Inspection on 26/05/06 for Tudor House - Pangbourne

This inspection was carried out on 26th May 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tudor House - Pangbourne 25/07/07

Tudor House - Pangbourne 20/12/05

Tudor House - Pangbourne 19/07/05

Tudor House - Pangbourne 30/11/04

Tudor House - Pangbourne 25/08/04

Tudor House - Pangbourne 27/02/04

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Tudor House - Pangbourne Farm Lane Maidenhatch Pangbourne Berkshire RG8 8HP Lead Inspector Katy Brown Unannounced Inspection 26th May 2006 12:10 Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 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 Tudor House - Pangbourne DS0000011174.V289988.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 Adults 18-65. 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. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tudor House - Pangbourne Address Farm Lane Maidenhatch Pangbourne Berkshire RG8 8HP 0118 974 5030 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) cynthia@vickery8648.freeserve.co.uk TACT Ms Cynthia Vickery Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th December 2005 Brief Description of the Service: Tudor House is a large detached house, surrounded by farmland, situated approximately three miles from Pangbourne village. The nearest bus stop is two miles away and Reading and Newbury, approximately six miles away, provide a comprehensive range of amenities. Tudor House provides accommodation and care for up to six residents, aged between eighteen and sixty-five years of age, who have a learning disability and some of whom also have a physical disability. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Tudor House is a community home for adults with learning disabilities, providing support to six residents. The site visit/inspection was unannounced and undertaken at the home on 26 May. Prior to the site visit, other inspection activity included; an examination of a pre-inspection questionnaire completed by the manager of the home and surveys sent to the service users. 3 surveys were completed and returned to the Commission. Telephone conversations were also held with relatives. Four residents users were spoken to and three residents files were examined during the site visit. The team leader and three care staff were spoken to and the home’s record of complaints and staff training records were also examined. What the service does well: What has improved since the last inspection? What they could do better: Detailed risk assessments and clear guidelines have not been completed for some residents. A resident that has had difficulties with incontinence problems, over a long period of time, has not yet been referred to a health professional for specialist intervention. This is an outstanding requirement from the previous inspection. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 6 Some walls have severe cracks and dents in the concrete and many of the doors need re-staining/varnishing. Although, the residents are encouraged to clean their own bedrooms, the windowsills and skirting are covered in much dust. The carpet in the downstairs part of the home needs cleaning/replacing, as does one of the residents bedroom carpet. The rug that is outside two resident’s bedrooms must be secured at the ends to reduce the risk of tripping. The taps in the laundry room are leaking and the floor frequently requires mopping, to soak up the water. There are no systems in place for quality assurance monitoring. This is an outstanding requirement from the previous inspection. These are things that are required by the Care Homes Regulations 2001. 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. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 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 the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. residents aspirations and care needs are assessed. EVIDENCE: All residents had received a care needs assessment prior to moving into their home. The information received from the assessment process, identified that that the living environment and the skills of the staff are appropriate to meet the residents needs. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 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 the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents make decisions, which are reflected in their care planning process. They are provided with a good standard of care that is consistent with their identified needs and risk management plans. EVIDENCE: Individual plans of care are available for all residents and they contain all the information that is specific to their personal care and social care needs. Staff keep a daily record of residents’ activities and any visits that they had received or appointments that they had attended. Clear guidance is in place to ensure that the residents’ needs are met. Risk management plans have been completed for most of the residents and staff are aware of the risks and adhere to procedures. It was noted however, that some residents did not have clear risk assessments and detailed guidelines regarding certain behaviours that pose a risk. Reviews of the care provided and risk management strategies are completed regularly and the resident’s and relatives’ that were spoken to, confirm that they attend reviews. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 10 Residents’ say that they are involved in their care planning and that they do make decisions about their lives. They attend regular meetings, where they discuss, life at the home, forthcoming events, holidays and meals. Relatives spoke positively about the staff at the home and the good standard of care that is provided. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in age, peer and culturally appropriate activities within the local community, and are enabled to maintain personal relationships with family and friends and make decisions about the way the home is run. EVIDENCE: Relatives that were spoken to, prior to the visit, said that the residents take part in a number of activities, including swimming, college attendance, the gym, bowling and visits to the pub for drinks and meals. Some residents also work part-time. Residents spoke of their enjoyment of working and taking part in their preferred hobbies. One resident spoke of a motorbike that he had worked on. He had rebuilt the engine and was now hoping to secure a position working with engines or motors. Staff have agreed to look into this for him. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 12 Staff and resident meetings are held and residents confirmed that they discuss, which recreational activities they want to be involved in. There is a key worker system in place and residents say that their key-workers help to resolve any issues or problems that might arise. One resident spoke of being transferred to an alternative placement as she has been unhappy at the home; she said that staff had been helpful in achieving this. Residents are aware of the rules and policies within the home. The home is non-smoking and a smoking policy is available for the residents. One resident keeps her cat in her bedroom and another has two budgies. Relatives confirmed that they are encouraged to visit the home and residents say that their families and friends are made to feel welcome. Staff will transport the residents to their family homes and relatives say that the staff are have a good understanding of the residents needs. Residents say that they enjoy the meals at the home and the menus reflect their likes and dislikes. They do have enough to eat and are given a variety of options if they are offered food that they do not want. Relatives say that the meals are nutritious and well balanced. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 & 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Most residents’ are provided with a good standard of care that reflects their wishes and meets their health needs. They are protected by the homes policy/procedures for managing medication. EVIDENCE: Staff are provided with appropriate information to identify the support service users require within personal care and also to ensure that the residents preferred routine is respected. All residents have their own room where privacy is assured. The staff have a good awareness and understanding of the residents’ health needs and individual records are kept for all health related visits. Relatives say that staff are proactive when a residents health changes or deteriorates and records indicate that all appointments with health professionals are kept. A resident that has experienced difficulties with incontinence problems for a lengthy period of time; has not yet been referred to a health professional for specialist intervention; this must be reviewed. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 14 Relatives confirmed that the residents do visit the doctor, dentist, dietician and hospital nurse. There are no residents at the home that self-medicate. All staff that provide support with medication, receive appropriate training. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 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 the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents views are listen to and they are protected from abuse, neglect and self-harm. EVIDENCE: Residents and relatives that were spoken to say that they would be comfortable making a complaint as they believed that their complaint would be taken seriously. They also confirmed that staff do resolve any issues or concerns that they have. The manager and staff keep a satisfactory record of any complaints that are made and appropriate investigations are carried out. The CSCI has not received any complaints in respect of this service. The home as adopted the Berkshire vulnerable adults, inter-agency procedures and both care staff and the manager have received training in abuse. There have been no vulnerable adult investigations in this home within this inspection year. Relatives and residents say that they feel safe at the home. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 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 the following standard(s): 24 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents live in a warm, homely and clean environment, although it is in need of repair and redecoration. EVIDENCE: A tour of the premises identified that most parts of the home is well decorated and the furniture looks nice. However, some walls require repair as there are severe cracks and chips of concrete removed. The doors are wooden and many require re-staining/varnishing and many windowsills and skirting boards in the residents bedrooms, are covered in large amounts of dust. A rug that is situated outside two residents bedrooms is curled at the edges and this poses a risk for a resident that has mobility problems. The carpet in the downstairs part of the home needs/cleaning/replacing as does a carpet in a resident’s bedroom. Residents say that they are happy with their accommodation and one said that he really enjoys his bedroom and spends much time there. The home has satisfactory policies for infection and control and the environment is clean and hygienic. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 17 Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 18 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and protected and have their needs met by competent and trained staff. EVIDENCE: The home has a satisfactory policy and procedure for the recruitment of staff. A resident spoke of his involvement in recruiting staff and said that he had sat in on interviews. Staff records indicate that they receive training that helps them meet the needs of residents. Staff receive an induction that is compliant with TOPSS specifications and also receive refresher training on a regular basis. Records indicate that staff are competent and are completing NVQ’s in care. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well run, but there are no formal systems to seek relative’s views. The safety and welfare of residents’ is met through the health and safety policies and procedures and care practices at the home. EVIDENCE: The manager has many years experience of working with adults with learning disabilities and has completed the registered managers award. Relatives and residents say that the home is well run and that they like and trust the manager. The home does not have a policy for quality assurance and relatives that were spoken to said that they have not received questionnaires, seeking their views and opinions of the service. This is a requirement that remains outstanding from the previous inspection. The home has satisfactory health and safety policies and procedures in place and an inspection of records identified that regular maintenance checks are Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 20 completed for equipment used at the home. The fire officer and the environmental health officer have visited the home; however, no requirements were made. Fire fighting equipment checks are completed by the appropriate agencies and staff ensure that fire drills take place. Staff receive training in health and safety and manual handling. Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 1 3 X 3 X 1 X X 3 X Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 22 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 YA9 Regulation 13 (4) (c) Requirement The registered person must ensure that clear risk assessments and risk reduction plans are completed for residents. Satisfactory guidelines must also be completed. The registered person must ensure that appropriate action is taken to investigate the cause and to ensure that one of the service users bedrooms remains odour free. (Outstanding from the previous inspection) The registered person must ensure that the walls are repaired, the doors re-stainedvarnished and the carpets are cleaned or replaced. The registered person must ensure that the rug outside the two downstairs bedrooms is secured at the ends to prevent a tripping hazard. The registered person must ensure that the taps in the laundry are repaired to stop the spillage of water on the floor. DS0000011174.V289988.R01.S.doc Timescale for action 26/06/06 2. YA19Y A30 12 (1) (a) 16(2)(k) 26/06/06 3. YA24 23 26/09/06 4. YA24 13(4)(c) 26/06/06 5. YA24 13 (40 (c) 26/06/06 Tudor House - Pangbourne Version 5.1 Page 23 6. YA39 24 There are effective quality 26/07/06 assurance and quality monitoring systems in place. (Outstanding from the previous inspection) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Tudor House - Pangbourne DS0000011174.V289988.R01.S.doc Version 5.1 Page 25 - 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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