Inspection on 12/02/09 for Tristford

This inspection was carried out on 12th February 2009.

CSCI found this care home to be providing an Excellent service.

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

Tristford 26/09/06

Tristford 03/10/05

Tristford 31/05/05

Tristford 09/12/04

Tristford 09/06/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

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Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Tristford 7 Radnor Park West Folkestone Kent CT19 5HJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Lawrence     Date: 1 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Tristford 7 Radnor Park West Folkestone Kent CT19 5HJ 01303241720 01303241720 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : MNP Complete Care Group care home 12 Number of places (if applicable): Under 65 Over 65 0 physical disability Additional conditions: 12 The maximum number of service users who can be accommodated is: 12 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Physical disability - PD Date of last inspection Brief description of the care home Tristford is part of the MNP Complete Care Group. It is a residential home providing care and support for up to twelve people with physical disabilities. It is a large, detached house that overlooks a local park. It is close to all local amenities in Folkestone. The accommodation for residents is arranged on two floors, the upper floor being accessed by a spacious lift. There are twelve single bedrooms that are comfortably furnished, light and airy. The communal space is large and well decorated. There is easy access to a safe, well-maintained and enclosed garden. On the third floor there is a large administrative office and a training room for staff. The MNP Group are the registered providers for the home. The registered manager is Care Homes for Adults (18-65 years) Page 4 of 24 Brief description of the care home Mrs Lorraine Harrington. Mrs Harrington is a registered nurse and has many years experience in care. She has managed the home for over two years now. The fees for this home range between £750 and £1500 per week and are based on the individual needs of each resident. Care Homes for Adults (18-65 years) Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection visit was unannounced and started at 10.15 and finished at 15.15. We (the Commission for Social Care Inspection, CSCI) looked at various records in the home. Information from the previous inspection carried out on 26 September 2006 and the annual service review undertaken in April 2008, was also referred to. We observed the residents who live at the home, noting how they reacted to staff and how relaxed and comfortable they were within the home. A tour of the building was undertaken and this included residents rooms. We made observations of staff interacting with, and supporting residents. We spoke to staff including the manager and staff on duty. We spoke to some of the residents and joined them for lunch. Care Homes for Adults (18-65 years) Page 6 of 24 Care Homes for Adults (18-65 years) Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents individual aspirations and needs will be assessed. Evidence: We looked at the care plans and assessments for two people living at Tristford. They showed that a careful assessment of needs is undertaken and this includes the involvement of the resident to reflect their wishes. The manager gave an example of a prospective resident being assessed at the moment and how the process included information from the care manager as well. The assessment of prospective residents is undertaken by the homes manager and sometimes involves the organizations group manager. Care Homes for Adults (18-65 years) Page 10 of 24 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent lifestyle as possible. Evidence: The two care plans we looked at for this inspection showed that they are compiled with the individual concerned. There is a note at the front of each care plan stating that residents must be made aware of any changes and there are also signatures of residents included within the plan. Examples of specialist input (for instance from the multiple sclerosis specialist nurse) was also noted. The home has a key worker system in place. The key worker writes an informal monthly report to keep everyone up to date with any changes to an individuals needs or wishes. The care plans are reviewed every three months. Daily records were seen to be informative and positive. The care plans contained information about what time someone likes to get up, as well as preferences for night time routines. There was also clear detailed information about Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: how people communicate their wishes. Most residents manage their own finances, making decisions about what to spend money on. The care plans contained risk assessments which were individual. Residents abilities vary but staff told us that they encourage people to be as independent as possible. We saw residents using their wheelchairs to move around the building or go outside into the garden with little or no assistance. One resident said that staff will always help when you want it but they dont crowd you. We noted aids being used with regard to eating and drinking to enable people to be independent. Care Homes for Adults (18-65 years) Page 12 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents. They will benefit from having a healthy diet. Evidence: The records showed that people living at Tristford have various opportunities for recreation, both in the home and in the community. This includes cinema, bowling, reflexology, out shopping and for lunch, attending clubs, theatre trips etc. Some people have enjoyed going away on holiday and are planning to again this year. Staff volunteer to support residents to do this, using their own holiday entitlement to do so. There is a large screen television in the lounge and a DVD library is being created, at the request of residents. People have televisions in their own rooms if they wish and one person has a computer. People are on the electoral roll and the manager said they Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: would be supported to vote if they wished. We noted examples of residents being supported to keep in touch with family and friends through emails, letters, phone calls and visits. One relative spoken to at this inspection said he was always made welcome. Individuals daily routines are a matter of personal choice and the manager said there were usually sufficient staff to support this. Preference for how they wish to be addressed