Inspection on 14/06/07 for Tidings

This inspection was carried out on 14th 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 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

Tidings 02/08/06

Tidings 20/02/06

Tidings 24/08/05

Tidings 31/01/05

Tidings 24/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

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

CARE HOME ADULTS 18-65 Tidings 1 Irnham Road Minehead Somerset TA24 5UD Lead Inspector Jane Poole Unannounced Inspection 14th June 2007 10:30 Tidings DS0000016190.V337104.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 Tidings DS0000016190.V337104.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. Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tidings Address 1 Irnham Road Minehead Somerset TA24 5UD 01643 702831 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 EILEEN ISABEL WAIN MRS EMMA LOUISE BRYANS MRS EMMA LOUISE BRYANS Care Home 8 Category(ies) of Learning disability (8), Mental disorder, registration, with number excluding learning disability or dementia (8) of places Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for 8 persons in categories MD & LD. One named service user, over the age of 65 to reside, as detailed in application dated 15 March 2006 2nd August 2006 Date of last inspection Brief Description of the Service: Tidings is located in the seaside town of Minehead. The property is located very near to the town centre and is in walking distance to the sea front. Tidings is registered with The Commission for Social Care Inspection to provide personal care for up to 8 people with a learning disability or mental health problems. The home is not registered to provide nursing care. Accommodation is arranged over two floors and mezzanine landing. Communal areas include 2 lounges and a dining room; all bedrooms are for single occupancy and have been fitted with a wash hand basin. Tidings is a family owned and run business. The Registered Providers are Mrs Eileen Wain and Mrs Emma Bryans. The Registered Manager is Mrs Emma Bryans. Fees at the home are dependant on the assessed needs of the service user. Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector over a six hour period. The inspector was able to meet with staff and service users, tour the building and observe care practices. All records requested were made available and the home completed an Annual Quality Assurance Assessment prior to the inspection. What the service does well: What has improved since the last inspection? Since the last inspection the home has registered an additional two rooms and created a second lounge area. The new rooms are on the ground floor making them suitable for people with mobility difficulties. There are assisted bathing facilities on the ground floor. The home continues to encourage service users to take more responsibility for their personal finances and have simplified their recording system in line with this. Individual training needs for staff have been identified and 3 more staff have now begun National Vocational Qualification training. Tidings DS0000016190.V337104.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. Tidings DS0000016190.V337104.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 Tidings DS0000016190.V337104.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, 3 & 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are able to spend time in the home before deciding to move in on a permanent basis. Full assessments are obtained by the home to ensure that they are able to meet the needs and expectations of prospective service users. EVIDENCE: Since the last inspection two new service users have moved into the home. The inspector was able to speak with one of the newest service users. They had been able to integrate into the home over a period of time. The service user stated that they had initially visited then had been able to have overnight stays. This gave the service user opportunities to meet with staff and existing service users before deciding to make Tidings their home. It was apparent that the home not only considers the needs of prospective service users but also the views of the other service users. Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 9 A full assessment of need had been obtained by the home before the service user was admitted and the home has already begun to link with relevant professionals in the area for advice and support. The inspector saw minutes of a staff meeting that showed that the new service user and their needs had been fully discussed giving the staff as much information as possible. Tidings DS0000016190.V337104.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, 8 & 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are involved in the running of the home and their views are sought as part of day to day life. Service users are able to make choices about their lives and risk assessments are in place where appropriate. EVIDENCE: The inspector viewed the care plans of two service users living at the home. Care plans covered areas such as personal care, behaviour, emotions and communication. Care plans were written from a positive viewpoint and emphasised the abilities and strengths of the individual whilst giving clear guidelines for staff about the assistance required. It was apparent that service users were involved in their care plans and their likes and preferences were recorded. Daily records are written and each month a summary is written. Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 11 Service users spoken to stated that they often discussed care plans at residents meetings and that they sat down with their keyworker every month to discuss any changes or amendments. All service users spoken to felt fully involved in the running of the home and decision making. People said that, in addition to formal residents meetings, they sat down with staff each morning to decide what they wished to do each day. The inspector observed throughout the day that service users were included in decision making and were offered choices about all aspects of their care. Service users manage their own finances with assistance from staff if required. Service users are encouraged to maintain and develop their independence and risk assessments are in place where appropriate. For example the home has worked with individuals to enable them to fulfil goals such as accessing community facilities without staff assistance. Tidings DS0000016190.V337104.