Inspection on 04/04/07 for Tunnicliffe House

This inspection was carried out on 4th April 2007.

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

Tunnicliffe House 02/06/09

Tunnicliffe House 03/03/06

Tunnicliffe House 05/07/05

Tunnicliffe House 02/02/05

Tunnicliffe House 19/08/04

Tunnicliffe House 25/02/04

Tunnicliffe House 09/12/03

Similar services:

Sunny Bank (P.R.S.) Ltd

Ashwood Court Unit 1

Clover House

Thornton Lodge

Parkside

Park Lodge

Mere Hall View

St Bonaventures

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

CARE HOME ADULTS 18-65 Tunnicliffe House 16 Tunnicliffe Street Macclesfield Cheshire SK10 1DE Lead Inspector Denis Coffey Unannounced Inspection 4th April 2007 09:00 DS0000006675.V331146.R01.S.doc Version 5.2 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 DS0000006675.V331146.R01.S.doc Version 5.2 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. DS0000006675.V331146.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tunnicliffe House Address 16 Tunnicliffe Street Macclesfield Cheshire SK10 1DE 01625 617129 F/P 01625 617129 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) Mr Sydney Neville Warrington Mrs June Mary Warrington, Mrs Giles Mrs Renee Lillian Giles Care Home 16 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (14), of places Mental Disorder, excluding learning disability or dementia - over 65 years of age (2) DS0000006675.V331146.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The total number of Service Users must not exceed 16 14 of the Service Users may be MD 4 of the 14 MD Service Users may be LD No more than 2 Service Users may be MD(E) Date of last inspection 3rd March 2006 Brief Description of the Service: Tunnicliffe House is a large detached property in a quiet cul-de-sac close to Macclesfield town centre. Although it is a three storey building, residents live only on the ground and first floors as the second floor is not registered to accommodate residents. The home is registered to provide care for adults with mental health problems and up to four adults with a learning disability. The home does not have a passenger lift or adaptations, as residents are abale to use stairs and move around the home without help. The weekly fee payable at the home ranges from £343.34 to £870. figures were provided by the owner on 4 April 2007. These DS0000006675.V331146.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 4 April 2007 and lasted six hours. This visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires from CSCI were also made available for residents, families and health and social care professionals to find out their views. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents were spoken with and they gave their views about the service. What the service does well: There is a good assessment process for people thinking of moving into the home. An assessment is carried out and people are invited to visit the home to see if their needs can be met and if the home is suitable for them. Care plans are drawn up for each resident to show how their needs are to be met. There are good links with doctors, nurses and other healthcare people. Residents are helped to use the facilities of the National Health Service when they need to so they stay as well as possible. Residents are enabled to make decisions about how they lead their lives. They know about the risk assessments carried out for them by the staff and have signed these to say that they have agreed them. Some residents have their regular routines and activities whilst others decide on a daily basis what they want to do. The home is clean and homely so that residents live in comfortable surroundings. Staff are well trained to do their work and when new staff are employed thorough checks are done to make sure that they are suitable to work with the residents. The home is well managed and residents’ views are listened to and acted upon where possible. Health and safety is taken seriously so that residents and staff remain safe and well. DS0000006675.V331146.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. DS0000006675.V331146.R01.S.doc Version 5.2 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 DS0000006675.V331146.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are given information, and have their needs assessed before deciding to move into the home so they know that their needs can be met. EVIDENCE: Residents spoken with said that they had enough information about the home before making a decision to move in. Two of the residents that had sent in comment cards to CSCI before the inspection visit stated that they had visited the home prior to moving in, during which time they met with other residents and staff, had a meal and viewed the room they were to be offered. There have been no new residents moving into the home since the last inspection. However, records were seen of assessment of need/care being carried out with people prior to them taking up accommodation at the home. Residents confirmed that they had received a contract that identified that the first four weeks of living at the home was a trial period, the weekly fee payable and what this covers, and the periods of notice required by themselves and the home. The records showed that the residents had signed their contracts to show they had seen and agreed them. DS0000006675.V331146.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The way in which residents’ needs are met means they can make choices and maintain their independence. EVIDENCE: The care records of two residents were read at this inspection visit. Both contained a profile of the person that included a summary of their needs, preferences and dislikes. Plans of care were in place for their identified needs/problems, and included an action plan showing how these needs were to be met. The records showed that these plans were reviewed and signed by the residents. The health of one of the residents had recently deteriorated and an appropriate plan of care had been devised and implemented for this. Daily records were seen regarding the residents’ health and welfare that were informative and detailed. DS0000006675.V331146.R01.S.doc Version 5.2 Page 10 Residents spoken with said that they are able to make decisions about their daily lives, and that they receive assistance in this from the staff when they request it. They also commented that staff listen to them and that the staff act upon what they say. Risk assessments were recorded in the residents’ care records. These appeared appropriate, and evidence was seen of the residents signing these and agreeing with their content. DS0000006675.V331146.R01.S.doc Version 5.2 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. 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 activities that suit their lifestyles and maintain their interests. EVIDENCE: Six of the residents attend an industrial workshop unit at a local hospital, and one resident attends a day centre run by a primary care trust during the week. One of the residents spoken with said that their physical and mental health had improved since moving into the home, and that they were now able to pursue one of their hobbies that they used to be interested in. Two of the residents are currently attending a local college where one is undertaking a computer course and the other, creative writing. Residents are free to come and go as they please and go into the town shopping either on their own or accompanied by a member of staff. Some of the residents visit a local public house on karaoke evenings. DS0000006675.V331146.R01.S.doc Version 5.2 Page 12 Comment cards were received by CSCI from the relatives of three residents prior to the inspection. All stated that the home helps their relative to keep in touch with them. One relative stated that their family member spends each weekend and bank holiday at the family home, and on the day of inspection, one of the residents was waiting to spend the Easter break with their family. Two residents attend a church of their choice on a regular basis, and the manager said that other residents attend church services when they choose to. Residents are given a key to their bedrooms. They said that the staff respect their privacy and that they can choose to be on their own if they wish. Staff were heard to address the residents appropriately, and when spoken with, demonstrated a good awareness in relation to residents’ choice and privacy. Menus were on display that appeared to provide varied and nutritious meals. These showed that an alternative is offered at each meal. Residents spoken with said that they enjoyed the food provided. DS0000006675.V331146.