is noted in residents care plans. Rooms are lockable and staff were seen to knock before entering rooms. One person has a notice asking that people knock twice, thus allowing time to respond. Residents choose to sit in their rooms or with others in the lounge/dining area, or between the two according to how they feel. We observed staff working hard to listen and understand when individuals had particular communication styles. We joined residents for lunch. There was a choice and people were asked individually what they would like. We saw residents supported with their eating according to their needs and preferences and aids were also evident. One resident said there was always plenty of food. Another said they always enjoyed the meals. One person told us that the cook would cook a special breakfast on request, especially if I am going to be out. We spoke to the cook who said she always asked people what they wanted and she was aware of special requirements such as soft food. She said she always serves food attractively even if it has to be luiquidized. Care Homes for Adults (18-65 years) Page 14 of 24 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes policies and procedures regarding medication and their physical and emotional needs will be monitored and responded to. Their preferences and requirements for support are actively sought and respected. Evidence: The care plans seen had clear information about how residents personal and health care needs are to be met. All the people have quite complex needs and the manager spoke about how staff have been provided with particular training in order to meet those needs such as catheter care and percutaneous endoscopic gastrostomy (PEG) feeding. As noted previously the plans are compiled and changed with the involvement of residents so their wishes about how they want to be supported are responded to. There is equipment in place to facilitate physical care such as special baths, shower beds, waterproof cushions, hand rails and hoists. The records showed that health care professionals are accessed both routinely and as required. One resident indicated that staff are very kind when helping. A member of staff said that it was very important to be as sensitive as possible because a lot of the care was hands on. Care Homes for Adults (18-65 years) Page 15 of 24 Evidence: We observed medications being given out by the senior on duty. This was done appropriately and with awareness of individuals preferences such as water or squash. She was conscious of peoples dignity and ensured tissues were available for any spills on clothes. The medication administration records were properly completed. She told us she had received training and that she was watched on occasions by her manager to confirm competency. The manager told us that only staff who have received training gave out medication. Care Homes for Adults (18-65 years) Page 16 of 24 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents views are listened to or ascertained, and acted on. Evidence: We asked three people who live at Tristford if they knew how to make a complaint and they all said they did. One of them said but you never need to. The manager explained that they try to sort out any issues before they become complaints. The home has not received any complaints in the last twelve months. Staff have received training with regard to the protection of adults and there are appropriate policies and procedures in place. One member of staff confirmed about the training and also said that staff are very aware of their reponsibilities. Care Homes for Adults (18-65 years) Page 17 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home which is homely and comfortable as well as clean and hygienic. Evidence: We toured most of the building including some residents rooms, with their permission. Tristford is well maintained and decorated attractively. The lounge/dining area is spacious allowing for wheelchairs to be used comfortably, both manual and electric. The home is close to the town centre with all of its amenities and is in keeping with the local community. The bedrooms seen were personalised and decorated as residents wish. The home was clean and fresh at the time of our visit. The laundry facilities are satisfactory and all staff have received infection control training. Care Homes for Adults (18-65 years) Page 18 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sound recruitment procedures and training already provided and training planned, will have a beneficial impact on residents. Evidence: We observed staff to make real efforts to understand residents with particular communication needs. We saw examples of staff being responsive and aware of residents without being too intrusive eg offering to clean someones glasses or help with reading a letter. Eleven members of staff have achieved a national vocational qualification (NVQ) at level two and four people have also achieved level 3. We looked at the records of two staff and they showed that the organization has appropriate recruitment procedures which includes an application form, an interview (which also includes meeting residents), a health questionnaire, references and criminal record bureau checks as well as a PovaFirst check. Staff receive written terms and conditions of employment and are given copies of the general social care councils code of practice. Tristford has a programme of training which starts with induction (in keeping with the common induction standards) and includes a range of topics from basic, health and safety and more specialized relating to the specific needs of the people living there. Care Homes for Adults (18-65 years) Page 19 of 24 Care Homes for Adults (18-65 years) Page 20 of 24 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. Evidence: The manager is a registered nurse and keeps her registration up to date through continual professional development. She has an NVQ level four and the registered managers award. She is a trainer for manual handling. She sends surveys out to residents twice a year and uses the information to inform the service provided. Residents meetings are also held regularly and one resident said that this was useful for putting across ideas and opinions. Policies were seen to be up to date in content. We did a spot check on some maintenance and service contracts and these were appropriate and up to date. Staff receive training relating to health and safety including manual handling, food safety, infection control and first aid. Care Homes for Adults (18-65 years) Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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