Inspection on 15/11/05 for Tor Vale

This inspection was carried out on 15th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Tor Vale 29/06/09

Tor Vale 17/05/07

Tor Vale 29/06/05

Tor Vale 18/01/05

Tor Vale 19/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Tor Vale Chittleburn Hill Brixton Plymouth Devon PL8 2BJ Lead Inspector Rachel Proctor Unannounced Inspection 15th November 2005 11:40 Tor Vale DS0000003613.V268877.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 Tor Vale DS0000003613.V268877.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. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tor Vale Address Chittleburn Hill Brixton Plymouth Devon PL8 2BJ 01752 480950 01752 480950 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) The Durnford Society Limited Lesley Amanda Barry Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Learning Disabilities (18 years and over) Date of last inspection 29/06/2005 Brief Description of the Service: Tor Vale is a purpose-built home for 5 service users with profound learning and physical disability. The staff provide 24-hour nursing care in a supportive comfortable homely environment. The home comprises a lounge, dining room, domestic type kitchen, five bedrooms, two toilets, one bathroom, one shower room, a treatment room and an office. The home benefits from level gardens, and paved seating areas. The mini bus is available to transport service users for leisure and recreational purposes. The home is situated close to the village of Brixton. The home is administered by the Durnford Society Ltd, which is a non-profit making industrial and Provident Society and has the charitable status.... Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The commission for social care inspection has introduced key standards to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that previous reports also be taken into consideration. This was an unannounced inspection and took place on the 15th of November 2005 between 11:40 p.m. and 3 p.m.. A tour of the home was completed as part of the inspection. Some record to inspected. The manager and some of the staff on duty was spoken to during the inspection. 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 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 the following standard(s): 2, 5 A competent caring staff team use a holistic assessment process, which, enables the individual residents aspiration and needs to be taken into account when planning care. EVIDENCE: Tor Vale has five residents who have lived at home for several years. One resident’s plan of care was viewed during the inspection. The ongoing assessment process of the individual residents care needs continues to be of a high standard. The assessments include physical, psychological, and social care needs, which had been identified over time by the staff team. The resident’s care plan viewed included a life plan, which gave information about the things that were important to them. Members of the multidisciplinary team including speech and language therapists and dietician had assessed this resident. The care plan had been developed from the assessment of need and changes to the care needs had been incorporated into the plan of care. The manager advised that the current resident’s are funded by a block contract through the National Health Service. One individual contract for a resident’s placement was viewed. This explained the terms and conditions of occupancy and the overall cost of the placement. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 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 the following standard(s): 6, 9, A caring competent staff team enable the residents to experience community activities in a risk managed way. EVIDENCE: Comprehensive care plan documentation is available for each of the five residents living at Tor Vale. Although the majority of the residents are unable to express their concerns and wishes clearly, their care has been personalised to reflect their preferences, which staff have learned over time. One resident’s plan of care was viewed during the inspection. This resident’s care needs had changed since the last inspection. The way the care had been tailored to the individual’s care needs was clearly recorded. The resident’s personal goals, which had been developed with the resident and their representative, were set out in a way that was achievable. One senior carer spoken to explained how he had used the sensory room to enable a resident to experience different light and sound combination. The plan for the therapeutic sessions in the sensory room had been recorded. This enabled other staff to provide the same structured programme for the Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 9 resident. The review of the session evidence the resident’s interaction with the therapeutic programme developed for them. The manager advised that the resident’s plans of care were in the process of being transferred to audio disc. She explained that the residents who were blind and unable to speak aapeared to listened when their plan of care was read to them. The complaints procedure has also been provided in this format since the last inspection. A key worker system is in place for individual residents. The manager confirmed that all residents have a formal six monthly review of their plan of care. The review team includes the resident ,their family/representative, health care professionals involved in their care i.e. speech and language therapists and the staff caring for the resident at Tor vale. One residents six monthly review was seen during the inspection. This identified the activities the residents had completed and their goals from the last review. New goals and planned activities for the resident for the next six months were recorded. