Inspection on 14/11/05 for Tinkers Hatch Limited

This inspection was carried out on 14th November 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tinkers Hatch Limited 17/12/08

Tinkers Hatch Limited 05/01/07

Tinkers Hatch Limited 14/05/05

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 Elaine Green Announced Inspection 14th November 2005 10:00 Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 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 Tinkers Hatch DS0000021272.V252938.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 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. Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 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 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) Mr Nigel Ashton Mrs Sarah Brown Mr Neil Sellman Care Home 32 Category(ies) of Learning disability (32), Physical disability (4) registration, with number of places Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users accommodated will have a learning disability. A maximum of four (4) service users who also have a physical disability can be accommodated on the ground floor. The maximum number of people to be accommodated is thirty-two (32). This number may be increased to accommodate thirty-three (33) service users in line with the variation approved on 23rd December 2004. That a maximum 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 placements must be reviewed on an annual basis. 14th May 2005 4. Date of last inspection 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 accommodates 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 DS0000021272.V252938.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Throughout the standards National Minimum Standards for Care Homes’ people who reside in care homes are referred to as “service users”. The people who reside at Tinkers Hatch have decided they prefer to describe themselves as “client(s)” and so this term will be used throughout the report. This Announced Inspection took place on the 14th November 2005 between 10 am and 5pm. Prior to the Inspection the Registered Manager completed a Pre Inspection Questionnaire to provide statistical information about the home and clients and their relatives were given comment cards on which they could feedback to the Inspector their opinions of the services provided by the home. On the day of the Inspection the Inspector has discussions with the Registered Manager regarding the day-to-day running of the home, had lunch with an small group of clients, observed a day care activity, had a tour of the building including clients own rooms, had group and individual discussions with both clients and staff. In addition a range of records and documents were examined including policies and procedures, staff recruitment and training files, service users care plans, health and safety records, menus and activity timetables. What the service does well: What has improved since the last inspection? All clients have a detailed care plan in place however, further requirements have been made within this report in relation to this. Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 6 Records are maintained to indicate when needs that are identified in the care plan have been met. Recruitment practices have improved and evidence that all the required checks have been undertaken prior to employment are now held in the recruitment files. Questionnaires are regularly distributed to clients and others involved in their care as part of the homes’ quality assurance. 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. Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 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 Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Prospective clients are provided with the information required in order to make an informed decision about whether to reside in the home. EVIDENCE: Prospective clients needs are assessed prior to admission. The manager undertakes detailed assessments as to prospective service users abilities and needs. The care plans examined were based on thorough and detailed assessments. They had been reviewed on a regular basis to ensure that they continued to meet the service clients’ needs. Prospective clients individual aspirations and needs are assessed as part of the pre admission assessment. This forms a basis on which the clients’ care plan are based. It covers all aspects of a clients life including their likes, dislikes, preferred activities, family/social contact, specific physical or emotional health care needs, spiritual needs, educational needs, skills and general interests as well as behavioural issues and risk assessments. The manager assured the Inspector that they work very closely with prospective clients family or representatives during the assessment process to ensure that the placement is appropriate. There is a detailed admissions procedure in place ensuring that clients are given the opportunity to visit the home prior to making a decision about moving in to the home. Clients can move in for a trial period. All clients receive a detailed and informative contract/terms and conditions of residence. The Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 9 home’s statement of purpose and service user guides were examined and found to be comprehensive and informative. Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 6,7,8,9,10. Clients care plans reflect the changing needs of individuals. Not all care plans provide adequate guidance for staff to follow to support clients appropriately. Clients are supported to lead an independent and autonomous lifestyle. EVIDENCE: Five care plans were examined. The support notes and guidance for staff to follow when supporting clients is inadequate. It is required that further detail should be included in care plans. This will assist staff to provide the support clients require more effectively in respect of their daily living and chosen activities and the management of challenging behaviour. The care plans examined had been reviewed and updated on a on a regular basis and in some cases had involved the client and their family. The manager stated that some of the clients have a Personal Centred Plan (PCP). A relative commented that, “ Tinkers Hatch offer a very high standard of care, and each person is treated individually, my son has a mixed and weekly programme of events that he enjoys.” Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 11 Each care plan specified the clients’ likes dislikes, diet, family involvement, risk assessments, correspondence, and guidance as to how to minimise any risks to the client. The day care facility and the activities offered play an integral part of the care planning process and the day centre facilitates many of the goals set at reviews. A weekly timetable should be included on the care plan to illustrate the activities that individual clients participate in. The care plan should also clearly identify goals set at reviews and specify how these goals are going to be met. Clients are consulted on, and participate in, all aspects of life in the home. Clients are involved in putting laundry away, laying the table, choosing the menu, cleaning heir own room, choosing the decoration and furnishings of their rooms, planning events and outings. The records examined were stored appropriately and clients do have access to the records kept about them should they wish to see them. Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 11,12,13,14,15,16,17. Clients at Tinkers Hatch are supported to develop personally and socially. The arrangements for the provision of food is good. Clients’ lead socially active lifestyles and access local facilities and amenities. EVIDENCE: This service provides stimulating, meaningful and varied activity programmes for all its clients. The activities in these programmes include skills required for daily living and are provided within the home as well as in the day care centre. The home provides continuity of care by the nature of the fact that some of the staff team from the residential side also provide the day care. The skills acquired by the clients are appropriate, transferable and are used within the home. Information is provided to the clients in an appropriate format and they are consulted on matters relating to the running of the home. Clients have the opportunity for personal development. They are encouraged and supported to attend appropriate courses at the homes’ own day care centre and those run by other local colleges. Courses include those which meet emotional and spiritual needs of the service users as well as those that are purely academic or skills based e.g. assertiveness. A member of staff stated Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 13 that not all objectives are task based and could include e.g. not interrupting people when they are speaking or following simple instructions. The home and day care facility involve the service users in a whole range of activities and trips such as BBQ’s, open days, art sessions, drama - Christmas show performed by the clients to which their family and friends were invited, bowling at the local leisure complex, sport with a day centre and other homes in the area with whom they have forged links, trips to the Eastbourne, Brighton, horse riding, going out for meals, going to the pub, etc. The clients are fully involved with the planning of these events and activities. Clients stated that their friends and family visit them in the home and that they go and visit them. They also spoke about going to the local shops and pubs. The service users gave very positive feedback to the Inspector re they social aspects of living at Tinkers Hatch. The Inspector joined a small group of clients and staff for lunch. The food was homemade fresh and well presented. Through discussions with clients, staff and the cook it is evident that personal preferences and special diets are catered for. Information regarding special diets and likes and dislikes is was on display in the kitchen. Although a choice of meals is not given the cook explained that if a client doesn’t want what is on offer that day, she can and does, prepare an alternative. Menus were examined confirmed that a balanced and varied diet is provided. Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 18,19,20. Clients are supported appropriately. Clients physical and emotional health needs are met. EVIDENCE: The interaction between staff and clients observed by the Inspector was balanced, appropriate. Staff were noted to be treating clients with respect and to engage with them in a dignified and friendly manner. Clients are encouraged to be as independent as possible subject to a risk assessment. Staff support clients to complete tasks themselves rather than doing it for them. The atmosphere between clients and staff appeared relaxed and the Inspector was pleased to note how well the staff communicated with those clients who had communication difficulties demonstrating that the staff had a good understanding and knowledge of the needs of these particular clients. Staff were observed on several occasions during the inspection to ask clients if they wanted any help or not. Records examined showed that clients regularly receive check ups from health care professionals and that thorough assessments are sought when needed. Detailed information is made available to staff in relation to meeting clients health care needs. Visits to, and by, health care professionals are fully documented. Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The complaints procedure is adequate and on the whole homes policies and procedures ensure that clients are adequately protected from abuse. However, the homes policies and procedures regarding making an adult protection alert are not in line with local guidance and must be amended. EVIDENCE: The home has a detailed complaints policy and procedure in place. The clients asked stated that they would tell their key worker or the manager if there was something wrong. None of the clients spoken to had any complaints to make to the Inspector. The home provides staff training on issues of what constitutes abuse and the Protection of Vulnerable Adults. The home did not have a copy of the local adult protection guidance The Brighton & Hove Multi-agency Guidelines, Policies and Procedures for the Protection of Vulnerable Adults and it is required that they obtain a copy without delay. All staff must be made aware of the guidelines and of how to make an adult protection alert. Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,30. Clients are provided with a clean, safe and appropriate environment in which to live in. EVIDENCE: Clients’ bedrooms are all personalised, decorated and furnished to the clients’ own taste. Service users are able to bring their own furniture to the home should they wish. Most bedrooms are single but there are still three shared rooms that are being phased out. There are an adequate number of bathrooms and WCs throughout the home. There is a newly upgraded adapted bathroom which had overhead tracking and other aids for the use of clients with mobility problems. There are several lounge and dining areas in the home and they are furnished and decorated adequately. The home has a large garden and is accessible to all service users subject to a risk assessment. All areas of the home were found to be clean and tidy on the day of the inspection. Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36. The staff team are competent, well trained and appropriately supervised. Recruitment procedures are adequate. EVIDENCE: Recruitment files examined hold documents confirming that all staff receive job descriptions that clearly define the extent of their roles and responsibilities in the home. All the required checks are undertaken prior to new staff being deployed to work in the home. All staff starting in a new position within the home are required to complete a comprehensive induction. Even if staff have worked there for a number of years a new position requires an induction to the new roles and responsibilities associated. The training programme for staff at Tinkers Hatch is also comprehensive and management show a commitment to staff long term leaning. The home has been awarded the Investors in People Award for the quality of training and support for staff. In addition to the mandatory training required by the National Minimum Standards, staff receive specialist training to enable them to work effectively with the client group at Tinkers Hatch and to ensure they can communicate effectively with those with communication difficulties. The home continues to work hard towards supporting their staff team to obtain a National Qualification (NVQ) in Care at Level 2 or above. Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 18 All staff receive supervision 6 weekly. When the home introduced supervision the staff team were consulted as to their preferences in regard to the structure and format that supervision would take, and this is commendable. All staff are given the opportunity to choose who will be their supervisor and one of the supervisors has put together information regarding supervision at Tinkers Hatch for staff. Staff stated that they felt that supervision works well and felt involved and supported by the process. The home has produced a comprehensive and informative staff guide that provides staff with information regarding the homes policies, procedures and the ethos of the home. A relative wrote, “ Tinkers Hatch provide our daughter with excellent care. The staff are most caring and carry out their duties professionally and with commitment.” Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41,42,43. This home is run in the best interest of its clients. Management and administration systems are good. EVIDENCE: The clients at Tinkers Hatch benefit from the being supported by a well trained and motivated staff team. Through discussions with clients, staff and the Registered Manager it is evident that the Manager and Management team are open and approachable. The views of the clients of Tinkers Hatch are sought on a range of issues through residents meetings, one to one sessions with their key workers and an annual questionnaire. The views of clients form an integral part of the planning process. Policies and procedures are reviewed on a regular basis and, with the exception of the lack of an adult protection alerting procedure, they protect and promote clients’ safety and wellbeing. Records relating to health and Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 20 safety were examined and found to be in order. All records examined were found to be accurate, legible and complete. The home has a realistic financial and business plan in place. Tinkers Hatch DS0000021272.V252938.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 4 3 3 3 4 4 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tinkers Hatch Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 DS0000021272.V252938.R01.S.doc Version 5.0 Page 22 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 YA23 Regulation 13(6) Timescale for action Adult protection alerting 15/12/05 procedures must be amended so they are in line local guidance as stated in the Brighton & Hove and East Sussex Multi Agency Policy, Procedure and Guidelines for the Protection of Vulnerable Adults and all staff must be made of the procedures they should follow should they suspect an incident of abuse may have occurred. Care plans must contain more 30/03/06 detailed information for staff to follow when supporting clients in their daily living including the management of challenging behaviour. A weekly activity timetables and information relating to goal setting should also be included within the care plan. Requirement 2. YA6 15(1) Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 23 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 Tinkers Hatch DS0000021272.V252938.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East Sussex Area Office 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 DS0000021272.V252938.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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