Inspection on 31/05/05 for Tristford

This inspection was carried out on 31st May 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

Tristford 12/02/09

Tristford 26/09/06

Tristford 03/10/05

Tristford 09/12/04

Tristford 09/06/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Wingham Court

Bethany Lodge

17 John Street

Red Oaks

Clare House Nursing Home

Broad Oak Manor Nursing Home

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

CARE HOME ADULTS 18-65 Tristford 7 Radnor Park West Folkestone Kent CT19 5HJ Lead Inspector Wendy Mills Announced 31 May 2005 9:30 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. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tristford Address 7 Radnor Park West, Folkestone, Kent CT19 5HJ 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) 01303 241720 MNP Complete Care Group Lorraine Celia Harrington Care Home only 12 Category(ies) of Physical Disability x 11; Physical Disabilty over registration, with number 65 x 1 of places Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 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, well maintained, late Victorian detached house that overlooks a local park. It is close to all local amenities in Folkestone. The accommodation 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. The registered manager is Mrs Lorraine Harrington. Mrs Harrington is a registered nurse and has many years experience in care. She was the deptuy manager at Tristford before being promoted to the position of home manager a year ago. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection began at 11.30 am and took five and a quarter hours. Mrs Lorraine Harrington, the registered manager, assisted the inspector throughout and she is thanked for her help. During the course of the inspection the inspector spoke to ten of the residents and three members of staff. In depth conversations were held in private with three residents and one member of staff. The responses to a pre-inspection questionnaire were considered, a tour of the home undertaken and key documentation examined. Discussion took place with the registered manager. Both indirect and direct observations were made throughout the inspection. The Home continues to maintain a high quality of care that meets the National Minimum Standards. The residents who spoke with the inspector said that they are very satisfied with their care in the home. They said that they feel their views are taken into consideration when decisions are made about the home and their lives. All areas of the Home are wheelchair accessible, well decorated, comfortable and homely. The responses to the pre-inspection questionnaire were very positive and relatives indicated that they are very happy that their familiy members are at the home. One respondent said, “I can’t speak too highly about Tristford, worry has been taken away from me”. Another said, “The quality of care at Tristford is vastly superior to *****’s previous experience of care (in another home)”. What the service does well: The home provides an accessible, comfortable environment in which the residents can maximise their independence. It encourages individual interests and hobbies and sees the needs and wishes of the residents as a priority. The home is proactive in accessing the necessary specialist equipment such as specialist communication aids and wheelchairs. Staff training is linked to the specific needs of the residents. Staffing levels are good and currently twelve out of thirty staff members are undertaking the NVQ level III. Four staff members have already achieved the NVQ at level III. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 6 Activities both within the home and outside are designed to meet individual needs and interests. The home offers very good support to relatives and friends. The long-term planning and quality assurance systems are excellent. 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. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4&5 The statement of purpose and the service user guide are comprehensive and good. The residents know that their independence will be promoted in as far as possible and that their goals and aspirations will be supported by the home. EVIDENCE: The residents said that they are aware of their rights and responsibilities whilst in the home. There are written statements of terms and conditions for each resident. Indirect and direct observation of the help the staff offered to some of the residents to help them organise their lives confirmed that they are supported to achieve their goals. Individual needs and goals are reflected in the care plans and risk assessments are in place. Inspection of documentation relating to the most recently admitted resident showed that all appropriate assessments and visits had taken place prior to admission to the home. Tristford H56-H05 S23615 Tristford V224658 310505 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) 6,7,8,9&10 The residents know that the home will respect their confidentiality and value their views. They are able to make decisions about their lives and participate in the decision-making process about the home. There is a clear and consistent care planning process that the residents and their supporters understand. Records and maintained securely. EVIDENCE: There are regular meeting within the home. Residents said that the staff listen to their views. A recent re-decoration programme involved the residents in choice of colour and soft furnishings. The bedrooms were already personalised and in good decorative order but now they are even more attractive. The residents had also been involved in improvements to one of the bathrooms. Some residents had told the manager that they thought the bathrooms looked too “clinical”. She immediately provided stencils for the tiles and now the bathroom looks more homely. Indirect observation confirmed that the residents are given the appropriate level of assistance to carry out the activities they wish. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 10 Responses to the CSCI questionnaires were positive and several praised the care at the home. Tristford H56-H05 S23615 Tristford V224658 310505 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) 11,12,13,14,16&17 The home offers excellent opportunities for personal development and is proactive in the way it assists and encourages the residents to lead fulfilling lives. The quality of meals is very good and special diets and wishes are catered for when indicated. EVIDENCE: The residents said that they are involved in as many activities as they wish. The home provides transport when needed. Frequent outings are organised. The residents make decisions about where to go and what to do. Recently residents have visited a local wildlife park, been out to meals and visited local places of interest. The residents said that future trips, including an outdoor concert at Bewl water, are planned. There are regular shopping trips to the town centre. Residents are supported to attend religious services if they wish and many attend local fetes and other community activities. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 12 Inspection of the kitchen, sampling of the main meal and discussion with the residents confirmed that meals are of good quality and quantity. The residents said that they enjoy their meals. Appropriate assistance is given to those who need it and special equipment is provided when indicated. Inspection of care plans showed that one resident, who was undernourished when admitted to the home, has gained weight and is now the correct weight for height. Relatives praised the work of the home in promoting the health of the residents. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19&20 Personal support is offered in a way that protects the privacy and dignity of the residents and promotes their independence. There are clear and comprehensive systems for the management and administration of medicines but some practice for the administration of medicines requires review. EVIDENCE: The residents said that the staff respect their confidentiality. They can discuss personal issues with staff if necessary. Indirect observation confirmed that personal assistance, when needed, is offered in a discreet and sensitive way. One response to the questionnaire said, The personal care is sometimes beyond the call of duty . The medical help that is given saves many hospital visits.” Inspection of care plans showed that healthcare is accessed appropriately. One resident is planning to move from the home to live more independently and the home has assisted in accessing rehabilitation services, in preparation for this move. The resident has already attended a computer course and attended both physiotherapy and occupational therapy. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 14 The written policies and procedures for the management of medicines in the home are clear and comprehensive. They now include a policy for the storage and administration of homely remedies. Staff training in the administration is up-to date. However, during the inspection it was noted that some administration practice did not take full infection control measures into account. The home should review staff practice in respect of the administration of medicines. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Staff have good knowledge and understanding of Adult Protection issues. They know how to protect the residents from all forms of abuse. The residents are confident that their concerns will be listened to and acted upon. EVIDENCE: The residents said that they can trust the staff to maintain confidentiality. Day-to-day concerns are dealt with as they arise. They were clear about how to complain if they need to. The responses to the relatives questionnaires indicated that they also aware of the complaints procedures. Some respondents said that they thought it was unlikely that they would ever need to make a formal complaint. There have been no formal complaints since the last inspection. Induction training is now more structured and includes adult protection. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 16 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 The standard of the environment in the home is very good. It provides the residents with an attractive and homely place to live. The layout and specialised equipment promotes the independence of the residents. EVIDENCE: A tour of the home was undertaken. There has been a significant amount of recent redecoration. The large lounge/dining room allows for good wheelchair access and there are ramps to both the front and rear gardens. It is tastefully decorated and has a comfortable and homely feel despite being large enough to accommodate several wheelchairs. The rear garden is flat and safe with some raised flower beds. Several of the bedrooms have been recently re-decorated. The residents said that they had been able to choose their own soft furnishings and colour schemes and decide how to arrange their furniture. All rooms are tasteful and well furnished. All areas of the home were very clean, tidy and free from offensive odours on the day of inspection. Tristford H56-H05 S23615 Tristford V224658 310505 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) 31,32,33,34,35&36 There is an enthusiastic workforce that positively promotes improvement in the quality of life of the residents. Staffing levels are good. The arrangements for staff induction are very good and staff demonstrate a clear understanding of their roles and responsibilities. There is a good training and development programme. EVIDENCE: Staff said they are clear about their roles and responsibilities. They spoke enthusiastically about their work in the home and about the way they support the residents to achieve their goals. There is an excellent training matrix and a high level of staff training is undertaken. Staff said that they appreciate the amount of training. Currently two members of staff are undertaking the NVQ level III and six members of staff have already achieved this qualification. One staff member is undertaking level II. There is a very stable workforce and no agency staff has been needed as staff work together to cover annual leave. Sickness levels and staff turnover are low and staff moral is high. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 18 Staff files were examined. It was noted that all appropriate checks, including telephone calls to the person providing the written reference, have been made before staff were offered work at the home. There is a good staffing structure that provides clear lines of accountability. One-to-one staff supervision is now well established and written records are kept. There are regular staff meetings. The written records of these meetings were examined and found to be of a high standard. They clearly state the action to be taken and by whom Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 19 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) 37,38,39,40,41&42 The home is well managed and provides a caring and supportive service that promotes the independence, health, safety and welfare of the residents. There are excellent quality assurance systems EVIDENCE: Mrs Harrington, the registered manger has many years experience in working at all levels in care homes. Prior to her appointment and manager at Tristford, she was the deputy manager for seven years. She is a nurse who has retained her registration and continuing professional development. She has recently completed all the necessary work for her NVQ level IV in Management and Care. However, there has been a delay in the assessment process for which the college has apologised in writing. Staff said that they like working at the home and respect Mrs Harrington for her fairness and ability as manager of the home. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 20 Conversation with Mrs Harrington confirmed that she has a very good level of understanding of the principles of good care practice. She has extensive knowledge of the specialist needs of those for whom the home cares. She relates well to the residents, their supporters and her staff. The registered providers visit the home frequently. It is well maintained and there is clear evidence of improvements to the fabric of the building. The CSCI has received regular and comprehensive quality reports in accordance with Regulation 26. the home actively seeks the views of the residents, their supporters and the staff. Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 21 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 4 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 4 3 3 4 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tristford Score 3 4 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 3 3 x H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 20 Regulation 13(2) Requirement The home must ensure that procedures ofr disposal of tablets that have become unusable due to an infection control risk, for example, if they are dropped on floor,are disposed of appropriately Timescale for action 01/06/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 Tristford H56-H05 S23615 Tristford V224658 310505 Stage 4.doc Version 1.30 Page 24 - 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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