Inspection on 24/08/05 for Tidings

This inspection was carried out on 24th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 1 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 20/02/06

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 Unannounced 24 August 2005 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 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 Stationary 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 D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tidings Address 1 Irnham Road Minehead Somerset TA24 5UD 01643 702831 Telephone number Fax number Email 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 1. People with mental disorders. registration, with number of places 2. People with learning disabilities. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 6 persons in categories MD and LD. Date of last inspection 31 January 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 D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection was conducted at 09.15 am. The service users had, had breakfast. Some other service users were relaxing in the lounge and dining room. This gave a very relaxed atmosphere to the home. The Inspector met with the Registered Provider and Registered Manager throughout the inspection and would like to thank the service users and staff for their involvement and time in the inspection process. The Inspector spoke to four service users. All service users stated that they were very happy living at Tidings and the feedback received was very positive. The Inspector also viewed care and support plans and records relating to health and safety. There were not requirements or recommendations made at the last inspection. As a result of this inspection the home had one requirement and five recommendations. What the service does well: What has improved since the last inspection? Since the last inspection the home have received planning permission to install replacement windows and these have now been installed. There were no requirements or recommendations at the last inspection. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 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. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 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 standard(s) These standards were not assessed, as there have not been any new admissions since the last Inspection. EVIDENCE: Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 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 standard(s) 6 7 9 10 The home maintains detailed care plans. The Registered Provider and Registered Manager advised the Inspector that the care plan format is under review. Risk assessments are conducted where needed and reviewed on a regular basis. The home promotes confidential. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 10 EVIDENCE: The Inspector viewed two care plans. The care plans are reviewed by the home on a monthly basis. Formal reviews take place at least annually. The care plans examined contained detailed information regarding the individual’s assessed needs and clear strategies identified for staff to follow. Strategies included the approach staff should take in relation to the management of epilepsy. Comprehensive information was also seen relating to the service user’s health needs. The Inspector recommends that the protocol for the management of one person’s epilepsy be sent to the person’s GP for updating of the agreed protocol. The Inspector was advised that the home is reviewing the format of the care plans. Draft care plans are currently being devised. The Inspector recommends that where possible service users are fully involved in the reviewing of their care plan and sign their plan if able to do so. Service users are encouraged to make decisions regarding day-to-day activities any restrictions are identified and risk assessments completed. Risk assessments had been reviewed. All records pertaining to service users are appropriately stored in a locked area. Service users have access to their personal files if requested. The home has a policy relating to confidentiality. Staff are made aware of this during induction and supervision sessions. Access to records is in accordance with the Data Protection Act 1998. Policies and procedures are available to service users, relatives and other interested stakeholders if requested. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 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 standard(s) 13 14 16 17 Service users are encouraged to access all local facilities and to pursue their personal interests. Service users are involved in activities of their own choice and are encouraged to experience new opportunities. Meal times are flexible and service users choose their meals on a day-to-day basis. EVIDENCE: The Inspector spoke to three service users at the time of the Inspection. All service users confirmed that they access local resources including shops, post office, pub, cafes and chemist. All service users are registered to vote. The home encourages and supports service users to pursue their own hobbies and interests. One service user commented that they have had a wonderful holiday on a cruise a few months ago. At the time of the Inspection the inspector noted that service users were watching morning television and occupying themselves with their personal interests. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 12 Service users are given support in cooking tasks as per assessed need. Daily routines are flexible to meet the needs and wishes of service users. The inspector noted staff consulting with service users on what they wished to do that morning, including the activities both in and out of the home. One service user commented that they are offered many activities and chose what they wanted to do. It was evident that service users were very relaxed and comfortable within the home. Staff were observed communicating with the service users in a respectful manner. The service users have total access to the home. All bedrooms have locks fitted but all service users choose not to lock their doors. Meal times are flexible and relaxed. The home does not have set menus. Service users are involved in the shopping for the home at local supermarkets and shops. Service users can choose where they eat but prefer eating together in the dining room. Fresh fruit and vegetables are available. At the time of the Inspection one service user was assisting in making the desert for the evening meal. Nutritional needs are assessed and regularly reviewed. Evidence of this was available in individual care plans and the inspector spoke to one service user who has specific dietary needs. The service user commented that these needs are catered for. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 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 standard(s) 18 19 20 The home ensures that service users personal support needs and preferences are identified in individual care plans. Service users have access to all appropriate health care professionals. The home should ensure that steps are taken to ensure that the home maintains good records in relation to the administration of medicines. EVIDENCE: Care plans viewed contained strategies and guidance that staff should take in relation to the management of epilepsy and the manner in which service users should be supported in moving and handling. The Inspector recommends that the risk assessment for the moving and handling needs of one service user be reviewed. The personal care needs of one service user are being reviewed on a regular basis. The Inspector spoke to this service user who commented that they felt their personal care needs are being met. The care and support plans that were viewed contained documentation of the visits made to health care professionals. These included visits to the GP, dentist, chiropodist and optician. Records are kept of all visits and consultations. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 14 The home uses Boots Nomad System. Medicines are individually administered directly from the “cassette”. Service users have regular medicine reviews. The Inspector viewed records relating to the administration of medicines. The Inspector advised that the home should ensure that two staff signatures support all hand transcribed medicines. There are no controlled drugs at the home. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 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 standard(s) 22 23 The home has a detailed complaints procedure and there are policies and procedures in place to safeguard vulnerable service users. EVIDENCE: The home has a complaints procedure. They have not received any complaints since the last inspection. The home has a whistle blowing policy. This policy is discussed at induction and regular supervision sessions. The use of advocates is encouraged and is currently being utilised by one service user. The home liaises closely with other professionals involved in the care and support of the service users. The home is in the process of staff recruitment. There have been no new recruitments since the last inspection. The home is aware of protocols in relation to POVA first checks. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 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 standard(s) 24 25 28 29 30 The Inspector did not view all areas of the home. Tiding is homely and comfortable. The shared space is well maintained and is fully accessible to all service users. On the day of the inspection the home was clean and tidy. EVIDENCE: Tiding is run as a family type environment. The communal areas are very well presented. There is a very homely lounge and dining room. Service users commented that it is very homely and that they love living at the home. Since the last inspection the home has replaced all windows following planning permission. The exterior of the home is due to be re-rendered in some areas in the near future. The Inspector did not view all bedroom areas at the time of the inspection. However, all bedrooms are of single occupancy and have wash hand basins. The service users spoken to stated that they were very happy with their bedrooms. The shared bathroom and toilet facilities were well presented and have specialist equipment where needed. There are still plans to provide further bathing/showering facilities. The Inspector will follow this up at the Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 17 next inspection. Tidings is not appropriate for people with a physical disability. One service user requires the provision of a wheelchair for long distances outside of the home. A physiotherapy assessment has been completed and the necessary equipment provided. On the day of the inspection the home was clean and tidy. The home has polices and procedures relating to COSHH and Infection control. The laundry is situated off the covered yard that is accessed through the kitchen. Due to the nature of the home and the service users, this is not currently felt to infringe on health & safety or infection control requirements. However, this situation must be kept under review. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 On the day of the inspection the home appeared adequately staffed to meet the needs of the service users. Recommendations were made in relation to the staffing rota. As there have not been any new staff appointments at the home since the last inspection the inspector did not view any recruitment records. EVIDENCE: The home has two care staff on duty at all times and one person sleeping in. There is an emergency on-call rota. Staffing levels are adjusted where needed to ensure that evening and weekend activities take place. The service users confirmed that there are two staff on duty. As previously stated the Registered Provider owns the home. The Registered Provider spends a great deal of time at the home and also works as part of the team. Some of the staff team at Tidings also provide support to a service user under Supporting People. The Inspector recommended that the staff rota be amended to distinguish the hours that are provided to this person so as to easily demonstrate the staffing hours at the home. The Inspector had detailed conversations in relation to staffing levels at the home. The home is in the process of advertising and recruiting more staff to Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 19 the team. The inspector recommended that the Registered Manager devised the staffing levels using the Residential Staffing Forum. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 42 The home seeks the views of the service users on all day-to-day matters. The home strives to promote all matters relating to health and safety. However, the home must ensure that fire safety is further promoted as detailed below. EVIDENCE: Service user meetings are held on an informal basis, which appears to work well for the home. Formal minutes are not recorded though any concerns/views raised at the meetings, are recorded in the individual’s plan of care. The service users that the inspector spoke to confirmed house meetings take place and that they feel listened to. Weekly fire checks are conducted. The emergency lighting system is checked monthly. Regular fire drills are conducted for staff and service users. The Inspector was not able to view documentation in relation to the annual service of the fire alarm system and fire equipment. The Inspector was advised that Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 21 this had been undertaken. The home must send copies of these to the Commission for Social Care and Inspection. Fire doors must not be wedged open. At the time of the Inspection records relating to fire training for all staff could not be seen. The Responsible Individual advised that all staff have received regular training. Records are kept of all accidents that occur at the home. The bath hot water outlet has been fitted with a thermostatic valve. Checks on the temperature are recorded weekly. The inspector did not review records relating to this. It was noted that at the last inspection the home’s electrical hardwiring was checked in December 04 and Portable electrical appliances were tested on the 18/10/04 & 08/11/04. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x 3 3 3 Standard No 11 12 13 14 15 16 17 x x 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tidings Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 1 x D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 23 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 YA42 Regulation 23 (4) c Requirement The home must ensure that adequate arrangements are in place for containing fires and the testing and maintenance of the fire equipment. Timescale for action 12.09.05 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. Refer to Standard YA6 YA6 YA18 YA20 YA33 Good Practice Recommendations The protocol for the management of one service users epilepsy should be forwarded to their GP for confirmation. Service users should be involved in the reviewing of their care plans and sign their care plan if able to do so. The Registered Manager should review the risk assessment for the moving and handling needs of one service user. The Regsitered Manager should ensure that all hand transcribed medicines are supported by two staff signatures. The Inspector recommended that the staff rota should be amended to distinguish the hours that are provided at Tidings and to the person under Supporting People. Tidings D53_D02 S16190 Tidings V234873 240805 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier, 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. 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