Inspection on 20/02/06 for Tidings

This inspection was carried out on 20th February 2006.

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tidings 14/06/07

Tidings 02/08/06

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 David Kidner Announced Inspection 20th February 2006 09:30 Tidings DS0000016190.V277867.R01.S.doc Version 5.1 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.V277867.R01.S.doc Version 5.1 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.V277867.R01.S.doc Version 5.1 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 6 Category(ies) of Learning disability (0), Mental disorder, registration, with number excluding learning disability or dementia (0) of places Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. REGISTERED FOR 6 PERSONS IN CATEGORIES MD AND LD. Date of last inspection 24th August 2005 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 6 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 a lounge and dining room; all bedrooms are for single occupancy and have been fitted with a wash hand basin. Tidings would not be suitable for people with mobility problems. 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. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The previous inspection was unannounced and took place on 24 August 2005. Two inspectors carried out this announced inspection (16 inspection hours) on 20 February 2006. Tidings provides a homely, family type environment for the people who live at the home. All areas are decorated to a good standard with comfortable furnishings. Four service users were living in the home. The inspectors spoke to three of the service users who were relaxing in the lounge. All service users commented that they are very happy living at Tidings. Two relatives comment cards were received. The inspectors spoke with the parents of one service user. These complimented the home and confirmed that relatives were very happy with the care provided. A comment card was also received from the GP. Eileen Wain, the Registered Provider was available throughout the inspection. Staff were very welcoming and were observed being kind and caring towards service users. The inspectors viewed the home and sampled records including care plans, medication and health records, recruitment, health and safety records, and staff training. The inspectors would like to thank the service users and staff for their involvement and participation in the inspection process. As a result of this inspection the home has four requirements and seven recommendations. What the service does well: Service users are very happy and enjoy living at Tidings. Service users’ families confirmed that they are happy with the care and support provided. Tidings provides a comfortable and homely environment for the service users living at the home. The home’s care plans are detailed and provide the necessary information to enable staff to support service users. Service users are offered a range of activities and opportunities. The home’s recruitment procedure is robust and protects service users from risk of harm. The home strives to maintain a safe environment for service users. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 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.V277867.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not assessed, as there have not been any admissions to the home since October 2003. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 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): 6,7,9,10 Care plans are detailed and comprehensive. Risk assessments are completed for individual service users. The home promotes confidentiality. EVIDENCE: The inspectors viewed two care plans. The care plans were comprehensive and detailed and provided clear information on how to meet service user’s healthcare needs. The home is planning to provide care plans in audio format on a cassette for service users. This is good practice. Care plans are reviewed regularly and contained a monthly summary that detailed professional visits. Service users are encouraged to make decisions, wherever possible. Individual service user risk assessments were available relating to radiators, windows, wardrobe, wash hand basin and mobility. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 10 All service users have individual bank accounts. The providers stated that benefits are paid directly into the account. The home keeps individual money tins for service users. Paperwork was available to record transactions. The inspectors recommended that a running balance should be maintained and two staff signatures obtained if possible to promote security. The home has policies and procedures relating to confidentiality. Access to records is in accordance with the Data Protection Act 1998. Staff spoken with were aware of issues of confidentiality. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 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): 11, 12, 13, 14, 15, 16, 17 Service users benefit from activities and opportunities within the home and in the community. The home encourages service users to maintain contact with family. Service users have choice in what they would like to eat on a daily basis. EVIDENCE: The inspectors spoke with three service users who were relaxing in the lounge before going out. All service users confirmed that they are able to access local amenities including shops, banks, cafes, and pub. The home consults service users to find out their preferences regarding activities and outings. One service user commented that they had enjoyed a recent visit to the theatre. Activities are recorded in service user’s care plans. The inspectors suggested that the home could record activities separately to Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 12 provide a clear record and to demonstrate the commitment and importance the home places on activities. Service users are encouraged to pursue interests outside of the home. One service user is attending college. Another service user attends the Seahorse Centre on a regular basis. The inspectors received comments cards from family and spoke with one service user’s family. The families confirmed that their relatives are very happy at Tidings. Families commented that service users are offered choice, asked their opinions and their privacy and dignity is respected. The service users have access to a phone to maintain contact with family and friends. Families commented that the staff make them feel very welcome when they visit. Staff were observed communicating with service users in a kind, friendly and respectful manner. The home does not have set menus. The choice of food is agreed on the day and recorded. Service users confirmed that they are involved in this process and able to make choices. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 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, 20 The home identifies service users support needs and preferences in individual care plans. Service users are able to access health care professionals. The home generally keeps good records relating to the administration of medicines. EVIDENCE: The care plans provide detailed information of service user’s care and support needs. They contain documentation relating to visits made to professionals including the social worker, GP and optician. Service users living at the home have choice in how they dress and how they wish to spend their time. The home uses a Nomad system. Medicines are administered individually from a cassette. Each service user has a named locker for safe storage of medicines. All records were signed and variable doses were stated. The home must ensure that maximum doses are stated. The inspector recommended that the home uses the coding system on the MAR Sheets. Each service user has a Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 14 list of homely remedies that has been agreed and signed by the GP. Individual records are kept relating to medicines that are returned to the pharmacy. