Inspection on 22/07/05 for Tozer House

This inspection was carried out on 22nd July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tozer House 25/11/08

Tozer House 05/12/06

Tozer House 12/12/05

Tozer House 11/10/04

Tozer House 28/06/04

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Insight - Eastchurch

Southfields

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Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Tozer House Tozer Way Chichester West Sussex PO19 4NX Lead Inspector Mrs K Allen Announced Friday, 22nd July 2005. V230881 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. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tozer House Address Tozer House, Tozer Way, Chichester, West Sussex, PO19 4NX 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) 01243 776703 01243 773929 tozer.house@westsussex.gov.uk WSCC - The Director of Social & Caring Services Mr P Buckwell Care Home (CRH) 15 Category(ies) of Learning Disability (LD) - 15, Learning Disability registration, with number over 65 years of age (LE(E)) - 15 of places Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Only service users under 65 years may be admitted. Date of last inspection 11th October 2004 Brief Description of the Service: Tozer House is a care home providing personal care and accommodation for fifteen people with a learning disability over the age of eighteen. It is within walking distance of the town of Chichester, West Sussex with all of its amenities and service by public transport. The premises consist of two houses within a complex of three, all of which are similar in design. They are two-storey and purpose built around a wellmaintained courtyard. All of the bedrooms are single although none have ensuite facilities. In addition, there is a separate building with an office, kitchen and communal lounge. There is no passenger lift. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection a review was made of the contact between the home and the Commission for Social Care Inspection (CSCI) since the last inspection, which included an analysis of incident reports and those of other statutory bodies such as the fire service. Comment Cards were distributed via the home to residents, relatives and visitors and thirteen were completed and returned. The inspection took place from 4.15pm over five hours on July 22nd 2005. During the inspection six residents were spoken to either in the lounge or privately in their room. A discussion was held with staff, the deputy and manager. In addition a number of records were seen and a tour of the premises was made. Residents said “I don’t want to go anywhere else””, “the staff are nice” and “I like it here”. 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. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3 & 4 Prospective service users have the information they need and their needs are assessed. The home meets the needs of current service users and new people can visit the home before deciding to move in. EVIDENCE: There is a written Statement of Purpose which is reviewed each year. It has been updated since the last inspection to take account of staff changes and their qualifications. A copy was provided for the inspector. This document is not written in a way that residents can understand however they are provided with a Service User Guide which is written using pictures and symbols. This includes details about how to make a complaint, how many people live at the home, information on their accommodation etc. Two new people had moved into the home and both had a written assessment of their needs. The home engages other professionals such as a continence advisor, the community learning disability team and occupational therapist to ensure resident’s needs are met. Staff communicate well with residents and have experience and qualifications for the job. One of the new people had been receiving short stays at the home for some time therefore he knew the service provided and the staff knew him. The other person had been settled in another home for many years and needed to move as it was closing. It was clear that this person was comfortable in her new setting and this had been achieved by a gradual introduction to the home. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 8 Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 9 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, 8 & 10 Service users assessed needs are reflected in their individual plan. They are enabled to make their own decisions and participate in all aspects of the home. Information about residents is handled appropriately. EVIDENCE: A care plan is drawn up for all residents based on their assessed needs. It is reviewed regularly involving other interested parties such as parents, when appropriate. A key worker for the resident also attends. They represent the person concerned and support them in representing themselves. Areas covered in the plan include social skills, diet, health needs, contact with family/friends etc. Residents have the opportunity to attend an advocacy group and minutes are kept of these meetings. Matters arising from this group are fed into staff meetings for consideration. Some which have been followed up are more assistance with self help skills, more involvement with medical appointments and issues about personal finances. An advocate also visits the home monthly and is available to all residents. Information about events in the home, appointments, who is working on what day etc are posted up on notice boards using photographs and pictures to assist residents understanding. Residents are encouraged to participate in the Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 10 staff recruitment process by meeting prospective staff and expressing their views about their suitability.. The home has a written policy on confidentiality which would be available to other agencies. All written documents are safely stored. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 11 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) 11, 12, 13 & 15 Residents have opportunities for personal development and to participate in appropriate activities. They are part of the local community and maintain contact with their family and others who are important to them. EVIDENCE: Residents attend day care and activity centres. They are able to learn and use practical life skills such as cooking, shopping, swimming and managing money. One person was a keen gardener and he continues to help with the homes’ garden. Another person keeps up her religious beliefs by attending church regularly. The home is within walking distance of the town and everyone goes out into the local community for various activities. They include shopping, swimming, the library and social events such as bowling. Staff give good support to residents in maintaining contact with their families. One person who has recently moved into the home goes to family each weekend and another kept contact with his father despite difficulties within the relationship. Social events are held at the home to which family and friends are invited. A longstanding relationship between two residents is supported. