Inspection on 17/08/05 for Tillson House

This inspection was carried out on 17th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tillson House 22/10/08

Tillson House 11/01/07

Tillson House 10/05/05

Tillson House 27/01/05

Tillson House 05/07/04

Tillson House 23/03/04

Similar services:

Hillside

Applegarth

Trevayler Residential Care Home

122 Scorer Street

Byars Care Home

St Marys Nursing Home

Jubilee Villa Care Home

Bramble Lodge

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

CARE HOMES FOR OLDER PEOPLE Tillson House Bradgate Drive Coalville Leicestershire LE67 4HF Lead Inspector Linda Clarke Unannounced 17 August 2005, 9:00am th 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 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. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Tillson House Address Bradgate Drive Coalville Leicestershire LE67 4HF 01530 832793 01530 832793 None Leicestershire County Council Social Services 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) Ms Carol Lomas Care Home 40 Category(ies) of Dementia (8), Dementia - over 65 years of age registration, with number (24), Learning disability over 65 years of age of places (4), Mental Disorder, excluding learning disability or dementia - over 65 years of age (6), Old age, not falling within any other category (40), Physical disability over 65 years of age (12), Sensory Impairment over 65 years of age (4) Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No person falling within category DE or DE(E) may be admitted to the home when 24 persons who fall within categories/combined categories are already accommodated within the home. No one falling within category MD(E) may be admitted to the home when 6 persons of category MD(E) are already accommodated No one falling within category LD(E) may be admitted to the home when 4 persons of category LD(E) are already accommodated. No one falling within category PD(E) may be admitted to the home when 12 persons of category PD(E) are already accommodated. No one falling within category SI(E) may be admitted to the home when 4 persons of category SI(E) are already accommodated. Service Users between the age of 55-65 years who fall within the above categories and were resident in the care home at the date of registration may continue to reside there. No one falling within category DE may be admitted into the home where there are 8 persons on category DE already accommodated. Persons falling within category DE may only be accommodated within the respite facility currently specialising in Dementia Care. No person under 55 years of age who falls within category DE may be admitted to the home. Date of last inspection 10th May 2005 Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 5 Brief Description of the Service: Tillson House is a residential care home providing personal care and accommodation for up to forty older persons. Tillson House also has a respite facility offering accommodation for upto eight individuals with Dementia, the facility being self contained within the home. The forty single bedrooms are without en-suite facilities. The Garden is accessible to residents with mature plants and trees, with seating areas. The premise is owned by Leicestershire County Council Social Services Department and is situated close to the town centre of Coalville, offering all local amenities. The home is accessible by private or public transport. Accommodation is provided over two floors with access between floors being via stairs or a passenger lift. Tillson House is fully accessible, with communal areas and bedrooms being located on both floors.. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection took place between 9.00am and 2.00pm. The opportunity was taken to look around the home, spend time with residents, view records and policies which, included viewing the care plans of three residents residing at the home, and two individuals accessing respite care. Information recorded on the pre-inspection questionnaire and resident, relative and General Practitioner Comment Cards has been incorporated into the Inspection report. The Registered Manager facilitated the Inspection, spending time with the Inspector; the Inspector also interviewed two members of care staff. What the service does well: What has improved since the last inspection? Staff have continued to attend training courses, and attain a National Vocational Qualification. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 7 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. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 1 and 3. Standarad 6 is not applicable. The admission process is well managed with residents needs being assessed ensuring staff have the appropriate information to meet individual needs. EVIDENCE: Tillson House has a Statement of Purpose, which outlines the care and accommodation offered to residents, arrangements for staffing including staff training, the daily living arrangements offered to residents including information on mealtimes. A separate booklet is available for those individuals accessing respite care services. As part of the assessment process residents and relatives are asked to provide a history of their life prior to admission, this provides additional information to help in the delivery of care and activities provided. Information supplied could be used to a greater advantage in the developing of resident care plans. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 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 standard(s) 7, 8 and 10. Residents are looked after well in respect of their health and personal care needs. EVIDENCE: Care plans of three residents’ were viewed; the detailed information recorded as to resident’s daily living arrangements and physical care needs is to be commended. Care plans could be further developed to encompass a comprehensive record of resident needs in relation mental health and social aspects including hobbies and interests, thus providing a holistic approach to care. Care plans of two individuals accessing respite care were also viewed; records contained the original assessment of need, and an outline of care needs. Records evidenced regular contact with health care professionals. The Inspector spoke with two members of care staff, who were able to relay the individual needs of residents. Staff were aware of the promotion of residents privacy and dignity, this was demonstrated through comments made to the Inspector and the Inspectors observation of staff interacting with residents. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 11 The Inspector spoke with three individuals residing at the home on an individual basis, all made positive comments as to the care they received and the friendliness of staff. ‘You couldn’t find anywhere better’ ‘I wouldn’t wish to live anywhere else’ ‘The staff are very friendly and always helpful’ On the day of the Inspection, one resident was being visited by a friend, who said she visited daily, spending time in conversation and on occasions going out of the home. Both the resident and her visitor confirmed they were happy with the level of care within the home, and that staff were helpful. The visitor felt confident that she could speak to any member of the management team or care staff to discuss any aspect of care. The Inspector received seven completed comment cards from residents, all indicated they were well cared for and that their privacy was respected and that they were treated well by staff. The Inspector received thirteen completed comment cards from relatives/visitors all confirmed they were happy with the overall care provided. Four comment cards incorporated an additional comment. “The staff have always been very efficient, professional and caring.” “Excellent service all round.” “After visiting one or two homes in the area we think Tillson House is one of the best we have seen.” “I think the Beacon Unit is an excellent unit.” The Inspector received two completed comment cards from General Practitioners, who confirmed that staff demonstrate a clear understanding of residents care needs, and that they satisfied overall with the care provided. One comment card incorporated an additional comment. “I am generally very happy with the staff and care at Tillson House.” Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 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 standard(s) Residents receive a balanced and varied diet. EVIDENCE: 15. The Inspector sat with four residents during lunch; all made positive comments as to the quality and quantity of the food. Residents confirmed that they made choices from the menu as to what they wished to eat. Following the meal some residents chose to have a drink from the bar, to which there is an additional charge. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 18. Policies and procedures are in place for the protection of adults from abuse. EVIDENCE: Policies and procedures devised by the Local Authority outlines the action to be taken by any member of staff should they suspect abuse. Staffs as part of their National Vocational Qualification, study the protection of adults from abuse consistent with the Department of Health’s Guidance. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19, 20, 25 and 26. A comfortable and safe standard of accommodation is provided for the resident’s including garden areas, which individually and collectively meets the resident’s needs. EVIDENCE: Tillson House is well maintained and is suitable to the needs of residents; it is decorated and furnished to a standard that creates a comfortable and homely environment. The garden is well maintained and has an area partitioned off for those residents accessing the respite facility, providing a safe environment with plants, flowers and seating. Tillson House has spacious sitting rooms on both the ground and first floor, which offers residents a variety of choices as to where to sit, one sitting room is for those individuals who wish to smoke. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. Staff at the home are well trained and supported, and employed in sufficient numbers to meet the needs of residents. EVIDENCE: The Inspector viewed training records, which evidenced staff receive training in a variety of topics, which include Dementia Care, report writing, resident rights, health and safety and first aid to identify some. Records evidenced that the home employs twenty-two care staff of which twelve have attained a level 2 National Vocational Qualification and three care staff have attained level 3. In addition to this the two Assistant Managers have attained level 2, both being a qualified National Vocational Assessor. This level of achievement is to be commended. Support staff such as domestic and catering staff have also attained a National Vocational Qualification relevant to their field of work. The Departmental Training Plan details training available to care staff in care plan and record writing and medical conditions, care staff should therefore be encouraged to access these courses to increase their awareness and develop and improve upon residents care. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 16 The record of one member of staff recruited since the last Inspection was viewed and was found to contain all relevant documentation including a Criminal Record Bureau check. Staff interviewed confirmed the staffing levels; one member of staff indicating that annual leave and staff sickness affected staffing levels, with particular reference to weekends. The Registered Manager confirmed that she is in the process of recruiting care staff specifically to work weekends. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35, 36 and 38. The Registered Manager offers a clear sense of leadership, which reflects on the day-to-day delivery of care practices of residents and running of the home. EVIDENCE: Care records indicated that financial arrangements were managed in a variety of ways, by the resident themselves or by their relatives. Staff members interviewed confirmed that they received regular supervisions from a member of the management team. The Inspector viewed the Fire Risk Assessment, which was in good order, and had been viewed by the Leicestershire Fire Service. The pre-inspection questionnaire evidenced the regular maintenance of the home. Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x x x 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x 3 3 x 3 Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 19 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 7 Good Practice Recommendations It is recommended that care plans contain additional information, evidencing an holistic approach to care. 1. Mental Health and its affects on the individual to be more detailed. 2. Recreational and activities form part of the care plan. 3. Daily records contain more detailed information, indicative of their care plan. It is recommended that staff access training in care plan writing and medical conditions, which would support staff in the devising of care plans. 2. 30 Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX 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 Tillson House C51 C01 S33449 Tillson House V242492 170805 Stage 4.doc Version 1.40 Page 21 - 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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