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 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, 23 The home has a detailed complaints policy. The home has procedures to protect service users from harm. EVIDENCE: The home has a complaints policy. They have not received any complaints since the last inspection. The complaint policy must contain contact addresses and telephone numbers. The home has a whistleblowing policy. This policy is discussed as part of induction and training. The whistleblowing policy should contain contact addresses and telephone numbers. The home has recruited new staff since the last inspection. Their files contained enhanced Criminal Record Bureau disclosures. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 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): 24, 25, 27, 30 The Tidings provides a homely and comfortable environment for service users. Service user’s bedrooms are well decorated and personalised. EVIDENCE: The Tidings provides a homely, family type environment for the people who live at the home. All areas are decorated to a good standard with comfortable furnishings. The service users spoken with confirmed that they love their home. There are plans to commence work on the outside rendering and repairs to the roof within the next month. Service users bedrooms are well decorated, homely and personalised. Service users have shared bathrooms. These were clean and well presented. The home is clean and hygienic throughout. COSHH records were viewed and infection control measures were in place. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 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): 32, 33, 34, 35 There appeared to be sufficient staff on duty during the inspection. Staff are aware of service user’s needs and receive regular training. The home’s recruitment procedures protect service users. EVIDENCE: The home has two staff on duty during the day and one person sleeping in. Rotas are adjusted according to service user’s needs. The home is currently reviewing staffing to provide more support in the evening. Staff have a good awareness of service user’s needs. The responsible individual confirmed that she has NVQ 3 in care. One member of the care team has NVQ 2 in care. Two other members of the care team are to be enrolled to undertake NVQ 2 in care. The home has an employee handbook that is comprehensive and clear. Each member of staff has an individual training file. The home keeps an overview of training. Fire training records are up to date. The inspectors recommended that the home ensures that staff sign to confirm they have received training. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 18 The home has robust recruitment procedures. The new staff files contained all the appropriate paperwork including references and enhanced CRB disclosures. A health screening questionnaire should be obtained for one member of staff. The interview assessment paperwork contains good detail about the applicants. Due to the service the Tidings provides, staff meetings are held on a two monthly basis. Detailed minutes of these meetings were available. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 19 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): 37, 39, 40, 42 The home is well run and managed. The home seeks the views of service users informally. The home has policies and procedures to safeguard service users. The home keeps good health and safety records that promote a safe environment for service users. EVIDENCE: The home is well run and managed. The Responsible Individual has NVQ3 in Care and works very hands on within the home. The Registered Manager has enrolled on the Registered Managers Award and the Deputy Manager plans to undertake the award. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 20 The home had told service users, relatives and professionals about this planned inspection. Service users commented that the management and staff listen to their views. Service users participate in informal meetings within the home. It was suggested that one of the service users could write the agenda and minutes of the meeting. The inspectors recommended that this could be developed further with the use of surveys as part of the home’s quality assurance. The home must develop its quality assurance systems. The home reviewed its policies and procedures on 30.09.05. The inspectors recommended that staff should sign to confirm they have read the policies. An environmental risk assessment was completed in January 2006. These assessments provided good information. The inspector recommended that risk assessments should be dated. The new double glazed windows are restricted on the ground floor. The registered provider is currently arranging restrictors for the remaining windows. Windows that are not restricted need to be risk assessed for service users. The inspectors recommended that wardrobes should be fixed or a detailed risk assessment should be in place. The inspectors recommended that the cupboard housing the boiler in the kitchen should be locked. The home has introduced a fire log. The local fire brigade have written a detailed fire risk assessment for the home. The inspector recommends that the status of the fire exit in the first floor bedroom is confirmed with the fire brigade and included in this assessment. The annual fire service took place on 11.10.05. Extinguishers were serviced on 17.11.05. All staff have received fire training. Weekly fire checks and fire drills are conducted. The inspectors recommended that the time of the fire drill be recorded. Records for fridge and freezer temperatures were up to date. First aid boxes are checked monthly. Portable appliance testing was carried out on 24.10.05. The electric test was carried out on 05.07.04. A letter from British Gas confirmed that the gas safety was checked on 05.11.05. However the home had not been issued with a Landlord Gas Safety Certificate. The Employer’s Liability certificate was available. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 21 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 X 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 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 3 X 2 X Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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. 2. Standard YA20 YA22 Regulation 13(2) 22(7)(a) Requirement Timescale for action 17/03/06 3. YA39 24 The home must ensure that the maximum dose is stated for paracetamol on the MAR sheets. The complaints policy must 22/03/06 contain contact addresses and telephone numbers including the CSCI. The home must develop effective 07/09/06 quality assurance and quality monitoring systems. The following issues relating to health and safety must be addressed or detailed risk assessments must be completed. • First floor windows must be restricted. • Wardrobes must be fixed. • The cupboard housing the boiler must be locked. 07/04/06 4. YA42 13(4) Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 23 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. 2. 3. 4. 5. 6. 7. Refer to Standard YA7 YA20 YA23 YA34 YA35 YA42 YA42 Good Practice Recommendations A running balance of service users’ monies held by the home should be maintained and two signatures obtained wherever possible. The home should use the coding system on the MAR Sheets. The whistleblowing policy should contain contact addresses and telephone numbers of external organisations including CSCI. A health questionnaire should be obtained for one member of staff and included in the application form. The home should ensure that staff sign to confirm they have received training. Environmental risk assessments should be dated. The time of the fire drill should be recorded. The status of the fire exit in the first floor bedroom should be confirmed with the fire brigade and included in the fire risk assessment. Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Tidings DS0000016190.V277867.R01.S.doc Version 5.1 Page 25 - 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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