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): 11, 12, 13, 14, 15, 16 & 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users have ample opportunities to access community facilities and are assisted to attend college and find work outside the home. Mealtimes in the home are a pleasant sociable occasion. Service users are free to choose how they spend their time. EVIDENCE: Service users are assisted to learn and develop independent living skills and take part in day to day tasks around the home. Responsibilities around the house are dependent on individuals abilities and wishes. Service users take part in shopping and therefore make decisions about the food coming into the home. Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 13 People are also encouraged to find work outside the home, one person works in a charity shop and another does some gardening work outside the home. On the day the inspection one service user had been to work in the morning and came home for lunch. People stated that they are able to have visitors at anytime. One person is an active church member and was arranging for the vicar to come round for tea. Everyone spoken to stated that there are numerous opportunities to go out. Some people attend day centre activities on a regular basis and some attend local college courses. The home is ideally located to take advantage of the local facilities such as shops, pubs and cinema. For trips further afield the home has a vehicle. All service users were very happy with the opportunities for social and education activities. People spoken to stated that they are free to choose how they spend their time and are able to access community facilities. During the inspection one person went out to a local hairdressers and another went to visit a family member with staff assistance. Staff in the home assist service users to keep in touch with family and friends. Service users stated that they are able to spend time in communal areas or in the privacy of their rooms. There is an annual holiday for everyone with staff from the home and some service users also have to chance to have holidays with family or friends. The inspector was invited to have lunch with staff and service users. This was a very relaxed event and provided another opportunity for service users to discuss any issues with staff. The main meal of the day is in the evening when everyone is at home. Lunch is a lighter snack meal for those who are in. Service users stated that there is no set menu but food for the day is usually discussed in the morning meaning that everyone gets a chance to make choices. Service users felt that they generally ate a healthy diet but enjoyed the occasional treats of ordering a take away or going out to eat. Staff stated that there are no restrictions on purchasing food and there was an adequate budget. The inspector noted that store cupboards were well stocked with good quality produce. Throughout the day there was constant interaction between staff and service users. Tidings DS0000016190.V337104.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 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that service users have access to healthcare specialists appropriate to their individual needs. The privacy and dignity of service users is respected. EVIDENCE: Care plans give details of the level of assistance that service users require with personal care. Service users stated that they felt that their privacy was respected and that staff assisted them with personal care in a sensitive and respectful manner. The home employs male and female staff, which gives service users a choice about the gender of the person that assists with intimate care. Service users are registered with local healthcare professionals according to their needs and wishes. All appointments are recorded and these show that people are accessing doctors, dentists, psychologists, chiropodists, opticians and speech and language therapists. Referrals to specialists are made on an Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 15 individual basis and assistance is provided to attend appointments outside the home. The deputy gave evidence that the home liaises with healthcare professionals to ensure that service users have access to specialists when needed. There is a key worker system in the home to ensure consistency of care. All service users spoken to were aware of who their key worker was. No service users currently living at the home administers their own medication although there is a policy in place to guide staff if any service user wished to do so. The home uses the Nomad Monitored Dosage System for medication. Service users medication is kept in individual secure lockers. The inspector viewed the Medication Administration Records (MARs) and found them to be correctly signed when received into the home and administered to service users. Each service user has a list of homely remedies signed by their General Practitioner. Tidings DS0000016190.V337104.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 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Reasonable steps have been taken to minimise the risk of abuse to service users. All concerns are listened to and acted upon. EVIDENCE: The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing. Staff receive copies of these in their handbook when they begin work. No complaints have been made to the home or the CSCI since the last inspection. Service users stated that staff are approachable and that they would be comfortable to raise any concerns. One service users said that one of the good things about the home was that if you did raise an issue “one of the managers always comes back to you to tell you what they have done and to make sure that you are happy.” There is a very open and relaxed atmosphere in the home that enables service users to discuss issues with staff at any time. The nature of the home means Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 17 that, any changes in behaviour or mood, which may be indicative of a problem, would be quickly noticed and addressed. All staff are checked against the Protection Of Vulnerable Adults (POVA) register and undergo an enhanced Criminal Records Bureau (CRB) before they commence work in the home. Tidings DS0000016190.V337104.