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 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 standard(s) 18 & 20 Residents receive appropriate personal support. The homes policies and procedures regarding medication are satisfactory however recording must be improved. EVIDENCE: All of the residents were well presented with attention being given to personal hygiene. They were all dressed appropriately to suit their age and style. Personal support is given in private either in the persons room or toilet/bathroom. Locks are fitted on toilets and bathrooms as well as individual rooms. Technical aids such as walking frames are supplied and hand/grab rails have been fitted in all of the bathrooms and toilets. Some handrails are in red as advised by an occupational therapist to help people with dementia. Staff are designated key workers and there is written guidance on individual residents preferred routines, likes and dislikes etc. No resident retains their own medication as it is considered that they do not have the capacity to manage it safely. Their medication is recorded. A contract is in place with a local pharmacist although some problems are currently being experienced with the service provided. The manager is, however confident that these will be sorted out and there has been no effect on residents. All medicines are safely stored and those responsible for its administration have received training. However, there are still occasions when medication is not recorded when it is given to residents. The incidents of this occurring have Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 13 lessened since the last inspection but the manager must ensure that this matter is resolved. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 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 standard(s) 22 Service users views are listened to and acted upon. EVIDENCE: There is a clear written complaints procedure which is translated into pictures and symbols for residents. They are given details within the Service User Guide and it is published in the Statement of Purpose. A record is kept of all complaints and this shows that they are dealt with promptly and satisfactorily resolved. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 26, 27, 28, 29 & 30 Residents live in a homely, comfortable and safe environment. Bedrooms meet service users needs and are well furnished and decorated. Toilets and bathrooms are private and meet individual needs. Shared space complements resident own rooms. Specialist equipment is provided to maximise independence and the home is clean and hygienic. EVIDENCE: The home provides satisfactory living space and new carpets have been laid in corridors and on stairways. It is safe and comfortable with good heating and lighting. The location is good in that it is near to the town and public transport and although in its own grounds is in keeping with its surroundings. The premises are accessible to all service users. Since the last inspection works have been carried out to meet the requirements of the fire service and overall the home is well maintained. An alarm system has been installed on external exits for the safety of two residents who are at risk should they leave the premises unaccompanied. There is a dedicated room in Bramley Cottage for residents staying at the home for short-stays and all service users have their own bedroom. They have their own key if they are able to manage this and they said that they “liked Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 16 (their) room” all of which are well furnished and equipped. One person was pleased to have a new television and another had a number of electrical ‘installations’ such as a fibre optic lamp and projector. There are sufficient toilets and bathrooms all of which have been re-furbished since the last inspection. In addition, two walk-in showers are now available to residents on the ground floor in each house. All rooms have suitable locks and hand/grab rails. One bathroom is fitted with a bath seat. Shared space is limited in the houses to one room, which operates as a lounge/diner. There is also a large communal lounge in the administrative block. Outdoor space is good in that it is well maintained and enclosed. Each house has its own kitchen and small laundry both of which are suitably equipped. All of the residents are able to get around the house although one person depends on a walking frame. As previously stated a small laundry is situated off the kitchen in each house. The manager confirmed that the increasing dependency of residents means that more soiled linen is generated. If this increases then the location of the laundry may have to be reviewed. The general cleanliness of the home was good. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Residents are supported by sufficient staff although less dependence on temporary staff would improve the service provided. EVIDENCE: Staffing hours have been increased to meet the needs of residents some of whom are becoming older and frailer. One person has support particularly because she has moved from a home where she lived for many years and needs time to adjust. Additional staffing hours are currently provided through the use of agency or temporary staff. One person who contacted the Commission for Social Care Inspection (CSCI) said that “they (temporary staff) do not relate well to the residents as they do not get time to know them – which can lead sometimes to difficulties with some residents who are more settled with the permanent staff”. The manager agreed and confirmed that recruitment of permanent staff was ongoing and some were due to start work at the home in the near future. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 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 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) 37, 38, 40, 41 & 42 Residents live in a well run home which has an open and inclusive atmosphere. Their best interests are served by the homes policies, procedures and record keeping. The health and safety of residents and staff is protected. EVIDENCE: The manager is experienced and suitably qualified. He has overall responsibility for the home and undertakes periodic training. He runs regular meetings with all of the staff groups including night staff as well as with residents. The home states that it is “dedicated to providing equality of opportunity” and “encouraging new initiatives”. Policies and procedures are in place in line with those required by the Care Standard Act 2000. They are regularly reviewed and up dated. Staff have access to these documents which are kept on the premises. All required records are kept. They are stored securely and residents have access to them should they request this. However, there is no reference to this in documents provided to residents. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 19 Since the last inspection work has been carried out to ensure that the home meets the recommendations of the fire service. All hazardous substances are safely stored and hot water and radiator temperatures are controlled. Accidents and incidents are recorded and the manager was given further clarification on notifying the CSCI of incidents. Safety procedures are posted up in easily understood formats and risk assessments are carried out, for example for someone leaving the premises unaccompanied. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 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 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tozer House Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 x x H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 20 Regulation 13 Requirement Medication must be recorded when it is administered. Timescale for action 22nd July 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 41 33 Good Practice Recommendations Reference to residents right of access to their records should be made in the Service Users Guide. There should be less dependency on temporary staffing. Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 2nd Floor Ridgeworth House Liverpool Gardens Worthing BN11 1RY 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 Tozer House H60-H11 S37456 Tozer House V230881 220705 Stage 4.doc Version 1.30 Page 23 - 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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