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14,17 A competent and caring staff team who have the residents best interests at heart enable them to experience a variety of leisure activities in the community. EVIDENCE: The manager confirmed that none of the current residents are able to participate in employment because of their disability. The care planning records demonstrate how individuals are encouraged to experience new activities. The use of the sensory room, which enables the residents to experience different sights and sounds in a safe environment, is provided. The manager advised that one resident would be visiting a holiday cottage in Cornwall with a view to using it for a holiday early next year. She further advised that over time staff had found that this resident enjoyed being near the sea and like the feel of the wind on their face. During the inspection one resident was taken to the local hairdressers. Another resident had a coffee morning arranged with one of the staff members for the following day. A wide variety of activities are available for the residents Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 11 that are within their capabilities. The manager advised that the staff are always looking for new opportunities for the residents to participate in the community. The manager explained how holidays and/or regular trips outside the home are organised for the residents. Personal choices are taken into account when planning activities. The inspector was told that over time staff had learned the type of activities each resident liked. These observations had been recorded in their individual plans of care and activities planned around these. A disabled access minibus has been provided for the resident’s. The manager advised that each member of staff had been trained to use the minibus. The manager advised that the residents usually go out individually with staff in the minibus to various activities within the community. The staffing numbers provided cover the residents who remain at the home as well as the residents who go out. The meals are cooked fresh each day by the staff. Residents who required puréed food had had this prepared to allow them to experience different tastes of the food. The staff assisting the residents to eat their lunchtime meal were doing so in a sensitive way. The residents likes and dislikes for food and any specialist dietary requirements had been recorded. The lunchtime meal presented during the inspection was nutritionally balanced and attractively presented. The mealtime was relaxed and unhurried with the residents being assisted to eat the food of their own pace. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 12 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, The residents at Tor Vale continue to have their health care needs met by a knowledgable well-trained staff team who understand their complex needs. EVIDENCE: The staff team have established the resident’s personal preferences and choices over time and these are recorded in their plans of care. The personal support the residents require is provided in private. The daily activities of the residents are flexible. One resident who appear to prefer a cooked meal in the evening had this provided. Residents who wish to rest after lunch were facilitated to do this. Key workers had been identified for each of the five residents. The manager explained that the personality and preference of the residents were taken into account when key workers were allocated. A variety of technical aids and equipment are provided for residents at Tor Vale. The training staff had received included use of specialist equipment provided within the home. Health care professionals including occupational therapists and speech therapists had provided input into the resident’s assessments. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 13 The manager advised that the majority of staff worked long days, which enables them to work with the resident throughout the day giving the staff and residents continuity. The involvement of the wider health care team in the residents care had been recorded. Where health professionals had offered advice this had been incorporated into the resident’s plan of care. None of the current residents are able to take control or manage their own health care. The manager confirmed that the residents have regular access to health professionals including the GP. GP visits were recorded in the resident’s plans of care. The manager confirmed that all health professional see the resident in the privacy of their own room. Each resident has a well-documented health care plan which includes the involvement of the wider multidisciplinary team. One residents care plan had a record of the speech and language therapists report and the joint assessment which was carried out with the staff at the home. The medication records for one resident was checked, this had been completed and is expected. The controlled drug register was checked, the entries had been made in line with good practice recommendations. The medication for the residents is stored in a locked room in a locked cupboard. A lockable drug fridge is available for the resident’s medication that requires this. The manager confirmed that only registered nurses administer the medication for residents at present. She advised that she was exploring how senior health care assistants could be trained to administer some of the resident’s medication when they are outside the home. How this would be risk assessed and the type of training required was discussed. Resident’s medication is organised to allow them to have trips outside the home or go on holiday. Key qualified staff have received training in use of emergency medication for residents. When medication is required for emergency purposes. The protocols for there use is well recorded and easily available to staff. Reference material for staff use regarding medication was easily available. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 14 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, The residents and their relatives can have confidence that any concerns they have will be dealt with sensitively by the staff team who have their best interests at heart. EVIDENCE: The complaints procedure is displayed in the reception area of the home. The manager advised that the complaints procedure was now available on disk and pictorial form. The disc was available in the office of the home. In addition to this the residents have a copy of the complaints procedure contained in their care plan. An example of this was seen. The complaints and comments book was provided for inspection. The home has continued to receive compliments about the way they provide care and support staff. No complaints had been listed and no complaints had been received by the commission regarding the care of the residents at Tor Vale. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 15 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 The residents at Tor Vale have a pleasant well maintained, clean fresh environment to live in, which has been decorated and equipped in a way that values their individuality and provides for their care needs. EVIDENCE: Tor Vale is a bungalow, which has five individual residents bedrooms, a dining room, lounge and kitchen. Two disabled access bathrooms are available. All the residents’ rooms have been redecorated in the last 12 months. Each of the resident’s rooms had been personalised to reflect their character and choices. The premises are safe, comfortable, bright, cheerful, airy, clean and free from offensive odours and provide sufficient and suitable lighting heating ventilation for the residents. The home is accessed via a long narrow driveway from the main road. Adequate parking is provided. The corridors and rooms provide easy wheelchair access and the garden areas are accessible through ramps. The gardens have been planted out with a variety of shrubs. A raised border along one side would be accessible to wheelchair users to undertake gardening tasks if they were able. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 16 The furnishings and fittings are of good quality and domestic in character. Ongoing repairs and renewals have taken place since the last inspection. Each of the resident’s bedrooms has sufficient floor space to enable hoist and wheelchair access. The residents have height adjustable beds, which are all hoist accessible. On the day of inspection the premises were clean, hygienic and free from offensive odours throughout. Policies and procedures are in place to control the spread of infection, which are in line with good practice recommendations. Hand wash facilities, gloves and aprons are readily available for staff who care for the residents. The manager advised that she contacted the Health Protection Agency for advice and support in relation to its infection control policy as required. Copies of advice received from the Health Protection Agency relating to the management of infections was available in the office. The manager advised that staff had received infection control training. The home has a separate laundry area, which houses a washing machine with the ability to meet disinfection standards, a domestic style sink and a drier. The laundry floor and walls are finished to enable them to be easily cleanable. Tor Vale DS0000003613.V268877.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): EVIDENCE: The standards in this section were not assessed on this occasion. All the key standards were assessed at the last inspection three of these were met and two were exceeded. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 18 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, 42, The manager manages the home in a way that protects the health, safety and welfare of the residents and staff . EVIDENCE: The registered manager is qualified, competent and experience to run the home. She is a first level registered nurse with several years experience in the learning difficulties field. Shes kept herself up to date with health-care changes and has completed management courses. She was able to demonstrate how she keeps her knowledge and skills up-to-date. The staff spoken to during the inspection were complimentary about the managers management style and the support she gave them to do their work. There are clear lines of accountability within the home and clear policies for the staff to follow. Health and safety meetings continue to take place on a regular basis to ensure the staff and residents safety is protected. The health and safety audit was available for inspection. The fire risk assessment, manual handling Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 19 assessments and other risk assessments had last been updated in March this year. The health and safety policy file in the office had been signed by members of staff to acknowledge they had read the policies. A first aid box which is checked regularly is available and there is a designated first aider on duty. Accident records are being completed. The manager advised that the accidents are audited and any changes that can be made to reduce the risk are carried out. One resident had had a new type of bed provided because a risk of them rolling out of bed had been identified. Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 20 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 X 4 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 X X 4 X Standard No 24 25 26 27 28 29 30 STAFFING Score X 3 X X X X 3 LIFESTYLESx Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tor Vale Score 3 4 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 x DS0000003613.V268877.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No 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. 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. Refer to Standard Good Practice Recommendations Tor Vale DS0000003613.V268877.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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