Inspection on 14/05/05 for Tinkers Hatch Limited

This inspection was carried out on 14th May 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

Tinkers Hatch Limited 17/12/08

Tinkers Hatch Limited 05/01/07

Tinkers Hatch Limited 14/11/05

Tinkers Hatch Limited 07/11/04

Tinkers Hatch Limited 11/05/04

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

CARE HOME ADULTS 18-65 Tinkers Hatch New Pond Hill Cross in Hand East Sussex TN21 0LX Lead Inspector Andy Denness Unannounced 14 May 2005 13:00 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. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Tinkers Hatch Address New Pond Hill Cross in Hand East Sussex TN21 0LX 01435 863119 01435 864062 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) Mr Nigel Ashton & Mrs Sarah Brown Mr Neil Sellman Care Home (CRH) 32 Category(ies) of Physical Disability (PD) 4 registration, with number Learning Disability (LD) 32 of places Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1.The maximum number of people to be accommodated is thrity two (32). This number may be increased to accommodate thirty three (33) service users in line with the variation approved on 23 December 2004. 2. Service users accommodated will have a learning disability. 3. A maximum of four (4) service users who also have a physical disability can be accommodated on the ground floor. 4. That a maximum number of eight (8) service users can be accommodated over the age of sixty five (65) as long as their individual needs can be met within the home. Individual placement must be reviewed on an annual basis. Date of last inspection 7 November 2004 Brief Description of the Service: Tinkers Hatch is situated approximately one mile from Heathfield town centre, where a limited bus service can be accessed. On site accommodation is provided in the main house, which accommodates 24 service users, the cottage which accomodates five, the flat which is for two service users and a unit for one service user. The home is registered to accommodate up to 32 adults with a learning disability four of whom may also have a physical disability and eight of whom may be aged over 65 years of age. The registered owners are Mr N Ashton and Mrs S Brown. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Inspection took place over a Saturday afternoon and early evening in May and lasted 5 hours. To help gather evidence on how the home is performing the Inspector, met with staff and the home’s manager, examined a range of records and written information undertook a tour of all four units and had discussions with twelve service users. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 6 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 Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 7 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) 1, 2 & 4. Pre admission procedures help ensure that service users are appropriately placed in a service that is suitable to meet their needs. EVIDENCE: A range of written information is available to potential new service users and their representatives to help them in their decision of whether to move to the home, these were of a good quality. Assessments are undertaken of service users to ensure that their needs can be met at Tinker’s Hatch, these happen both before and after admission so as to address changing needs, and can entail input from other professionals including members of the local Community Learning Disability Team; a sample was examined they were of a good quality. One service user who had fairly recently been admitted to the home said that he had the opportunity to visit and look around before moving in. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 8 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) 6,8 9 & 10. In most instances practices and systems are in place to help ensure that staff provide appropriate levels of support to meet service users sometimes complex and changing needs, whilst ensuring them choice and independence. EVIDENCE: Individual plans of care are in place for each service user these identify amongst other things what support they require from staff to meet their day to day needs in relation to health, personal and social care needs. A selection of these plans was examined; they were generally of a satisfactory standard. However in one instance a service user who had been admitted to the home six months ago had only a brief plan in place, which did not detail her full care needs, particularly in relation to her specialist communication requirements, which were complex. Also the current recording system does not show when individual needs detailed on care plans have in fact been met. It has been required that action is taken to address both of these matters. Staff said that service user meetings take place on a regular basis where discussions take place regarding excursions, holidays menus etc, this was confirmed in discussions with service users. Risk assessments are in place for each service user, these assess risk and identify action to reduce dangers; a sample was Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 9 examined, they were of a satisfactory quality. All records regarding service users were stored securely to ensure confidentiality. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 10 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) 12, 13, 14 & 17. Arrangements in the home help ensure that’s service users participate in range of leisure, recreational and educational activities on site, in the local community and further a field. Catering arrangements ensure a healthy and varied diet for service users. EVIDENCE: From records examined and discussions with staff it was evident that an excellent range of leisure, recreational and educational opportunities are available to service users. As well as accessing local colleges the home has its own day centre where a range of activities is offered on a daily basis. Service users were very enthusiastic and positive about these opportunities. One group had the previous day planted some hanging baskets at college and were discussing where in the home to hang them, whilst another group spoke enthusiastically of a drama production that they were in that was soon to be performed in the local community. Several service users said that they either had been or were soon to go on a holiday organised by the home, which they were looking forward to. On the day of the inspection several groups of service users had been shopping in home’s mini bus. Menus examined confirmed that a varied diet is provided; service users said that their meals were good. