Inspection on 20/07/05 for Tulip Gardens

This inspection was carried out on 20th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tulip Gardens 13/08/07

Tulip Gardens 03/11/06

Tulip Gardens 01/02/06

Tulip Gardens 10/11/04

Tulip Gardens 06/07/04

Tulip Gardens 01/03/04

Tulip Gardens 12/09/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 Tulip Gardens 5 Court Farm Way Selly Oak Birmingham B29 5BW Lead Inspector Brian Reamsbottom Unannounced 20 July 2005 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. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Tulip Gardens Address 5 Court Farm Way Selly Oak Birmingham B29 5BW 0121 478 3505 0121 478 3505 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) New Outlook Housing Ms Sharon Cope Care Home 8 Category(ies) of Younger Adults, Learning Disability, Physical registration, with number Disability of places Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Residents must be aged under 65 years with the exception of one named service user. Date of last inspection 10 November 2004 Brief Description of the Service: Tulip Gardens is a purpose built home in a residential area on the border of Selly Oak/ Northfield, approximately 2 miles from Northfield town centre. Northfield provides a range of facilities to meet the recreational, social and religious needs of the community.The home is single story with eight single bedrooms. It comprises of two wings, with four bedrooms on each wing.There is a large secluded sensory garden with trees, shrubs and plants chosen for their fragrance, touch or sound.There is parking for emergency vehicles and cars within the grounds. The car park is electronically secured and has CCTV. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was inspected unannounced from 11.00 to 15.45. Ms. Margaret Wyre Expert by Experience (XbyX) assisted at this inspection. The documentation inspected included the following: Care plans, risk assessments, fire records, medication records, health and safety records, accident book, daily records, complaints and adult protection records, staff personal files and staff training records. What the service does well: What has improved since the last inspection? Person Centred Planning is being introduced for all service users. One service user who has used the system stated that she was very pleased to be in control of her needs and wishes. There is a commitment to the training needs of all staff members. A well trained staff team is very good for service users. Service users, staff and management are looking into new activities and college courses for all living in the home. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 6 Service users are encouraged by the staff team to be as independent as they wish. 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. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 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 Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 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) 2 Information is available to enable prospective users make an informed choice as to whether they want to live at the home. EVIDENCE: There has been a new service user admitted since the last inspection. There is a full assessment in place. The service user said that she was very involved with the assessment and is pleased with the outcomes to meet her needs and wishes. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 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 7 and 9 Service Users assessed needs and goals are reflected in their individual care plans so that staff know how to support each individual. Service users should be given a copy of their care plan in an appropriate format. Residents are consulted on, and participate, in many aspects of life in the home to ensure good outcomes for them. Service users are supported to take risks within a risk assessment framework. EVIDENCE: The three service user files that were inspected have a care plan. Person Centred Planning has been introduced. The plan for the new service user was inspected. It included the service users likes and dislikes her needs and wishes. The service user said that she was happy with her level of involvement in the making of the care plan. There were questionnaires completed by the following people; the service user’s mother, sister and a member of staff from the day centre, who is well known to the service user. The questionnaires covered the chosen lifestyle of the service user, her past history, people and issues that are important to her. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 10 The other services user’s care plans are being reviewed using the Person Centred Planning format. The licence agreement with each service user states that care plans are reviewed every twelve months. This will need to be changed to show that care plans are reviewed at least every six months. The XbyX spoke with two service users and asked if they had a care plan or any other plan. One service user was not sure and the other said everyone had a plan for keeping their rooms clean and other household chores. However, the reviews of care plans are on each service user’s file showing that they where present at reviews. It may be helpful for service users if the manager and key workers explained the purpose of care plans. It would be good practice as identified by the XbyX for service users to have a copy of their care plan. Service users say that they are assisted and encouraged to make decisions in their daily lives. Service users finances are dealt with at the organisation’s headquarters. The XbyX asked a service user if she would like to keep her own money. The response was that the service user said that it would be unsafe to keep money in her room. She went on to say that there are not always enough staff available to take her to the bank. The other service user spoken with said that he has £10.00 each week given to him on a Thursday. When asked if he required money on a Wednesday what would he do? He responded that he would have to wait until the Thursday. The manager and key workers should seek the wishes of each service user as to how they would like their personal money be dealt with. Service users wishes should then be recorded in their care plans. Each service user has a risk assessment they are relevant and up to date. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 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) 12 13 14 15 and 17 Resident’s are part of the local community and participate in appropriate leisure activities. Arrangements are in place to support residents to have appropriate family relationships. Residents choose what they eat and enjoy their meals and mealtimes. EVIDENCE: Service users have weekly sheets showing the activities in the home and away from the home. Day centres and colleges are attended for various activities, for example, cookery training, ceramics, and computer skills. Service users make good use of the local community to shop, visits to the cinema, clubs, places of worship and other places of local interest. Service users have had holidays to Lyme Regis, Southport and the Lake District. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 12 A service user spoke about making breakfast and would like to do more cooking. She went on to say that the staff cook the other main meals. The service user said that she would like to cook her own lunch but is quicker for the staff to do it. The manager and staff should explore ways of giving more time to service users wishing to cook individual meals. The manager said that the activities for service users are being looked at, on an individual basis for the start of the autumn term. Service users make use of progressive mobility sessions. An aroma therapist visits on a regular basis. Three service users commented that they enjoy the sessions. Contact with family and is maintained with the assistance of staff if needed. One service user visits her sister once a month, which she enjoys. Records show that family and friends are encouraged to visit. The food on offer is varied, wholesome and nutritious. Service users decide once a week what meal they would like for dinner. The service user then purchases the food items, and prepares and cooks the meal with assistance from the staff group if required. A service user was asked what was for lunch today, she said “that she did not know.” Service users must be involved in the menu planning and made aware of the choices on offer. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 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) 19 and 20 The medication management is good ensuring service users receive medication as prescribed. Systems are in place to ensure that service users receive the care they need. EVIDENCE: Service users have support to maintain their health. Service users have access to special health professionals when needed. They visit GPs, Dentist, Opticians and Community Nurses. The manager, staff and service users are implementing the Health Action Plans and good progress is being made. Health Action Plans are in place, however, the will need further development with service users to meet their needs. Service users are unable to administer their own medication. The management of medication is generally good. A Monitored Dosage System (MDS) is in place. There are protocols for ‘as required’ (PRN) medication. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 14 A Pharmacist from the supplier of the MDS visits the home on a regular basis giving support in the safe administration and storage of medicines. Medication is safely stored in an appropriate cabinet. All medication administration records had been signed for correctly. A stock control record of medication received and given is kept All staff have received accredited medication training. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 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 and 23 The complaints and adult protection procedures available ensure that service users are protected from harm. EVIDENCE: The home has a complaints procedure in place it is also available in large print and audiotape, this is to be commended. There have been no complaints received at the home or the CSCI since the last inspection. The adult protection procedures used in the home are in line with Birmingham’s Multi-Agency Guidelines for the Protection of Vulnerable Adults. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 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 27 and 30 The home was clean, warm and fit for its purpose and provides service users with a safe, homely and comfortable environment. EVIDENCE: The decoration and furnishings of the home are of a high standard and meet the needs of the service users. The bedrooms are decorated and furnished reflecting the personalities of service users. The bedrooms have an en-suite with toilet and shower. The home is warm, clean, free from odours and well maintained. The laundry is sited away from where food is prepared and eaten. The home has a comprehensive infection control policy and a contract with a clinical waste company, which was seen by the inspectors. Hand washing facilities are prominently sited in areas where infected material would be handled if necessary. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 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) 34 and 35 The homes recruitment procedure is robust and ensures service users are protected from harm. Staff have received training to enable them meet service users needs. EVIDENCE: Staffing records were inspected all the information and documentation required by Schedule 2 of the Regulations are on the individual files. The staff group have had induction training and have done all statutory training. The staff team has completed learning Disability Award Framework (LDAF) training. Interactions between staff and service users were observed. These were positive and service users appeared happy and comfortable in the presence of staff. A new member of care staff was interviewed he demonstrated that he had an understanding of the individual needs of service users. A service user told the XbyX that a member of staff talks to him in a raised voice. The manager must ensure that all staff members speak to service users in a respectful manner. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and42 The home is well managed to promote the health and safety of service users. EVIDENCE: The home is involved in producing a quality assurance monitoring system to include the views of service users, family, friends and involved professionals. There is an annual development plan for the business available if required. The home has a range of policies, procedures and systems in place to comply with the requirements of health and safety legislation. Service contracts of electrical and gas appliances were available and in date. Staff are trained in First Aid, Moving and Handling, Fire, Health and Safety. Basic Food Hygiene and Infection control. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 19 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 3 x x x Standard No 22 23 ENVIRONMENT Score 4 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x 2 Standard No 31 32 33 34 35 36 Score x x x 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tulip Gardens Score x 2 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 20 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. 2. Standard YA6 YA7 Regulation 15.(2)(a) Schedule 4 9(a&b) 12 (1) (a) (2) Requirement The servivce user plan must be made available to the service user. The manager must consult with service users how they want their finances to be held and administered. Each service user must have a Health Action Plan in line with Valuing People. A Health Action Plan is a perosnal plan about what a person with a learning disability can do to be healthy. It lists any help people might need to do those things. It helps to make sure people get the services and support they need to be healthy. The manager must complete the NVQ Managers Award by 2005. There must be a continuous self monitoring, using an objective, consistently obtained and reviewed and variable method and involving service users and an internal audit takes place at least annually. Timescale for action 31October 2005 31 October 2005 30 Novmber 2005 3. YA19 4. 5. YA37 YA39 9.(2)(i) 24.(1)(a) (b)(2)(3) 31 December 2005 30 November 2005 Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 21 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 YA35 Good Practice Recommendations It would be good practice for the staff team to look at how they speak to service users in a respectful manner. Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ 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 Tulip Gardens E54 S17161 Tulip Gardens V240727 200705 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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