Inspection on 29/06/05 for Tor Vale

This inspection was carried out on 29th June 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

Tor Vale 29/06/09

Tor Vale 17/05/07

Tor Vale 15/11/05

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 PL8 2BJ Lead Inspector Rachel Proctor Announced 29 June 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tor Vale Address Chittleburn Hill, Brixton, Plymouth, Devon, PL8 2BJ 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) 01752 480950 01752 480950 The Durnford Society Limited Lesley Amanda Barry Care Home 5 Category(ies) of Learning Disability (5) registration, with number of places Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Learning Disabilities (18 years and over) Date of last inspection 18/01/05 Brief Description of the Service: Tor Vale is a purpose-built home for 5 people 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 D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 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 announced inspection and took place on the 29th of June 05 between 9:45 a.m. and 3:45 p.m. a tour of the homes environment was completed as part of the inspection. Two residents relatives and the majority of staff on duty was spoken to during the day. Some records were inspected. What the service does well: What has improved since the last inspection? What they could do better: Any improvement the home manager makes will build an already good practice. All the standards inspected were met or exceeded on this occasion. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 6 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 D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 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 standard(s) 2, The residents and their relatives can have confidence that the staff at Tor Vale will assess their care needs in a holistic comprehensive way ensuring that as their care needs change these continue will be met. EVIDENCE: Two relative comments cards received stated that they had been able to influence the care they relative received and are being kept informed of changes that occurred. Two relatives spoken to advise the inspector that staff continually check to ensure that their relative’s care is appropriate for the needs. They also said they were aware of the care plan and had been asked to participate in its development. One resident’s file had a comprehensive assessment of their care needs recorded. This assessment included physical, psychological, and social care needs identified over time by the staff team. The manager confirmed that all the residents care plans are completed to the same standard. The life plan was viewed for one resident. This resident was unable to communicate verbally with staff. The life plan identified the things that were important to the resident and how staff could facilitate this. The life plan had been developed in conjunction with the resident and the staff responsible for Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 9 their care. It recognised what individual gestures and expressions the resident used to express their like or dislike. The manager confirmed that each of the residents has a reassessment review on a six monthly basis where health care professionals, the relatives or advocates, and staff responsible for the care attend. One residents six monthly review was seen during the inspection. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 9, The residents are enabled to make decisions in a risk managed way, this enables their personal goals to be reflected in their plans of care. EVIDENCE: The care the residents need is recorded in a comprehensive care planning system. These were available for each of the five residents living at Tor Vale. One resident’s plan identified how staff ascertained the resident’s views, likes and dislikes. This resident’s plan identified that they enjoyed being outside and listening to sports. A trip to the motor sport event had been arranged for this resident by the staff. A comprehensive risk assessment processes in place. All the activities the resident undertake including personal care, health care and any social activities they undertake our risk assessed to ensure the resident’s safety is maintained. Several of the staff spoken to explained how they assess and monitor the care of the resident they were responsible for. The little things that they had noticed were important to the residents were incorporated in the plan of care. For example one resident really enjoyed listening to music another enjoyed being outside. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 11 Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 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 standard(s) 13, 15, 16, 17, The residents at Tor Vale are treated with respect and enabled to experience a variety of leisure activities in the community supported by a knowledgeable staff team. EVIDENCE: During the inspection two members of staff took one of the residents on a trip to Dartmoor. This resident’s plan of care identified that they preferred to be in the home at night and therefore daytrips out were provided instead of a holiday. The relatives spoken to advised that the staff at Tor Vale ‘do their best’ to ensure that their relative has the things they value and is treated in the way that they would like. The comment cards received were complimentary about the facilities and services offered to the residents. The daily routines of the individual residents are recorded in the plans of care. The residents at Tor Vale have lived there for several years the staff have built up an understanding of the residents likes and dislikes. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 13 The lunchtime meal observed was unhurried the residents were being assisted by staff in the discreet supportive way. The residents who were able were being encouraged to eat. The manager confirmed that the menus are planned in conjunction with the staff. Each of the residents personal preferences of food have been recorded over time, this is allowed meal planning to take into account the individuals needs. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 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 standard(s) 18, 19, 20, The residents at Tor Vale have their health care needs met by a knowledgeable well-trained staff team who understand their complex health care needs. EVIDENCE: The way the individual residents preferred their care to be delivered has being established over time. All the residents have lived at Tor Vale for some years; this has allowed the staff to build up a clear picture of what pleases the individual residents. These observations that had been built up over time regarding individual residents had been recorded in one residents life plan. These included observations of the types of activity that the residents enjoyed. How the individual residents health care needs were assessed and monitored were an integral part of the care planning process. The involvement of members of the multidisciplinary team including health and social care professionals had been documented. The plan of care for the resident had been updated following professional assessments of their care needs. These included speech therapists, physiotherapists and psychologists. The involvement of the tissue viability specialist’s nurse had been recorded and advice she had given implemented for one resident. Wound care management is recorded in a comprehensive way. The clinical training staff had received included updates in wound management. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 15 The medication practices at Tor Vale meets the required standards. Each of the resident’s medication records had been completed. Medication was securely stored in a locked cupboard within a locked room. Reference material for staff use regarding medication was easily available. Where medication is required for emergency purposes the protocols for there use is well recorded and easily available for staff. Key qualified Staff have received training in the use of emergency medication for the residents. Resident’s medication is organised to allow them to have trips outside the home or go on holiday. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 16 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, 23, The residents and their relatives can have confidence that any concerns they have will be dealt with sensitively by the staff team at Tor Vale. The residents are cared for by a knowledgeable staff team who promote their interests. EVIDENCE: The complaints procedure is easily available for staff, residents and their representatives. This explains how complaints will be handled and who to contact. The complaints procedure has also been prepared in pictorial form for the residents. The manager confirmed that she was exploring ways of providing the information on tape or disk. The complaints and comments book was provided for the inspection. Several compliments had been recorded in the comments section of this book and no complaints had been listed. No complaints have been received by the Commission regarding the care of the residents at Tor Vale. A list of the training of staff had received was provided. This includes no secrets” adult protection training. Policies and procedures are in place to guide staff. These policies were easily available in the office of the home. Comment cards received indicate that the residents are well cared for and their relatives feel they are protected. Positive comments were received about how the staff interact with the residents in a friendly and supportive respectful way. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 17 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, 30, The residents at Tor Vale have a pleasant well maintained, clean fresh environment to live in, that has been decorated and equipped taking their individual tastes and care needs into account. EVIDENCE: Tor Vale is a purpose-built one-storey home. The environment is bright, airy and homely. One resident relative asked said the home is always pleasantly decorated and their relative was asked about the decor in their room. One resident confirmed that they had chosen the colour scheme and new floor covering for their room. The manager confirmed that two further residents’ rooms were going to be redecorated. She advised that the residents would be enabled to choose the colour scheme for their rooms. One of these residents’ relatives had guided the staff regarding their relative’s colour and texture preferences. All the residents individual rooms are larger than square 12 square metres. The furniture and furnishings are domestic in character. The beds the individual resident use can be electronically adjusted to the correct height for the resident. One resident told the inspector that they liked their new bed. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 18 Tor Vale has an adapted minibus capable of transporting the residents and their wheelchairs. This was being used on the day of inspection to take one of the residents on a trip to Dartmoor accompanied by two members of staff. The manager confirmed that staff are trained to drive the minibus. Staff had replanted the gardens outside the home since that last inspection. The seating in the gardens and spaces provided a pleasant place for the staff, residents and their relatives to sit and enjoy the summer sunshine. Maintenance records were available for inspection; the inspectors saw that ongoing repairs and renewals were taking place. The home was pleasantly decorated in all areas. The home was fresh and clean at the time of the inspection. Relatives asked said the home is always beautifully clean and well presented. Policies and procedures are in place for infection-control practices. The home has a disinfecting sluice and a washing machine with the sluice cycle. These reduce the risk of cross infection. Cleaning materials and protective clothing were available for staff use; these were stored appropriately and easily available. Staff training includes infection-control practices. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 19 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) 31, 32, 33, 34, 35, 36. The residents at Tor Vale are cared for by well-trained knowledgeable staff team, led by a manager who has skills, qualities and experience to ensure the residents benefit from a well run home. EVIDENCE: Each of the staff spoken to during the inspection were clear about their roles and responsibilities. They also confirmed they felt well supported by the manager and had access to training and help them look after the residents. The manager is the first level nurse with several years experience in the learning difficulties field; she holds a management qualification and has kept her knowledge and skills up-to-date. The training staff had received had been recorded and copies of certificates were available. The manager confirmed that all staff are encouraged to complete LDAF qualifications to enable them to gain a greater understanding of the residents group. Four members of staff confirmed that they were in the process or had completed this course and were finding it very useful. The staff on duty at the time of the inspection were working well as a team supporting the residents and ensuring they were cared for in a professional way. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 20 Three of the staff files confirmed that all the records required are kept. The pre-employment checks required had been completed and each member of staff had had the CRB completed. The manager confirmed that all staff have regular supervision and appraisals, the records of these were available. Those seen evidence that staff have a training and development plan that meets their professional needs and links to the residents care needs. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 21 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) 39, 43, The manager has policies, procedures and practices in place that ensure the care home fulfils its stated purpose and objectives, and meets the needs of the residents who live there. EVIDENCE: The manager provided the results of an internal audit carried out. This included health and safety aspects as well as reviewing how care is directed for the residents. The resident’s representatives regularly give feedback to the staff regarding the services provided for their relatives. Copies of letters were provided. The comment cards received from relatives were complimentary about the care and services provided by the staff at Tor Vale. One comment card received from a health professional stated that staff are very professional, theyre good at communicating important issues and actively involved in all suggestions regarding the physical management of the people who live at Tor Vale. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 22 Systems are in place to ensure that staff receive the training and supervision they required to carry out their work. The manager has a system in place that ensures the health and safety of the residents and staff and maintain. A comprehensive risk assessment process for the activities the residents undertake and the environment they live in were available from inspection. Comprehensive manual handling assessments were available for each resident these identified how staff should assist individual residents and the type of equipment required. The manager confirmed that manual handling assessments are completed on a regular basis and when the care needs of the residents change. This was evident in the residents plan is viewed. Any accidents are recorded and actions taken to address any identified concerns were in place. The fire logbook included a record of the instruction staff had received and the regular checks on fire extinguishers and alarms. The training registers showed that staff were completing first aid, food hygiene and infection control training. The training records confirmed that all staff receive induction and foundation training that meets requirements. Two staff spoken to advise how useful the training specific to the learning difficulties group had been in enabling them to provide care for the residents at Tor Vale. Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 23 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score 4 3 x 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME 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 x x 3 x x 3 x D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Tor Vale D54-D07 S3613 Tor Vale V225840 290605 Stage 4.doc Version 1.30 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!