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The healthcare needs of the residents are well managed to ensure that they receive the care and attention they need. EVIDENCE: Residents’ preferences are identified in their care records, and in conversation, residents confirmed that their wishes and preferences about how they are supported and cared for are taken into account. All of the residents are registered with a general practitioner and consultant psychiatrist. Staff accompany residents to hospital and doctors appointments if requested. A social worker supervisor sent in a comment card to CSCI prior to the inspection and commented that the health care needs of the residents were well met, that their privacy and dignity was respected and that the staff support the residents to live the life they choose. A further comment made was “Tunnicliffe House offers a family type environment to those with severe negative symptoms. It is unique in filling a service gap where residents are only pressured to move on as they want to be. It is a valuable and much needed resource”. A relative also commented that they are confident that their family member’s physical and emotional needs are being met. DS0000006675.V331146.R01.S.doc Version 5.2 Page 14 Staff responsible for the administration of medicines to the residents have received training in this and the management of medicines at Stockport College. Residents’ medicines are identified on their individual Medicine Administration Record (MAR) sheets, and when these were seen they were found to be filled in accurately. A random sample of medicines was chosen for stock reconciliation and found to be correct. One resident has assumed responsibility for taking their own medicines and records were seen of staff checking that these were being taken correctly. DS0000006675.V331146.R01.S.doc Version 5.2 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. 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. Staff are provided with information on the protection of vulnerable adults to enable them to safeguard the residents at the home. EVIDENCE: There have been no recorded complaints received at the home since the last inspection. A copy of the home’s complaints procedure was on display at the home and residents spoken with said that they knew the procedure for making their concerns known. A copy of the Department of Health’s document ‘No Secrets’, which contains information on abuse and how to report it, is available for the staff to refer to. The manager said that this is given to all new staff to read when they start working at the home. The manager went on to say that she has provided training in protecting vulnerable adults up to now but that in future this would be provided by a senior member of the care staff team who has shown an interest in this. The home also has a whistle blowing policy that advises staff as to how they can make their concerns known if they witness or suspect poor practices occurring. DS0000006675.V331146.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained so the residents live in clean and comfortable surroundings. EVIDENCE: The standards of furnishings and décor around the home have been well maintained. At the time of inspection redecoration of one of the bedrooms was taking place following which new carpeting was to be laid. The owner said that two more bedrooms and the smokers room were to be redecorated in June when the residents were on holiday in North Wales. Most areas of the home were visited and were found to be clean, tidy and free from unpleasant smells. DS0000006675.V331146.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. 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. Staff have had training to help them develop their skills and provide safe care. Recruitment procedures are thorough enough to ensure that residents are protected. EVIDENCE: A review of the staff rotas showed that there are two members of care staff on duty during the day and one at night. Either one of the owners of the home is also present in the home during the week. Eight care assistants are employed at the home, four of whom have successfully completed an NVQ training course, with a further carer currently undertaking this training. The staff at the home have received mental health awareness training from a mental health nurse employed by a local trust. Two staff are updating their first aid training, and three staff have attended a study day on infection control. As previously stated all staff responsible for the administration of medicines have undergone training in this. The manager said that further staff training is to take place on health and safety, protection of vulnerable adults and basic food hygiene. DS0000006675.V331146.R01.S.doc Version 5.2 Page 18 The personnel files of two staff employed at the home since the last inspection were read. Both of these contained completed application forms, two satisfactory references, a medical declaration, and a satisfactory Criminal Records Bureau disclosure. DS0000006675.V331146.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using The management available evidence including a visit to this service. arrangements at the home ensure that the health and safety of the residents and staff is well promoted. EVIDENCE: The manager is one of the owners of the home and has been in post for a number of years. Residents spoken with were positive about how the home was run. They said that they could talk to the manager whenever they wanted and that she took notice of what they said. Residents’ meetings are held three monthly, and residents said that their points of view were taken on board. They also said that they could approach the manager in between these meetings if they had concerns about anything at the home. These comments were reflected in the comment cards received by CSCI. DS0000006675.V331146.R01.S.doc Version 5.2 Page 20 All of the staff have received fire safety training within the past twelve months that was followed up by a questionnaire to ascertain that staff had understood this. The fire and emergency lighting systems are tested regularly. The home’s cold water system was disinfected in June 2006 and this treatment has been booked to place annually. A service of the central heating system was undertaken in March this year. Products subject to the Control of Substances Hazardous to Health legislation were seen to be stored securely. DS0000006675.V331146.R01.S.doc Version 5.2 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 3 3 X 4 3 5 3 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 3 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 4 X 4 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 3 3 X 3 X 3 X X 3 X DS0000006675.V331146.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 DS0000006675.V331146.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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