Inspection on 04/07/05 for TNP House

This inspection was carried out on 4th July 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

TNP House 09/09/08

TNP House 02/10/07

TNP House 06/12/05

TNP House 25/10/04

TNP House 24/05/04

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 T.N.P House 15 Comberford Road Tamworth Staffordshire B79 8PB Lead Inspector Jane Capron Announced Monday 4 July 2005 09.45am 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. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service T.N.P House Address 15 Comberford Road Tamworth Staffordshire B79 8PB 01827 316177 01782 68857 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) TNP Homecare(UK) Limited Janine Owen Care Home 12 5 12 7 Category(ies) of DE(E) registration, with number OP of places PD(E) T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25 October 2004 Brief Description of the Service: TNP is a family run residential care home registered for 12 service users over the age of 65, 5 of whom may have dementia care needs and 7 may have physical disabilities. The home is set in a large detached house with a single storey extension at the rear. The property is located in a pleasant area of Tamworth. It has a rear garden with provision for service users to sit outside. The home is surrounded by mature shrubs and hedges and is set back from the road. There is adequate car parking space at the front of the home. The home has two lounges and a separate dining room, although some of the service users choose to eat and sit in their bedrooms. The home provides accommodation in six single bedrooms and three shared bedrooms. Ensuite facilities are provided in five of the single rooms and in one of the shared rooms.The home has a vertical shaft lift to the first floor. The home provides two assisted baths and has sufficient toilet facilities. During the summer months the home arranges outings for the service users. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over a period of five hours. Discussions were held with the manager and the staff on duty. The views of six residents were sought. Comments were also received from a relative visiting the home and a District Nurse who was visiting to attend to a resident. A range of documents relating both to the environment and the care of the residents was examined. The accommodation of the home was looked at as part of the inspection and the system for administering medication was examined. Four relatives and four residents responded to a pre-inspection survey. The CSCI has received no complaints since the last inspection and no additional visits have been made. What the service does well: Residents spoke highly of the care they received describing the staff as caring and the home as ‘home from home’. Residents liked the meals and said that there was always a choice. Residents said that the routines were flexible and they could get up and go to bed when they wanted and could either spend time in their rooms or in the lounges. Staff and residents interacted positively together and there was regular talking between them. The home had a very relaxed and friendly atmosphere. Staff treated residents with dignity and respect. The home placed a high emphasis on training and seven of the twelve care staff had got NVQ 2 or above. The home was well managed and there were good relationships between staff and the care manager/ owner. The staff worked well together and were very supportive of each other. There was little turnover of staff with a number of staff having worked at the home for several years. The staff and manager/ owner were fully aware of the individual needs of the residents and worked to provide each resident with an individual service that respected their individual needs and preferences. The home surveyed the residents for their views on the service provided. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 6 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 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 standard(s) 2,3,5 Residents had the opportunity to visit the home to assess whether they wanted to live there and all placements were made on a trial period. The knowledge of the staff, the relationships with health care specialists and the pre-admission assessment process enabled residents to be reassured that the home would be able to meet their needs. The home provided residents or their representatives with a contract ensuring that residents were aware of the services covered by the fees and what they may have to pay for in addition. EVIDENCE: Residents or their representatives all received a contract that outlined the terms and conditions of occupancy identifying fully the service to be provided and those items that the resident needed to pay for. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 9 Residents’ needs were assessed by the home and the local authority prior to any placements being offered. Residents and/or their representatives always had the opportunity to visit the home before making a decision to live at the home. Copies or assessments were present on file. Placements were made on a trial basis. Staff were fully aware of each residents’ needs and their preferences. Staff were well trained with a high number of staff being NVQ trained. Staff were aware of actions to show respect to residents and to respect their privacy and dignity and to promote choice. The home had developed good relationships with health professionals and referred appropriately. The home had no resident with needs relating to culture or religion and this would need to be discussed prior to admission. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 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) 7,8,9,10 The care planning process provided staff with the necessary information to be able to meet the needs of the residents. The health care needs of the residents were being met and there was evidence of positive multi agency working taking place. Personal care support was provided in a manner that afforded the residents dignity and respected their privacy and promoted their individuality. The systems for administrating medication were good ensuring that the residents’ medication needs were met. EVIDENCE: The home completed a personal care plan for each resident that covered the areas of health, personal care and social needs. The plan identified how these areas would be met. The plans were being evaluated on a monthly basis. The resident if able and the relatives were involved in this process. Risk assessments were in place including those for residents using bedrails. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 11 The health care needs of the residents were being met. The residents received dental care; chiropody and an optician visited the home. Residents were provided with equipment related to the promotion of tissue viability. The home had developed relationships with the local health care services that visited when needed. A District Nurse visiting a resident stated that the home referred residents appropriately and responded to any advice given. Records showed that residents received services from the continence adviser and a CPN when needed. Residents spoken to stated that they were well supported by staff and that the staff were caring. Staff respected residents’ privacy and dignity when undertaking care staff and they were aware of good practice issues. The home had a monitored dosage system for the administration of medication and observation of the process showed that medication was being administered correctly. The appropriate records were being completed and staff had received training although the home was looking to develop this training. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 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) 13, 15 The home provided an environment where residents were able to have visitors when they wished, to see them in private and who were made to feel welcomed. The home provided a varied menu that provided residents with choice and was able to respond to individual needs. EVIDENCE: Relatives felt welcomed to the home and were able to meet their relative in private. Visits could take place at any reasonable time. Relatives were provided with full information over the services provided at the home. Relatives confirmed that they were consulted over the care of their relative. The residents liked the food and stated that they were provided with choice and were consulted over what they wanted to eat. The home provided a main meal and pudding at lunchtime. Residents had breakfast when they got up and a number had it in their bedrooms. Breakfast consisted of a choice from cereals, porridge, toast, egg and tomatoes. Residents chose what they wanted for tea from a range of foods such as sandwiches and cheese on toast or a similar alternative followed by cake, yoghurts etc. However the home will respond to any requests from residents if they want something specific. Snacks were available between meals and for supper. The home provided T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 13 home baked cakes and puddings and used fresh vegetables. Fruit was available. The home was able to provide for some specialist diets such diabetic. There were no residents that had dietary needs due to their religion or culture. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 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 standard(s) 16,18 The home had a satisfactory complaints system that was known to residents and relatives and residents felt that any concerns would be acted upon. The home’s procedures and the knowledge of the staff should ensure that any incidents of adult protection were identified and acted upon. EVIDENCE: The home had a complaints procedure that was displayed in the home and was given to residents and their representatives. Residents spoken to say that they would raise any concerns with staff and felt that they would be dealt with. Relatives reported that they were aware of the complaints procedure. The home also sought the views of residents over the service provided. No formal complaints had been received by the home or the CSCI since the last inspection. The home had a procedure for responding to any incidents of adult protection. Staff that had undertaken NVQ qualifications had received training in this area. Staff spoken to were clear that that they would report any concerns they might have if they had concerns over a resident. The home does not look after residents’ money. Staff were understanding of incidents of aggression by any resident. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 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 standard(s) 19,20,21,23,24 The standard of the environment was satisfactory and although certain areas would benefit from redecoration the residents were provided with suitable communal and private accommodation. The home supported residents to make their bedroom their own by having their own items of furniture and personal belongings around them. The cleaning procedures in place provided the residents with an environment that is clean and hygienic. EVIDENCE: The home’s layout and design was suitable for the residents. There were some areas within the home that would benefit from redecoration. Bedrooms were suitable for residents and there were screens provided in shared rooms. Bedrooms were lockable and those that wished had a lockable facility provided. Bedrooms had the necessary furniture and seating was provided. Bedrooms had been personalised with residents able to bring in items of furniture, pictures, ornaments and their own soft furnishings if they wished. The home had adequate communal facilities with one large lounge and a small lounge as T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 16 well as a separate dining room. The home had a small laundry and suitable kitchen facilities. The home had suitable bathing and toilet facilities. The home was clean and tidy throughout. The home employed domestic staff. The home had procedures in place to control the risk of infection. There were plenty of gloves and aprons provided and staff were aware of issues of infection control although had not received training in this area. The laundry was suitable to meet the laundry needs of the home. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 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 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) 27,28,29,30 The home provided staff that had been subject to pre employment checks and in such numbers that could meet the needs of the residents. Staff were well qualified, knowledgeable and were enthusiastic providing the residents with a good quality of care that respected their privacy, dignity and individuality. EVIDENCE: The home had a minimum of two care staff on duty during the day and night. In addition the Care Manager was often available to provide additional care support. This level of staffing was suitable to meet the needs of the residents. In addition the home had a staff member who undertook the cooking and further staff who undertook domestic staff. The home placed a high emphasis on staff training and approximately 60 of staff were qualified to at least NVQ level 2 and four of these had achieved NVQ level 3. A further staff member was doing NVQ level 2. All new staff undertook induction training and the home organised additional training related to the needs of the residents. The staff were caring and the needs of the residents were paramount. Staff were committed to providing a good standard of care promoting the principles of privacy, dignity and individuality. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 18 The home operated suitable recruitment processes and undertook the necessary pre-employment checks. The home had a very stable staff group with little turnover. Several of the staff had worked at the home for over 5 years. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 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 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) 31,33,36,38 The residents benefited from a home that was well managed and from a manager that was committed to providing a good service. The Quality Systems in place provided the residents with a home that consulted with them and took action to improve the service. Whilst the home undertook regular on the job support and informal supervision the development of formal supervision could improve staff knowledge and skill providing the residents with a higher quality of service. The home had Health and Safety procedures in place and provided a range of relevant training but there were some areas that needed to be addressed in order that the residents were not adversely affected. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 20 EVIDENCE: The home was well run and the manager/ owner was supportive to staff and treated them and residents with respect. The manager/ owner had completed NVQ level 4 and the qualification to manage a care home. She worked fulltime in the home and undertook care tasks alongside the care staff. The manager/ owner had the necessary knowledge, skill and experience to be an effective manager. Although a small family run home the home operated some Quality Assurance systems. The manager undertook checks on a number of records and undertook surveys of residents and relatives over the care provided. Evidence showed that any areas of dissatisfaction raised by residents was addressed. The home was not undertaking formal staff supervision although staff worked closely with each other and were observed working on a daily basis. The home had health and safety procedures in place. Staff had undertaken training in food hygiene, first aid, lifting and handling and fire safety. Staff had not undertaken training in infection control. The servicing of equipment such as boilers, lifts and hoists was completed. Fire checks were being undertaken. Procedures were in place to control the risk of legionella. Hazardous substances were kept securely. Records were maintained of the temperature of food stored and of hot water. The home did still need to address the issue of hot surfaces – radiators - and this has been outstanding for sometime. The home had a gas safety certificate but no current electrical installation record. Records of accidents were being kept. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 x 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 3 x 3 4 x 3 x x 2 x 2 T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 22 yes 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. 2. 3. 4. Standard 36 38 38 38 Regulation 18(2) 13(4)(c) 13(4)(c) 13(4)(c) Requirement That all staff are provided with individual formal supervision That staff undertale training in infection control That an electrical installation check be completed.NIC or equivelent. That evidence be provided that the process of covering hot surfaces is being addressed. (previous timescale not met) Timescale for action 1.9. 2005 1.10.2005 1.9.2005 1.10.2005 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. 2. Refer to Standard 24 Good Practice Recommendations That redecorating take place in the corridors and communal areas that require it. T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 T.N.P House E51 E09 S5029 T.N.P House V228609 040705 Stage 4.doc Version 1.40 Page 24 - 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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