Inspection on 14/12/05 for Tiled House

This inspection was carried out on 14th December 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tiled House 11/11/08

Tiled House 22/11/06

Tiled House 18/07/05

Tiled House 20/10/04

Tiled House 27/05/04

Tiled House 30/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Tiled House 200 Tiled House Lane Pensnett West Midlands DY5 4LT Lead Inspector Richard Eaves Announced Inspection 14th December 2005 11:30 X10015.doc Version 1.40 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 Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 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 Older People. 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. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tiled House Address 200 Tiled House Lane Pensnett West Midlands DY5 4LT 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) 01384 813425 01384 813427 N/K Dudley Metropolitan Borough Council Anita Williams Care Home 48 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (36) of places Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. By the 31 September 2003 water available from bedroom/bathroom taps together with any exposed pipeworks shall not exceed 43 degrees celsius. In the interim folowing risk assessments, strategies are Implemented to safeguard service users. All requirements contained within the registration report of 10 December 2002 are met within the timescales contained within the action plan agreed between Dudley Metropolitan Borough Council and the National Care Standards Commission. Day care provision must not encroach on the facilities, staffing and services provided to residential service users. One service user named in the variation applicationof 21 April 2004 may be accommodated in the category of PD as a respite placement. This will remain until such time that the identified service users placement is terminated. 18th July 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Tiled House is a large forty-eight bedded unit owned and managed by Dudley MBC. The home is divided into six residential units, these are situated on two stories. One unit is specifically identified to care for people who are in need of respite or an emergency admission. The home is well maintained with good arrangements for monitoring the environment and servicing on a regular basis. Each of the six units are self sufficient other than the centralised services of catering and laundry facilities, which also serve the day unit. Each unit has a separate lounge/dining area with kitchen facilities. The intention of the small units is to ensure a more personalised care service to the residents. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection visit was undertaken by an Inspector from the Commission for Social Care Inspection using the following information: the action plan submitted by the home to the unannounced inspection in undertaken during July 2005, reports from the organisation relating to the conduct of the home, the pre-inspection questionnaire, comment card responses from service users and relatives and records held at the home. The inspection involved a full tour of the bedrooms, communal rooms and service areas and provided an opportunity to speak with most of the service users. Comment cards were received from 26 service users and 14 relatives/visitors to the home, the results of which are included in the body of the report but were overall very positive towards the home. What the service does well: What has improved since the last inspection? The programme of redecoration and re-carpeting is well progressed and the bedrooms in the respite unit have been provided with pictures and ornaments to give the rooms a homely feel. The rearrangement of some of the units has brought about an improvement of facility for the permanent service users. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 6 The views of service users about the range and appeal of the activities provided have brought about a broader programme of events. 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. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 –5 The homes statement of purpose and service user guide are good sources of information providing details of the service enabling service users and families to make informed decisions about admission to the home. Pre-admission assessments are undertaken by the most experienced staff and confirmation is given to the service users that their needs can be met by the home and further confirmed by contract at the time of admission. Service users are invited to visit and trial the home before committing themselves to staying at the home. EVIDENCE: The statement of purpose and service users guide have recently been the subject of review and are an excellent source of information for current and prospective service users. A sample of 5 case files were randomly selected for case tracking and show that the assessment process is thorough, including all activities of daily living and an extensive range of risk assessments, all assessments are subject to monthly review. The file documents information of the service user or representatives involvement in the assessment process. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 9 Each case file includes a contract and a letter confirming that the agreed assessed needs can be met by the home, the letter also invites prospective service users to take the opportunity to visit and trial the services offered. The home does not offer an intermediate care service. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 – 11 Health care needs of service users are fully met. Care plans are derived from a comprehensive range of assessments and provide the basis for the delivery of care and detail the actions required of staff to meet the identified needs. Medications are well managed all facilitating the promotion of service users health. Service users are treated with respect and their privacy upheld. Staff have been developed to provide care at the time of service users dying with sensitivity and respect. EVIDENCE: A sample of case files were selected at random in each area of the home to be inspected and case tracked. The care plans were drawn from the assessed needs process and were relevant and maintained to a good standard. The care plans reflect actual care requirements and the service users preferences of how it is to be given. All service users are registered with a GP and the district nursing service visits on request. Allied medical services such as dentist and ophthalmics are provided on a regular, as required basis. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 11 The Boots monitored dosage system is used for the administration of medicines. An inspection of the administration of medication procedure identified that is was administered to a satisfactory level. Medications are stored in a locked cupboard and records maintained of medicines received and returned to the pharmacists. Staff involved in the administration of medicines receive accredited training. The TOPPS induction programme includes a section on treating service users with respect and their privacy is upheld, locks are fitted to bedroom doors, staff were observed to knock before entering and interact in a friendly and open way using the service users choice of name. It is an infrequent occurrence at the home for service users to die there as most would be in hospital having been admitted in response to an observed deteriation in health. The manager is confident that the staff are able to manage the care of the dying with sensitivity and would assure attentive care. The respondents of the comment cards all expressed satisfaction with there care and were happy to confirm this in conversation with the inspector a number also wrote comments such as “very happy living here”, “very, very happy”, “more than happy to be here”. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15 The home provides well-organised and varied social and recreational activities that provide interest and pleasure for the residents. Visitors are welcome and help to keep service users informed about the wider community Many aspects of care evidences that service users exercise choice and control over their lives. The meals at Tiled House are good, offering both choice and variety and catering well for special dietary needs. EVIDENCE: The home provides a wide range of activities and social events which has been broadened in response to views provided by service users; residents spoken with indicate a good deal of satisfaction with the opportunities provided at the home. The home has the benefit of using the day centre for evening entertainments and activities such as fish suppers it being large enough to accommodate all service users at one time. Each Tuesday service users meet to discuss entertainments for the coming week and to plan events, current favourites being exercise to music, karaoke and bingo, over the summer the Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 13 garden has been a rich source of pleasure to a number of service users providing salad crops and colourful borders for everyone to benefit. A range of events and activities have been planned for the period running up to Christmas including entertainers, hand bell ringers and lunch out at a local public house. The home has open visiting and a number of families were met and all spoke well of the home. One service user demonstrated clearly how she is able to exercise choice over her life in the home by regularly choosing to remain in her room for days at a time but then spontaneously choosing to rejoin the group. Al service users spoken with expressed the view that they made their own choices in most aspects of daily life. The home has a 5-week rolling menu that is well thought out and offering variety and a balanced diet to service users, choice of meal including a cooked option is always available and a record kept of individual service users intake and meals taken in the setting of their choice. Regular satisfaction surveys are undertaken of the meals served. The main meal of the day is served at 5 pm except the weekend when lunch is chosen to be the main meal this change has been well received. Fresh fruit is provided during the afternoon tea-time. A special menu has been prepared for over the holiday period. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 – 18 The home has a satisfactory complaints policy and service users and their supporters can be confident that their views will be listened to and acted upon. Staff have all undertaken adult protection training with social services preparing them to uphold the welfare of the service users and to protect their rights. EVIDENCE: The complaints procedure is readily accessible to service users and their supporters with reference in the contract, the statement of purpose and is on display on the notice board. One expression of concern has been received since the previous inspection that another service user has been annoying entering rooms, this was resolved to the satisfaction of the service user when there was a reorganisation of the units. The electoral roll has recently been completed and a number of service users have received confirmation that they will be able to make a postal vote in forthcoming elections. The home has robust procedures for responding to any suggestion of abuse and in-house training is given in adult protection procedures. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The home provides a good standard of décor, furnishings and managed services providing a safe environment and an attractive, comfortable and homely place to live. The home is clean, free from odours and hygienic. EVIDENCE: An internal programme of decoration and replacement of carpets is well advanced with most bedrooms now complete and one lounge area remaining to be done after Christmas holiday period. Records of the homes environmental and services auditing were inspected and show that these are up to date and show the home to be maintained safely. The tour of the building confirmed that the home is maintained in a clean and hygienic condition with no evidence of malodour. The fitting of a second double electric socket remains outstanding. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 16 The commissions comment card replies show that all service users like living at the home and in conversation many expressed the view that the bathrooms and toilets were conveniently close to their bedrooms and they were happy with the furnishings provided. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 – 30 The home has a stable, well-motivated and trained staff group offering consistency of care and enthusiasm to maximise the quality of life for the service users. Service users are further protected by good recruitment and selection practices. EVIDENCE: The rotas confirm that staff numbers across the 24hour period are appropriate to the needs of service users. The manager has the flexibility to increase staff numbers should the dependency needs of service users increase. The ancillary services provide a full 7-day service. Care staff with NVQ qualification at level 2 or above exceeds the 50 requirement of the standard. The process of CRB checking of all staff is complete and recruitment is undertaken using the Dudley MBC recruitment procedure. A sample of recently employed staff files show these to be completed to a good standard with appropriate pre-employment checks being undertaken and the most recent appointee is currently undertaking TOPSS induction. Staff are issued with the General Social Care Councils code of conduct. The Authority provides comprehensive induction and foundation training the documentation of which is included in a starter pack. There is also a Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 18 comprehensive package of mandatory and developmental training opportunities for all groups of staff. Training undertaken since the previous inspection has included ongoing NVQ’s in care and supervision, infection control and health and safety, mandatory training for fire safety and food hygiene, adult protection, safe handling of medicines, and emergency first aid. Repeat opportunities to attend the above are planned for the coming months. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Leadership of this home is good and staff demonstrate an awareness of their roles and responsibilities and service users benefit from this consistency. The sound financial management of the home and arrangements for safekeeping of their money safeguards service users interests personal and financial. Staff receive supervision and direction to ensure that the service users receive consistent quality care. The best interests of service users are safeguarded by the homes record keeping, policies and procedures. Environment management and staff training in respect of health and safety ensures service users safety and welfare are protected. Delay in addressing identified work potentially undermines this level of safety. EVIDENCE: Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 20 The home is managed by a well qualified and experienced manager who meets regularly with staff and service users. Service users views are in addition regularly surveyed using a range of questionnaires that between them cover all aspects of service. The views of respite service users and their families are consistently sought by way of a questionnaire available at the entrance to the unit. The manager acts as appointee for service users and has in place good accounting practice to assist service users in keeping their personal allowance safe. Supervision notes seen by the inspector demonstrate an effective formal supervision process for staff of at least six times per year. Annual appraisals have also been undertaken. Policies and procedures are available for staff to read. Records required by regulation and the schedules are maintained and kept up to date. Health and Safety is given appropriate priority with a broad range of monitoring and maintenance in place with all staff receiving training at induction and ongoing at appropriate intervals. During the tour of the building it was observed that all corridors were clear of any obstruction and the premises are kept in a safe condition. Appropriate arrangements are in place for the monitoring, recording and reporting of accidents. An inspection of the service and inspection certificates identified work outstanding to validate the electrical wiring. Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 2 Tiled House DS0000036816.V263329.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23(2)(f) Requirement The responsible person must provide at least two accessible double electric sockets in each bedroom. Previous timescale of 31.3.2005 not met. The responsible person must ensure that the homes electrical wiring is covered by appropriate certification. Timescale for action 31/03/06 2 OP38 23(2)(b) 31/03/06 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 OP9 Good Practice Recommendations The manager is recommended to audit the documentation of medication administration weekly and maintain a record. 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