relatives surveys of the home are another way of knowing how the service is seen by others who have an interest. One resident has an external independent advocate and the acting manager was aware of the implications of the Mental Capacity Act 2005 and the responsibility the home had when assessing the capacity of the residents. There had not been any complaints since the last inspection. The inspector was given a copy of the resident’s complaint procedure. It provides a written procedure, which is supported by appropriate pictures to assist residents in their understanding. It also provides information about the Commission for Social Care, and the Local Authority who are responsible for the resident. Staff had received training in respect of the identification of abuse and were aware of the need to keep up with any changes which may affect their procedures. The staff spoken to were clear about the many aspects of abuse and were anxious to provide an environment where residents are protected from any Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 16 form of abuse. Staff were seen to treat residents in a dignified manner providing privacy if appropriate. Beeches (The) (Seven Kings) DS0000065788.V350081.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 excellent. This judgement has been made using available evidence including a visit to this service. The home provides a pleasant and comfortable physical environment and has been maintained to a high standard. EVIDENCE: The home was clean and odour free and a number of staff had recently attended infection control training. All of the communal accommodation and four of the bedrooms were seen. The home was in good decorative order and furnished with comfortable and domestic furniture. The bedrooms, four of which are ensuite, reflected the interests of the residents and it was clear that staff and residents had worked hard to personalise each bedroom. A number of the residents showed their rooms to the inspector and they were pleased to be able to show the results of their efforts. Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 18 The grounds are extensive and include craft rooms, and fields, which have pigs and a horse. Beeches (The) (Seven Kings) DS0000065788.V350081.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 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home takes care over recruitment and ensures staff are suitably trained. The care staff were seen as competent, and good listeners and communicators. EVIDENCE: A number of the care staff were seen individually during the visits. They had a good knowledge of the residents and the direct evidence of the exchanges between them and residents during the inspection clearly indicated that they had a good relationship. They were supporting the residents and helping them to determine lifestyles in an environment, which provided safety and security. Comments from the staff survey included “the home provides a good service” and staff “always respects the views of the residents and “we always try to resolve issues and help the residents”. The records in respect of the most recently appointed carer were seen and the home was meeting the requirements in respect of the necessary checks. The inspector discussed the recruitment procedure with the acting manager and it was evident that care and time is taken when staff join the home. Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 20 The inspector spoke to the acting manager about a number of changes in the Regulations. The changes referred to new appointments and specifically the additional safeguards where the prospective employee has worked with vulnerable children/adults. The information required before any appointment are contained in Schedule 2 (Regulations 7,9 and 19) The process of recruitment included a number of visits to the home by the prospective carer. This allows other staff, and as important residents to see the person and comment to staff on how they feel about that person coming to work in the home. Many of the staff seen had or were undertaking training and it was clear they had an interest in learning and were keen to attend courses. The provider has encouraged and enabled staff to attend courses and all staff have to attend courses that the home feels are essential e.g. fire, health and safety, food hygiene, and protection of the vulnerable adult. The residents told the inspector that staff were patient and caring and took took time to listen and communicate. The evidence of this was clearly seen during the inspection when staff were seen to take considerable time in listening to and responding to requests from the residents. A copy of the staff rota was given to the Inspector. Rotas should be clearly dated and include the duties of all staff to include the acting/registered manager. The home is committed to giving attention to the recruitment, training and development of staff. Beeches (The) (Seven Kings) DS0000065788.V350081.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): 37.39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The acting manager is making great efforts to provide an environment where the needs and wishes of the residents are paramount. The home is ensuring quality of their services by regular surveys addressed to relatives and residents EVIDENCE: The Registered Manager left the home earlier this year and the position is vacant. The inspector spoke to one of the providers and was informed that an application would be submitted to Central Registration Team in Taunton. The application will refer to a proposal to appoint the deputy manager of the home to the position of Registered Manager. The application should be sent to Central Registration Team, CSCI, Tangier, Castle Street, Taunton, TAI HAL Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 22 The deputy manager is managing the home at present and was seen as a competent person who whilst needing some training in certain areas was seen as having the necessary skills. She is supported by the providers and other employees who assist in the recruitment and the management of finances. After speaking to staff and residents the Inspector felt that the home was well run and organised. Regulation 26 visits to the home are now being undertaken by someone employed by the home but who is not providing direct care. The acting manager confirmed that copies of the reports would be sent to the Commission. The risk assessment of the building has been completed and there is a record of the fire practices and of the inspection of fire activation points. Beeches (The) (Seven Kings) DS0000065788.V350081.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 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 3 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 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 3 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 Beeches (The) (Seven Kings) DS0000065788.V350081.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Regional Office 4th Floor Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Beeches (The) (Seven Kings) DS0000065788.V350081.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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