Inspection on 14/09/05 for Toray Pines

This inspection was carried out on 14th September 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

Toray Pines 10/07/06

Toray Pines 06/02/06

Toray Pines 16/03/05

Toray Pines 01/07/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Toray Pines School Lane Coningsby Lincs LN4 4SJ Lead Inspector Jean Cope Unannounced Inspection 14th September 2005 09:30 X10015.doc Version 1.40 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 Toray Pines DS0000002558.V249249.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 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. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Toray Pines Address School Lane Coningsby Lincs LN4 4SJ 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) 01526 344361 01526 343294 Tanglewood (Lincolnshire) Limited Mrs Gillian McLellan Care Home 52 Category(ies) of Old age, not falling within any other category registration, with number (52), Physical disability (8) of places Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. All of the following rooms may be used to accommodate people within the category PD: numbers 15, 16, 17, 18, 40, 41, 42 & 43. Any service users within the category PD will be aged between 50 and 65 years. Occupancy When used by service users within the category PD, these rooms will be used on the basis of single occupancy and the overall occupancy will be reduced proportionately. 16/03/05 Date of last inspection Brief Description of the Service: Toray Pines is a purpose built home situated in the village of Coningsby, which has a range of local services and facilities. It is one of a group of homes operated by the same company, Tanglewood (Lincolnshire) Limited. It is set in its own well-maintained gardens with a patio area. Gardens are accessible for those service users with mobility difficulties or who need wheelchairs. Accommodation is provided on two floors, which can be accessed through a shaft lift or stairs. The majority of rooms are for single occupancy. Lounge and dining areas are located on both floors. There is car parking available to the side of the property. Toray Pines is registered as a care home to provide care and accommodation for up to fifty-two service users in total. The main registration is for older service users who are aged sixty-five years or over. Conditions of registration have been varied to enable the home to cater for up to eight service users with physical disabilities aged between 50 to 64 years of age in designated rooms which, when used for this category are used for single occupancy. At the time of inspection only two persons were requiring care in this category. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place with the assistance of the office manager, Andrea Dolby, as the manager and deputy manager were not on duty on the day of this unannounced inspection. One inspector undertook the inspection over a three hour period. The inspector toured the building, spoke with one member of staff and the office manager, relatives and residents. The main method of inspection used was called ‘case tracking’ which involved the selecting of three residents and tracking the care that they receive through discussion with them and the care staff and observation of care practices. There were thirty nine residents in the home on the day of the inspection. What the service does well: What has improved since the last inspection? Since the last inspection, all communal rooms and corridors have been decorated and new pictures have been hung on the walls. New serving areas have been installed in the dining rooms. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 6 The manager has achieved the Registered Manager’s Award at National Vocational Level 4. 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. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 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 the following standard(s): 2 and 4 Residents know that staff will try to ensure that they meet their needs. EVIDENCE: Terms and conditions are usually given to new residents on their admission to the home. Extra charges are made for hairdressing, chiropody, toiletries, newspapers, and trips out and for staff if they need to escort a resident to a hospital visit. One resident said that she was ‘very well looked after’. A visitor also said, that ‘you couldn’t wish for a better home with friendly staff who communicate with me and pass on messages from me to my relative’. A resident said that they ‘knew most of the staff and that they came straight away when they called for assistance’. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 9, 10 and 11 The privacy and dignity of residents is seen as important by the staff working in the home. EVIDENCE: A relative confirmed that the community nursing team are regular visitors to the home and that Doctors are called when necessary. Medication given to residents is already pre-packed by the home’s pharmacist and comes in a monitored dosage system. Seventeen staff have received training on the safe administration of medication within the last twelve months. One resident’s prescribed cream was seen in a communal bathroom, this was brought to the attention of staff immediately who removed it. A visitor said that her relative was ‘at the end of their life, but the staff are very caring and kind towards him’. Staff were seen to respect residents’ privacy and dignity. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 10 Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 12, 13 and 15 Residents’ families and friends are encouraged to visit the home and are made welcome. Food served in the home is of good quality and the menu offers a good variety of choice. EVIDENCE: A hairdresser was visiting the home on the day of the inspection and does so on a weekly basis. The home is currently advertising for an entertainments officer, but two forthcoming events were advertised including a visit from an entertainer. A church service is held in the home on a monthly basis. The home operates a four weekly rota, which offers a choice of midday meal, which states that fresh fruit or salads are available on request. Care staff ask residents what menu they would like to choose for the following day. Two residents said that the food was good, one saying ‘I have what I want to eat with a choice of two midday meals and the variety of food is very good’. Relatives were visiting their relations in the privacy of the resident’s room and were seen to come and go as they wished. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 12 Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 16 Residents can be sure that their complaints are taken seriously. EVIDENCE: Information received from the home states that there has been one complaint about the home in the last twelve months which was responded to within the home’s complaints procedure. There were only positive comments received, with one resident saying, ‘I wouldn’t want anything changed in the home’. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 19, 20, 22, 23, 25 and 26 Residents are able to live in a comfortable, clean and well maintained home. EVIDENCE: The home is decorated, maintained and cleaned to a high standard. It is comfortable and homely and residents are encouraged to bring small items of furniture into their own rooms as well as their own belongings. The home was odour free and hygienic and staff are aware of the need to eliminate infection and were able to give a good account of the procedures in the home, which include good hand washing techniques. Specialist equipment is available for the more frail residents, including assisted baths, hoists, specialist mattresses and cushions. One resident was unable to reach her call bell; this was brought this to the attention of staff on duty on the day. A resident had been able to have his room changed around to meet his needs. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 15 Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 16 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30 There is a good skill mix of staff working in the home who are well trained. EVIDENCE: The home has a manager and deputy manager supported by a care team leader, senior care assistants and care assistants. Each resident is allocated a named worker who is the point of contact for any advice or queries that a resident may have. The home also employs a head chef and deputy head chef, kitchen assistants, chambermaids, laundry staff and a gardener/maintenance person. A full time office manager is also employed. Over the past twelve months, staff have received training on moving and handling, fire training, basic first aid, health and safety, disability training and medication management, with further training being planned. A resident said that the staff team communicated well between each other. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 17 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 31, 33, 35 and 38 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, 35, 37 and 38 The home is managed by a qualified and experienced manager who is responsive to staff and residents’ needs. Residents can be sure that the home treats health and safety matters seriously and ensures that equipment is regularly checked and maintained. EVIDENCE: The home has a registered manager who has completed successfully the Registered Manager’s Award. Staff said that she was a ‘good manager and was very fair, addressed problems but looked at all aspects before she makes a judgement’. A copy of a meeting with senior staff indicated that staff were being asked, as well as residents in the home, how services could be improved in the home. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 18 The fire officer visited the home in February 2005 and left no recommendations. Fire bells are tested on a weekly basis and staff in the home have regular fire drills. A resident confirmed that fire bells had been tested the previous day. Equipment in the home is regularly serviced and the home has a current fixed wiring electrical certificate and the gas central heating system has been checked. The home has a range of policies and procedures, which are available for all staff. Staff said that there was a ‘nice atmosphere and staff genuinely care, and want to make residents happy and to see to their needs’. The home has safe and secure systems for looking after residents’ monies and all receipts are kept and the accounts are checked by two staff members. Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 19 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X 3 X X 4 4 X 2 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 20 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. 1 Standard OP9 Regulation 13(2) Requirement Timescale for action 15/09/05 2 OP22 23(2)(n) All prescribed medicines, lotions and creams must be used only for the person named on the label with immediate effect. Calls bells must be left within the 15/09/05 reach of every resident 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 Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Toray Pines DS0000002558.V249249.R01.S.doc Version 5.0 Page 22 - 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. 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