Inspection on 20/01/06 for Townsend House

This inspection was carried out on 20th January 2006.

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

Townsend House 15/10/07

Townsend House 19/09/06

Townsend House 30/08/05

Townsend House 28/09/04

Townsend House 25/05/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Townsend House Bayswater Road Headington Oxfordshire OX3 9NX Lead Inspector Jane Handscombe Unannounced Inspection 20th January 2006 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 Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 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. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Townsend House Address Bayswater Road Headington Oxfordshire OX3 9NX 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) 01865 762232 01865 744681 The Orders Of St John Care Trust Jean Pyle Care Home 45 Category(ies) of Past or present alcohol dependence over 65 registration, with number years of age (3), Dementia - over 65 years of of places age (17), Learning disability over 65 years of age (3), Old age, not falling within any other category (45), Physical disability over 65 years of age (20) Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 45. 30 August 2005 Date of last inspection Brief Description of the Service: Townsend House is situated in Headington on the outskirts of the city of Oxford. It is a care home for 45 older people, formerly a County Council home and now the responsibility of The Orders of St John Care Trust. The two storey building has a lift, and each room is linked to a call system to summon staff assistance when required. The care home provides single rooms with several lounge areas, one being designated for smoking. There is a communal dining room, an attractive conservatory room and pleasant accessible grounds with seating. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which lasted 5 and a half hours and took place on 20th January, 2006. The purpose of the visit was to see how the home is meeting the National Minimum Standards. The visit involved touring the premises, speaking to residents to ascertain their views upon the care they receive at the home, staff members and the manager, viewing records held whilst also observing the day to day operations of the home. Comments received from residents during the inspection include: ‘Its very good here’ ‘I feel safe here’ ‘Its always very clean’ The ‘care I get is very good’ ‘The food here is excellent’ The inspector would like to thank the residents, staff and visitors to the home for their warm welcome and their assistance during the inspection process. What the service does well: What has improved since the last inspection? A new system of care planning is now in use, however care planning needs further development. An activities co-ordinator has been employed since the previous inspection, which allows for a greater level and range of activities for the residents to take part in and enjoy. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 6 The complaints procedure has been updated to include contact details, which were omitted during 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. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 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 Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 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): 3 and 5 Individual care needs assessments are carried out before admission to ensure that the home can meet the individual’s needs. All prospective service users are invited to visit the home before making a decision. EVIDENCE: Whilst individual care needs assessments are undertaken by a person qualified to do so, the inspector found these did not always evidence that there had been appropriate consultation regarding the assessment with the prospective resident/representative. Prospective residents are encouraged to visit the home in order to meet with the staff, fellow residents and view the facilities and services offered at Townsend House, in order that they can make an informed choice as to whether the home is suitable for them. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 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): 7,8 and 10 All residents have a plan of care drawn up from an assessment of needs, although these are not always comprehensive. The care planning and review process is of a poor standard and needs to be addressed to ensure that residents’ needs are met in full. The inspector is of the opinion that there is little improvement since the previous inspection, and this needs to be addressed immediately to ensure the health, welfare and safety of all those in their care. EVIDENCE: The inspector examined a sample of care plans and generally found them to be incomplete; risk assessments and moving and handling assessments were not always being undertaken. The reviewing of the risk assessments that had been undertaken, were being undertaken at inappropriate intervals as were the reviewing of residents’ plans of care. The lack of risk assessments and regular reviews of care means that both the staff and residents’ safety and well-being is potentially put at risk, and does not ensure that residents’ needs are met in full. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 10 Admissions to hospital were not always logged in the care plans and monthly recording of residents weight were not always being carried out. One resident’s inventory of valuables brought to the home was unsigned by both the manager and resident. The manager must ensure that personal inventories are undertaken for each resident upon admission and it is a good practice recommendation that they be dated, witnessed and signed in order to protect the interests of both the resident and the home. Evidence to show service user/representative involvement in the care planning and assessment process, and their agreement to the care plan was not evident in the majority of those files viewed. An immediate requirement was made in which the manager was to complete risk assessments for those residents identified during the inspection, whose files did not contain these. It was required that these be completed within 24 hours and CSCI to be forwarded confirmation that this had been undertaken. The manager telephoned the inspector to confirm that this had been undertaken, and to confirm that one resident’s review of care highlighted during the inspection had in fact been undertaken. The resident herself spoke to the inspector during the visit confirming that a review had in fact taken place, however, there was no evidence of this review or of any necessary changes made to the care plan. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 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 and 15 The daily life and social activities provided at Townsend House match the residents’ preferences and interests. Residents receive a wholesome nutritious diet, and every effort is made to ensure that meal times are a pleasurable experience. EVIDENCE: The home provides a daily programme of activities to suit the varying needs of the residents within the home which include seated exercise, bingo, cooking, art and crafts, news discussions, quizzes and shopping trips on a one to one basis. The activities co-ordinator works with the residents both in group activities, and on a one to one basis for those who prefer. A log of participation is kept as are the residents’ hobbies and interests, to ensure that the activities offered match their preferences and expectations. The residents informed the inspector that they enjoy the cooking sessions in which they make biscuits, tarts etc which everyone is able to savour. The home has recently employed a new chef, who informed the inspector that all the meals were freshly prepared and cooked on the premises. The chef undertakes a monthly monitoring of meals, and gains residents’ views and comments in order to ascertain their preferences and dislikes. One resident Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 12 informed the inspector ‘the food here is excellent’ whilst another said ‘the meals I can’t fault at all’. The inspector found the kitchens to be kept clean, tidy and to a very high standard. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 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 are aware of the complaints procedure, and confident that any concerns or complaint would be taken seriously and acted upon appropriately. EVIDENCE: The home has received one complaint since the last inspection regarding a damaged wheelchair. The matter was dealt with appropriately and the resident was satisfied with the outcome. The complaints procedure is posted on notice boards throughout the home, although the inspector found inconsistencies and recommends these be rectified. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 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 The home provides comfortable surroundings, which are equipped to meet the residents differing needs. Risk management in relation to access to parts of the home were poor. Some communal facilities were inaccessible due to poor storage arrangements, and thus hazardous to residents’ safety. EVIDENCE: The home has sufficient toilet, washing and bathing facilities, most of which were accessible and clearly marked. However the inspector noted wheelchairs being stored in one of the residents’ communal toilets along with a resident’s intimate personal belongings, which compromised their dignity and respect. A requirement had been made within this report to ensure wheelchairs are stored appropriately to allow residents easy access all parts of the home without obtrusion, thereby ensuring their health, safety and welfare. Likewise, residents’ rights to privacy, dignity and respect must be upheld at all times Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 15 Further issues compromising residents and staff’s health, safety and welfare were found during the inspection. Requirements have been made to address these issues in order to safeguard residents’ and staff’s health safety and welfare. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 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): 29 and 30 Staff undergo the appropriate training to ensure competency in meeting the residents needs. EVIDENCE: The recruitment of staff is thorough, and a sample of staff files were viewed which showed that there are good systems in place. All members of staff undergo induction training, upon appointment to their posts, and are offered ongoing training which equips them to meet the assessed needs of the residents within the home. Staff members are encouraged to undertake the National Vocational Qualification (NVQ) in care. The inspector was informed that 12 members of staff are participating in training for the NVQ level 2 in care, with a further 4 participating on the NVQ level 3. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 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): 35 and 38 In view of the findings during the inspection around assessments, care planning and health and safety issues, the home is not presently protecting the health safety and welfare of the residents appropriately. The absence of thorough assessments of needs and reviews of these needs does not protect and promote the health, safety and welfare of those using the service and could result in residents being placed at risk. There are clear robust systems in place to protect the residents’ financial interests. EVIDENCE: The inspector met with the administrator and discussed the management of the residents’ finances. Systems and records are in place and provide a clear audit trail to safeguard the residents’ financial interests. Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 18 The home is not presently protecting the health safety and welfare of the residents appropriately (see sections headed Health and personal Care and Environment) Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 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 x 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 x 2 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x 1 Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 20 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 OP3 Regulation 14(1)a,c Requirement The registered manager must ensure full assessments are carried out with all prospective service users and to which they/their representatives have been included in the assessment and care planning process. This was also made a requirement during the last inspection. The registered manager must ensure that assessments of residents needs and their care plans are kept under review and revised at any time when its necessary to do so. The registered manager must identify and document potential risks to all residents and/or staff members within a risk assessment with the relevant means to be undertaken to eliminate unnecessary risks The registered manager must undertake risk assessments for the residents identified during the inspection and confirm to CSCI that this has taken place. DS0000013161.V279177.R01.S.doc Timescale for action 31/01/06 2 OP7 14(2)a,4 28/02/06 3 OP7 13(4)c 28/02/06 4 OP7 13(4)c 21/01/06 Townsend House Version 5.1 Page 21 5 OP10 12(4)a 6 7 OP38 OP19 13(4) 13(4) The reg manager must raise the issue of personal intimate belongings on display with regard to residents dignity and respect with all staff. Food in communal refrigerator’s must be stored appropriately. The registered manager must store wheelchairs and hoists appropriately 28/02/06 20/01/06 07/02/06 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 OP37 OP16 Good Practice Recommendations It is a good practice recommendation that personal inventories be dated, witnessed and signed in order to protect the interests of both the resident and the home It is a good practice recommendation that the complaints be visited and inconsistencies be rectified Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Townsend House DS0000013161.V279177.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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