Inspection on 08/11/06 for Tikvah Tovah

This inspection was carried out on 8th November 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tikvah Tovah 05/11/08

Tikvah Tovah 28/12/05

Tikvah Tovah 01/06/05

Tikvah Tovah 13/12/04

Tikvah Tovah 05/06/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Tikvah Tovah Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ Lead Inspector Sandra Grainge Unannounced Inspection 8th November 2006 10:30 Tikvah Tovah DS0000011371.V318909.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 Tikvah Tovah DS0000011371.V318909.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. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tikvah Tovah Address Ravenswood Village Nine Mile Ride Crowthorne Berkshire RG45 6BQ 01344 755529 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) Tikvah@norwood.org.uk bucketsandspades@norwood.org.uk Norwood Ravenswood Ltd T/A Norwood Miss Danielle Baird Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28.12.05 Brief Description of the Service: Tikvah Tova is registered to provide support and care for five adults with learning disabilities. It is set in Ravenswood Village, which is a Jewish community. The village is situated near to Crowthorne; a controlled barrier protects the entrance drive. Tikvah Tova’s ethos is derived from the Jewish faith; belief, practice and values of Judaism underpin all aspects of residents lives. The home is a bungalow and each resident has their own bedroom, none of them have en-suite facilities. There is a spacious lounge area and a separate dining room. The many facilities of the village are available to all Service users. Tikvah Tova has its own vehicle and Service users have access to public transport. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key report contains information collected during an unannounced site visit to Tikvah Tovah made during a weekday by a locum inspector. Information held in the CSCI service file pre-informed the inspection, together with data provided by the Registered manager. In addition, prior to the visit, Service user views had been sought in a survey “Have your say”. Three forms were returned to CSCI; the comments were favourable and are included in the appropriate sections of this report. A barrier has recently been installed to protect the one entrance road into the village. The inspector gained entry by using the telephone provided at the barrier. The registered manager was in charge when the Inspector arrived. There is one empty place in the house; the inspector was able to meet and speak to the other four service users, two of whom are non-verbal but have the ability to understand and make their wishes known. All indicated that they are happy with the service that they receive. Care practice was observed; Service users related well to the staff and were pleased to be with them. No relatives visited the home during the visit. Records were inspected and the inspector spoke to the registered manager and care staff. What the service does well: What has improved since the last inspection? The staff team is established and morale is good. During the year the record keeping system has been standardised throughout the organisation. A sensory unit has been added to a bathroom to assist service users; several have autism and staff have monitored their behaviour patterns as part of a development and desensitising programme. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 6 New robust furniture has been provided throughout the home. There has been improvement of the quality of the food provided within the cultural guidelines and addressing the preferences of service users. There were no requirements following the last inspection and the only recommendation made has been adopted in that the complaint procedure has been reviewed and improved. 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. Tikvah Tovah DS0000011371.V318909.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 Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2,3, 4, and 5 Quality in this outcome area is good. There is evidence that detailed information about the service is given to prospective users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Norwood Ravenswood foundation has a Statement of Purpose and a Service users’ guide for Tikvah Tovah; this is also produced in a format that is easier for Service users to use. There is currently one vacancy in Tikvah Tovah; the registered manager explained the assessment process, including trial visits that take place prior to the offer and acceptance of a place in the house. Each Service user has an individual contract and statement of terms. Tikvah Tovah DS0000011371.V318909.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, 8, 9 and 10 Quality in this outcome area is excellent. Each service user has an individual up to date plan of care that gives detail of how the service will meet their assessed needs and include their individual choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The needs and aspirations of service users are recorded in care plans that are developed and explained to them by their keyworker. Service users are offered the opportunity to make decisions about their day-today lives and are consulted appropriately as the home specialises in the provision of care for individuals with autism. Each plan contains detail of needs, likes, dislikes, interests and the way they do and don’t like to be supported by staff. Individual requirements such as any risk assessment and safety arrangements are included; such as the strategy in place to protect each individual from self harm or harm to others. Details of each person’s communication method and behaviour pattern are included. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 10 Care plans are reviewed regularly and include the next of kin and a representative of the funding authority. Staff respect service users’ right to make decisions; as most are unable or unwilling to manage their own finances there is a system in place. This was illustrated by a service user’s reaction to the cash payment he earned for giving assistance in the village. He was not interested in the money and gave the envelope rapidly to his care worker for safe keeping and later treats. Record sheets are maintained for each service user, and receipts are retained for any expenditure, whether it is by the service user or on their behalf. There is a policy and procedure in place to allow Service users to participate in day-to-day activities and running of the home. Meetings are held and the statement of purpose is updated and developed with their participation. Risk assessments are made and appropriate plans made for safety. One Service user has frequent seizures; these have been monitored and she now wears a helmet at times when she is at risk of injury. Staff handle service user confidential information with respect. All records seen were up to date and in good order. Staff have worked hard to standardise the management of records throughout the organisation. Tikvah Tovah DS0000011371.V318909.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, 14, 15, 16, and 17 Quality in this outcome area is good. Service users enjoy their lifestyle in the home where they have opportunity to develop social, emotional, and independent living skills. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is evidence that staff respect the rights of service users; not only is this contained in the in the policies and procedures of the home, it is practiced by the staff. The organisation was founded to provide service users with care but also to encourage their development and participation with responsibility in aspects of their daily lives. The staff knock before entering individual bedrooms and were heard to explain events to service users and to give prompts to facilitate the Service users’ participation in daily life. There is continuing interaction between service users and staff throughout the day; though service users can choose to spend time alone if they wish. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 12 Service users are offered a healthy diet that is in accordance with the Jewish cultural beliefs, it also reflects their individual preferences; they clearly enjoy the meals. They are encouraged to be involved in food shopping and meal preparation as well as other household tasks; though the level of involvement varies. Several service users enjoy the education and training that is provided on site. Staff have made a plan to enable one person to attend by going through the back door to the college on his own and so avoiding his personal problem with the use of roads. Service users enjoy attending the on site synagogue on Saturdays; this includes those who are not of the Jewish faith. All prospective service users are made aware that the organisation is part of the Jewish faith and they agree to live in accordance with the culture. Two surveys sent to service users were returned to CSCI with comments that “Saturdays are different”. The Manger explained that there are many things to do on Saturdays within the village but the culture does not allow the use of the transport vehicle unless there is special reason. The village is very well provided with leisure activities; there are riding stables, a farm, hydrotherapy pool, a library, leisure centre and a cycling track that is very mush liked by one of the residents of Tikvah Tovah. Family members are welcomed and everyone has family visitors; one service user regularly goes away to her parents for the weekend. No one visited during the inspector’s visit but there was evidence in the home of the relatives’ approval of the home and the care that staff give. Meals are shared in the dining room of the house and cooked by staff and service users, some of whom participate with the planning and shopping. Service users like to make their own drinks and a member of staff is always in the kitchen with them for safety when this happens. The kitchen is clean and tidy but rough handling by one service user has damaged the cupboard doors. The units are not old but have been repaired before. A plan for the provision of more robust units is needed. Tikvah Tovah DS0000011371.V318909.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, 20 and ,21 Quality in this outcome area is good. Service users receive personal support and care from staff who treat them in a manner that respects their privacy, dignity and independence. When necessary, referral is made for medical and nursing care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff provide support to enable service users to lead as independent a lifestyle as possible. Individuals have a dedicated key worker who is responsible for their wellbeing. It was clear that staff on duty were familiar with the needs of the residents in the house and had the skills to ensure that they are referred for professional care when necessary. None of the service users is able to be responsible for the administration of medication. Medication was stored correctly and administered by staff trained to do this. There was evidence that a pharmacist regularly inspects the management of the administration of medication. One of the service users had become more disabled earlier this year and the Manager outlined the arrangements made to provide him with appropriate care elsewhere in the village. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 14 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. There is a clear effective complaints procedure in operation and service users are safeguarded from all forms of abuse by the policies and procedures of the Foundation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure has been explained to service users and it was clear that some raise issues informally. These are resolved effectively without needing to be treated as complaints. Service users are protected from abuse, neglect and harm; staff receive regular training on the protection of vulnerable adults from an accredited trainer. No allegations have been made but staff were able to describe the procedure that should be followed in such an event. The registered manager has ensured that there is a clear and detailed record kept of the progress of any complaint as recommended following the previous inspection. Service users are either unable or do not choose to manage their own personal finances. There is a procedure for the safe keeping of this money and this was demonstrated when a carer returned with a service user who had been given an envelope of cash in payment for his assistance on the farm. He gave the money to his carer for storing and it will be used later in the week to buy him a treat of his choice. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 15 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): 24,25, 26,27,28,29 and 30 Quality in this outcome area is good. The environment of the village and each house has been designed to meet the needs of the service users and to comply with legislation. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Tikvah Tovah is a bright, comfortable house that is attractively decorated. It is set in Ravenswood Foundation’s village, which is self-contained and has many opportunities for service users to participate in both leisure and learning. The village site is secure; there is only one entry road and this has now been fitted with a barrier. Parents and staff are given the entry code. At the barrier the Inspector had to use the phone that is provided to ask for entry from the reception office. In Tikvah Tova new furnishings and robust furniture have been provided in the last year; these are in keeping with the lifestyle of the service users. Each person has a single bedroom. Some of these are of more unusual shape that makes it difficult for the home to offer care to service users who have physical disability. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 16 Bedrooms are individually furnished and reflect the interests and lifestyle of each occupant. The shared space in the home is attractive and comfortably furnished. Service users enjoy using the kitchen, for their safety this occurs when a member of staff is present. In spite of this one of the service users has managed to damage the kitchen cupboard doors. These have been repaired; however, a plan to solve this problem is needed. The home was clean and tidy. The laundry equipment is capable of washing to infection control standards. Staff did not have paper towels for hand washing to help with the prevention of the spread of infection. The manager agreed to provide these. Service user’s are able to enjoy the space of the whole village and the on site facilities. The garden of the house is landscaped and offers a BBQ area and seating. One bathroom has been fitted with sensory lights and music to enable service users to relax in private; new water isolator valves have been fitted so that Service users are protected and unable to run hot or cold water that would injure them. One bathroom contains a bath with a damaged panel; this occurred when a Service user fell during a seizure. Plans are in progress to improve the layout of the bathroom. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Service users receive continuity of care and support from a stable well-trained workforce who work together as team and have the skills to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of staff files was inspected and found to be in order. The Foundation values its staff and there is a very low turnover. Agency staff are not frequently used and there is scope for career progression within the service. A thorough recruitment procedure is followed to ensure that service users are protected. Induction and ongoing training is provided. Staff are given supervision as required and records are kept of these sessions. Staff informed the Inspector that they enjoyed working in the village. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 18 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. 29. 40, 41, 42, and 43. Quality in this outcome area is good. Service users benefit from living in a home that is safe because the Management policies and procedures support their quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered manager for Tikvah Tovah is currently completing an HSC Level 4 course before starting the Registered Managers Award. There is an open positive atmosphere in the house and Service users clearly trust the manager. The registered manager has records to show that there is compliance with Health and Safety legislation for service users and staff relating to fire protection, manual handling, COSHH regulations, service of water, gas and electricity supply. Accidents are recorded and monitored. Staff did not have paper towels available outside of the kitchen for hand washing to prevent the spread of infection. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 19 There is evidence of quality assurance being undertaken by the Foundation. Registered provider visits and inspections are recorded and each house is also visited on an unannounced basis by lay monitors who are often parents or carers of service users who live in other houses in the village. Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 4 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 3 3 3 3 3 3 3 3 3 Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 21 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. 1 Standard YA30 Regulation 12(3) Requirement Timescale for action 12/12/06 2 YA24 16(2),(g) 3 YA20 13,(2)(4) The Registered manager must provide paper towels for staff hand washing for infection control. The Registered Individual must 12/12/06 send a plan for provision of suitable kitchen units to withstand Service user behaviour. The Registered manager must 12/12/06 make safe arrangements for storage of the master keys of the home. 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 Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Tikvah Tovah DS0000011371.V318909.R01.S.doc Version 5.2 Page 23 - 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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