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Inspection on 20/09/05 for Tudor Rose

Also see our care home review for Tudor Rose for more information

This inspection was carried out on 20th September 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Service users are supported to be active members of their local community. Care is provided to service users in the way they want it to be and support is provided to attend health appointments. Service users feel confident that staff will listen to any complaints they have and respond to them. The home is well maintained and provides a homely and safe environment for service users. Sufficient and suitably trained staff are provided, which meets the needs of service users. The views of service users are used to plan how the home should develop.

What has improved since the last inspection?

Care plans have been revised and now reflect the personal goals of service users. Risk assessments have also been revised and now cover all areas staff have identified as risks and action to taken to minimise the risks. There are now safer systems in place to support service users to withdraw money from the bank.

What the care home could do better:

The manager needs to make sure that accurate records are kept of money that is being held on behalf of service users.

CARE HOME ADULTS 18-65 Tudor Rose 23 Borovere Lane Alton Hampshire GU34 1PB Lead Inspector Craig Willis unannounced 20.09.05 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. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Tudor Rose Address 23 Borovere Lane Alton Hampshire GU34 1PB 01420 544118 01420 544140 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) Iliace Limited Ann-Marie Glass CRH 4 Category(ies) of LD Learning disability registration, with number of places Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection 12.04.05 Brief Description of the Service: Tudor Rose is registered to provide care and accommodation for four adults with learning disabilities between the ages of 18 and 65. The accommodation is provided in a large detached house, approximately half a mile from Alton town centre. The home has a large lounge, a dining room and kitchen and each service user has a single bedroom. There is an enclosed garden to the rear of the home which service users are able to access. Service users are supported to take part in the running of the home and to take part in employment and educational opportunities. The home is managed by ILIACE Ltd, who have a number of similar services in Hampshire. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four hours, during which the inspector spoke with three of the service users, a member of staff and the manager. All of the communal areas of the home were viewed during the visit. What the service does well: What has improved since the last inspection? Care plans have been revised and now reflect the personal goals of service users. Risk assessments have also been revised and now cover all areas staff have identified as risks and action to taken to minimise the risks. There are now safer systems in place to support service users to withdraw money from the bank. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 6 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. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 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 Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 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) None The key standard was assessed at the inspection of 12th April 2005. EVIDENCE: Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 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 and 9 There are clear care planning and risk assessment systems in place, which provides staff with the information required to meet the needs of service users. EVIDENCE: Individual plans were in place for all of the service users, all of which were revised in July 2005. These plans are developed from the initial assessments that were completed prior to the service users moving into the home. Since the last inspection the manager has supported service users to expand their plans to include personal goals. Goals set include the development of skills such as completing household tasks and developing independence with personal care. The goals are reviewed monthly with service users and staff complete daily records indicating what support has been provided. Since the last inspection risk assessments have been completed for all areas of identified risk for service users. The assessments include actions that staff should take to minimise the risk and have been signed by staff to say they are aware of the action they should take. The assessments were completed in July 2005 and are subject to two monthly reviews. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 10 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) 13 Service users are active members of their local community and benefit from meaningful activities. EVIDENCE: Three of the service users work in local charity shops on a voluntary basis. Service users said they regularly use the local library, cinema, local pubs and go shopping for groceries. The manager reported that the home had a good relationship with the immediate neighbours. Some of the service users attend a local church group and all of them are registered on the electoral roll. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 11 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 and 19 The personal care and health needs of service users are met with evidence of access to a range of NHS services. EVIDENCE: Details of the support service users require and how it should be provided are included in their individual care plans, including details of their likes and dislikes. Service users spoken with said that the staff treated them well and provided support in the way that they wanted. Records indicated that service users are supported to attend a range of health services, including GP, occupational therapist, dentist, psychologist and neurologist. A record was kept of these appointments, and included any advice that was given by the practitioner. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 12 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 and 23 Service users are confident staff will listen to complaints and act on them. There are good systems to support service users to withdraw money from the bank, however, the records of service users money held by the home are poor and may place service users at risk of financial abuse. EVIDENCE: The home has copies of the Iliace complaints procedure available and accessible versions, with pictures and symbols, have been supplied to service users. The procedure sets out who would deal with a complaint and when the complainant could expect a reply by. The document also contained contact details of the Commission for Social Care Inspection. Service users spoken with said that they felt confident any complaint they made would be taken seriously and investigated. No complaints have been received by the home since the last inspection. Since the last inspection the manager has made changes to the way service users are supported to withdraw money from the bank. Staff providing support no longer store the card and personal identification number together. All withdrawals are recorded and a copy of the receipt kept. These recorded withdrawals matched details on the service users bank statements. Most of the money service users withdraw is kept by them, however, the manager reported that the home does look after money on some occasions, for example if service users have some money left over after a trip out. On these occasions money is individually stored in a safe, however, no record is maintained of how much money is being held by the home. The home does not spend money on behalf of service users. The rest of standard 23 was not covered as it was assessed in the inspection of 12th April 2005. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 13 Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 14 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 The systems for maintaining the home are good, which provides a homely and safe environment for service users. EVIDENCE: The home has been re-decorated since the last inspection and service users spoken with said they chose the colour scheme and liked the improvement. New chairs and sofas have been provided in the lounge, which have a more domestic appearance. The home is well maintained and has sufficient communal space to meet the needs of service users. The manager and staff spoken with said that staff no longer sleep in the lounge when ‘on-call’ overnight, but use the office / sleep in room. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 15 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 and 35 The numbers of staff employed meets the needs of service users and there is a good induction and training programme, which gives staff the skills and knowledge required to meet the needs of service users. EVIDENCE: The home had a staff rota indicating that there were a minimum of two staff on duty at all times between 7.30am and 10pm. One member of staff was ‘oncall’ and sleeping in overnight. The home operates a ‘shift leader’ system, which ensures that there is always an experienced member of staff on duty. Service users spoken with said that there were enough staff working at the home to meet their needs. Staff spoken with said that they thought Iliace provided good training. Training records indicated that staff had completed an induction and courses in medication, first aid, communication, epilepsy, adult protection, fire safety and food hygiene. The organisation has a planned training programme for the forthcoming year covering all of the core training areas and courses specific to the needs of service users, such as Makaton sign language and the NVQ awards. The manager reported that she was able to get places on courses for her staff. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 16 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) 39 and 42 The development of the home is based on the views of service users and there are good systems to ensure the safety and welfare of service users. EVIDENCE: The manager reported that Iliace does not carry out a formal survey of service users or relatives, although their views are sought during review meetings and at the monthly visits to the home by senior managers or their representatives. The home has a set of goals to develop the service, which include increased use of Makaton sign language, development of health action plans and increased use of person centred approaches to activities. Monthly house meetings are held, which gives service users the opportunity to comment on the service provided and suggest improvements. Records of these meetings were made available in an accessible format. Service users spoken with said that decisions made in the meetings were acted upon. The home had current gas and electrical safety certificates, which were not available at the last inspection. The rest of standard 42 was not covered as it was assessed at the last inspection. Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 17 Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 18 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 x x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x x 3 x x x x Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tudor Rose Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 19 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 23 Regulation 17 (2) Requirement The registered person must keep an accurate record of any money held by the home on behalf of service users, as per schedule 4 (9) (a). Timescale for action 31/10/05 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 Tudor Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Rose H54 S62129 Tudor Rose V248529 200905 stage 4.doc Version 1.40 Page 21 - 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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