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tidings provides a comfortable home for service users. All areas are decorated and furnished to a high standard in line with choices made by service users. EVIDENCE: Tidings is a large older style building that is situated in the seaside town of Minehead. The main shopping area of the town and the sea front is within walking distance. Since the last inspection the home has increased the number of service users it is able to accommodate from 6 to 8. There are now three bedrooms on the ground floor, which are suitable for service users with poor mobility. The other 5 bedrooms are on the first floor and can only be accessed by stairs. A further two bedrooms and a bathroom are being created on the top floor of the house. Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 19 The bathroom on the ground floor has been fitted with mobility aids to encourage service users to maintain their independence. An additional lounge on the ground floor has been created which provides service users with a quiet space away from the main lounge. Pre inspection information received states that there are plans to install a computer into the new lounge for service users to use. Service users are able to personalise their bedrooms, which makes rooms very individual and homely. As identified at previous inspections, there is no laundry at the home. The only washing machine is located in a store cupboard in the yard. There are handwashing facilities and it meets the current needs of the home but should be kept under review as the number of service users increases. On the day of this inspection all areas seen by the inspector were well maintained and furnished in line with domestic living. All parts of the home were clean and fresh. Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 20 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): 31, 32, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are confident in their roles and demonstrate a good knowledge of the needs of the service user group. EVIDENCE: The home employs 8 care staff, 2 have a National Vocational Qualification (NVQ) at level 2 or above and a further three people are working towards the award. (Figures taken from pre inspection information) One new member of staff has been employed since the last inspection. The inspector saw evidence of a thorough recruitment process and all required information, including written references and Criminal Records Bureau check had been obtained prior to them starting work. Staff turnover in the home is very low and no staff have left in the past 12 months. Since the last inspection individual training needs have been identified and appropriate courses attended. All staff have received training in fire safety, Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 21 manual handling, first aid and food hygiene. There is an induction programme in line with the skills for care common induction standards. It is strongly recommended that the home arrange training for all staff on the implications of The Mental Capacity Act 2005. Service users spoken to were extremely complimentary about the staff who worked in the home and more than one person said that it was like being in a big family. Staff spoken to were confident and well motivated. People thought that there were adequate training opportunities and adequate staffing. During the day there is a minimum of two staff on duty and overnight there are two sleep in staff. Additional staffing is provided when required. Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 22 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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in line with the views of service users and other interested parties. Appropriate steps have been taken to provide a safe environment for service users. EVIDENCE: The registered manager is Emma Bryans however on a day to day basis the home is run by the deputy manager Hannah Wain who was available throughout this inspection. There are plans for Hannah to apply to the Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection to take over the registered manager position and responsibility. Currently no member of the management team has a qualification in care or management at NVQ level 4. The management team work alongside other staff in the home to create a family type atmosphere and promote good practice. Staff and service users felt that the management was extremely open and approachable. There are regular staff and service user meetings which are a formal opportunity to share views and ideas. The home regularly sends out questionnaires to service users and interested parties to audit the quality of care provided by the home. The inspector viewed the most recently returned responses and found them to be very positive. The home has an improvement plan in place that focuses on the building and facilities. The home has systems in place to maintain health and safety in the home. A fire detection system is fitted and records show that this is tested on a regular basis. The building is well maintained; electrical installation, gas and portable electrical appliances are checked on an annual basis. All accidents are recorded. Certificates of insurance and registration are displayed in the office. Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 24 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 3 4 4 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 3 27 x 28 3 29 x 30 2 STAFFING Standard No Score 31 x 32 2 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 4 4 3 x LIFESTYLES Standard No Score 11 3 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 3 3 x x 3 x Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 25 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. 1. Refer to Standard YA30 Good Practice Recommendations The registered person should keep the laundry facilities under review to ensure that they continue to meet the needs of the service users. 50 of care staff should hold a National Vocational Qualification in care at level 2 or above. All staff should receive training on the implications of the Mental Capacity Act 2005. 2. 3 YA32 YA32 Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Tidings DS0000016190.V337104.R01.S.doc Version 5.2 Page 27 - 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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