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Inspection on 05/01/06 for Tupwood Gate Nursing Home

Also see our care home review for Tupwood Gate Nursing Home for more information

This inspection was carried out on 5th January 2006.

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

During a tour of the building the inspectors found the home to be warm, clean and tidy with all resident`s looking contented. The staff was busy getting the resident`s up for the morning but the atmosphere was calm. The activities co-ordinator was busy in the conservatory with a music session and some of the resident`s had instruments to play. The resident`s that the inspectors spoke with were complimentary about the home and were pleased to show their room. Personnel possessions were seen in each room that the inspectors entered. A couple of resident`s were nursed in bed due to their frailty but they looked comfortable and appropriate measures were in place to keep them comfortable.

What has improved since the last inspection?

All requirements from the previous inspection have now been met. The Registered Manager stated that she has now recruited a Clinical Manager who was busy ordering the monthly medications when the inspectors arrived and the pharmacist was about to arrive to do his regular audit.

CARE HOMES FOR OLDER PEOPLE Tupwood Gate Nursing Home 74 Tupwood Lane Caterham Surrey CR3 6YE Lead Inspector Lesley Garrett Unannounced Inspection 5th January 2006 10:00 X10015.doc Version 1.40 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 Tupwood Gate Nursing Home DS0000013363.V275751.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 Older People. 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. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tupwood Gate Nursing Home Address 74 Tupwood Lane Caterham Surrey CR3 6YE 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) 01883 342275 01883 341951 Cygnet Health Care Limited Mrs Jennifer Carol Roach Care Home 35 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (35) of places Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Of the total number of Service Users up to 15 beds may be used for the care of older people in category DE(E) The age range of services users will be: over 65 years 1 named Service User under the age of 65 years for Palliative Care. Date of last inspection 21st June 2005 Brief Description of the Service: Tupwood Gate Nursing Home is a large detached property, converted to provide accommodation for 35 older people who require nursing care. It is situated in a quiet residential area on the outskirts of Caterham. The home is well presented providing a good standard of accommodation. The home has a garden and there is parking to the front and side of the premises. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three and a half hours and was the second inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. Lesley Garrett, Lead Inspector for the service and Maggie White Regulation Manager carried out the inspection. Andreas Shelembe, Clinical Manager represented the establishment. Jenny Roach Registered Manager joined the inspectors later. A full tour of the premises took place. The inspector saw most of the residents and spoke with some of them in their rooms. This was a positive inspection. The inspector would like to thank the residents, staff and manager at Tupwood Gate for their time, assistance and hospitality during this inspection. What the service does well: What has improved since the last inspection? All requirements from the previous inspection have now been met. The Registered Manager stated that she has now recruited a Clinical Manager who was busy ordering the monthly medications when the inspectors arrived and the pharmacist was about to arrive to do his regular audit. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 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. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Core standards checked at previous inspection. The home does not have intermediate care beds. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8,9 & 10 The home has contact and is visited by health care professionals when they are required. The medication was administered in the correct manner and records were accurately completed. There were no issues identified around privacy or dignity. EVIDENCE: The home has good support from their local G.P. who visits the home every week and more frequently if required. The home also has visits from the Tissue Viability nurse and the Continence Nurse advisor. The home has access to a NHS dentist and on the day of inspection the hygienist was due to visit. The residents are also visited by the NHS chiropodist every two to three months. Nutritional risk assessments are completed for all residents and are in the individual plan of care. No resident is able to administer their own medicines. The home uses a local pharmacy and the pharmacist arrived, during the inspection, to do their own audit. The home has a local pharmacy policy but this did not contain The Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 10 pharmacy telephone number therefore this will be a requirement at the end of the report. All medication returns are checked and written in the book before they are put in the clinical bin. The home administers their medication from bottles. There were no controlled drugs in the home and there were photographs of the residents in place. The home has no specific privacy and dignity policy but the subject is covered during induction, this will be a requirement at the en of the report. The manager stated that all staff work in pairs therefore new staff do not work together they are always with someone more experienced. When the doctor visits the home the residents can be seen in the privacy of their own room. Each room can have a private telephone if they wish, post is delivered unopened and all rooms have been personalised with their own pictures and furniture if they wish. The inspectors saw this on their tour of the home. All residents are asked on admission their preferred name and this is documented in their care notes. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 The staff encourages the residents to make choices in their daily life and routines EVIDENCE: The clinical manager stated that all residents are given menu choices. They can select on the day and the chef will provide alternatives if necessary. They can also choose where to eat and some residents prefer to eat in their room. All residents can bring their own furniture and possessions into the home and the inspectors saw this as they walked around the home. The inspectors were told that no resident is able to manage their own finances. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Core standards checked at previous inspection. No issues at this time. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Core standards covered at previous inspection and no concerns at this time. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Core standards covered at previous inspection. No concerns at this visit. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 35 The home has a competent manager who is fit to be in charge and the resident’s financial interests are safeguarded. EVIDENCE: The manager at the home is a registered nurse who has also got her RMA. She also holds an NVQ assessor and verifier certificate. The home is also able to nurse palliative care residents as the manager also has a palliative care certificate. It is the homes policy not to keep residents money or hold pocket money accounts. The manager stated that the families act on their behalf or they have financial advisors or power of attorney. The home does have a lockable cupboard for valuables kept on a temporary basis. The valuables are documented and the family sign for them when they are collected. Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 16 Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X X Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 18 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. 1. Standard OP9 Regulation 13 Requirement The registered persons to amend the local pharmacy policy to include the telephone number of their pharmacy. The registered persons to provide the home with a privacy and dignity policy The registered persons to ensure that paperwork relating to the residents is not on display in the dining room Timescale for action 05/02/06 2. 3. OP10 OP10 12(4)(a) 12(4)(a) 05/02/06 12/01/06 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 Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Tupwood Gate Nursing Home DS0000013363.V275751.R01.S.doc Version 5.1 Page 20 - 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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