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 11 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 and 20. It appears that current arrangements and practices in the home ensure that a good standard of support is provided for service users by staff to meet their personal and healthcare needs, however a lack of detailed records regarding personal care needs made this difficult to evidence. Procedures, policies and practices ensure satisfactory management of medication matters. EVIDENCE: Whilst individual plans of care do detail in most instances what personal care should be provided for service users, there were few records in place to indicate if these needs had been met. Records are in place, which confirmed that appropriate steps are taken to meet service users health care needs, a range of health care professionals are accessed to help with this. Staff manage medication on behalf of service users; a monitored dosage system is used, records and storage were examined and found to be in order. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 12 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 Procedures and practices in the home ensure that complaints made by service users are managed appropriately in line with national minimum standards. EVIDENCE: A written complaints procedure is in place for service users or their representatives to follow should they be unhappy with any aspect of the care provided at Tinker’s Hatch. Service users said that they would feel able to approach to the manager if they had any concerns or complaints. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 13 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) 24,25,27,28,29,&30. Physical standards throughout the home were satisfactory ensuring that service users live in a safe, comfortable and clean environment that is suitable for their needs. EVIDENCE: Accommodation is provided in the ‘main house’ (24), The Cottage (5), the ‘Flat’ (2) and a single self-contained unit. An inspection of all areas with the exception of the flat took place physical standards throughout were satisfactory. Most bedrooms are single although there are still three double rooms in use, which are gradually being phased out. The rooms were furnished and decorated to a satisfactory standard in such a way as to reflect service users individual likes and interests. Sufficient WCs and bathrooms are available to meet service users needs, including one bathroom/WC that is equipped with ceiling hoists for those service users who have mobility problems. The home has a selection of lounge/dining rooms, which were decorated and furnished to a satisfactory standard. The home was clean and hygienic throughout. To comply with national minimum standards the owners are investigating ways of splitting the main unit into smaller self-contained units. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 14 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) 32,33 34 & 35. Staffing arrangements ensure that service users needs are met by a welltrained, motivated staff team. EVIDENCE: Staffing levels on the day of the inspection were satisfactory to meet service users needs. Records examined confirmed that this is the case at all other times. Service users said that there were always enough staff on duty to meet their needs. Records examined indicated that an excellent range of training is made available for staff, this was confirmed in discussions with staff who also said that the home have been awarded the Investors in People Award for the quality of the training and support for staff. Most staff are trained to NVQ level as is required by national minimum standards. Records confirmed that as well as training linked to health and safety issues, staff are also trained in communication skills and other matters directly linked to the individual needs of the service user group living at Tinker’s Hatch. A selection of recruitment records was examined; these were generally in order although in one instance a Criminal Record Bureau check form was missing. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 15 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) 38, 39 & 42. Management and administrative systems in the home help contribute to the good standard of care provided. EVIDENCE: The manager presented as confident and motivated and demonstrated a clear understanding of the needs of adults with a learning disability. The home does have its own quality assurance system; the questionnaires used in this have not been distributed as regularly as they should, it has been required that this now happens. The manager clearly understood the importance of ensuring a safe environment for both service users and staff, records examined confirmed that he uses the risk assessment process well to assist with this. A selection of health and safety records including fire system tests, risk assessments and servicing records were examined, these were all in order. A selection of other records required by regulation were inspected, these were in order and were stored securely. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 3 3 3 Standard No 11 12 13 14 15 Tinkers Hatch x 3 3 3 x Standard No 31 32 33 34 35 36 Score x 3 x 2 3 x Version 1.20 Page 17 H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc 16 17 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 2 x x 3 x Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 18 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 6 Regulation 15(1) Requirement That detailed care plans that provide guidance for staff on how to meet servcei users needs are in place for all individuals are in place for all service users. That records are maintained to evidence that needs identified in individual care plans have been met. That Criminal Record Bureau checks or evidence that they have been obtained, inspected and been disposed of, are held on all recruitment files. That as part of the homes quality assurance system questionairres are regualarly distributed to service users and other involved in their care. Timescale for action 14/6/05 2. 6 15(1) 14/6/05 3. 34 19(1)(a) 14/5/05 4. 39 24 14/8/05 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. Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 19 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Tinkers Hatch H59-H10 S21272 Tinkers Hatch V225636 140505 Stage 4.doc Version 1.20 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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