Inspection on 16/01/07 for Tweed

This inspection was carried out on 16th January 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

Tweed 24/01/06

Tweed 30/08/05

Tweed 01/02/05

Tweed 01/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Tweed 8-10 Silverdale Road Eastbourne East Sussex BN20 7AL Lead Inspector Nigel Thompson Unannounced Inspection 16th January 2007 09:30 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 Tweed DS0000021276.V324062.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 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. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tweed Address 8-10 Silverdale Road Eastbourne East Sussex BN20 7AL 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) 01323 733223 01323 649741 Emilie Galloway Trust Mrs Jacqueline Heywood Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is twenty-one (21). Service users must be older people aged sixty-five (65) years or over on admission. 24th January 2006 Date of last inspection Brief Description of the Service: Tweed is a large detached house on three floors, with a basement area, situated in the Meads area of Eastbourne, and five minutes walk from the seafront. There are local shops, and other social and leisure facilities in close proximity. Public transport routes run near to the home and there is a main line railway station in the town. Décor and furnishings are maintained to a good standard. Service user accommodation comprises of ten single rooms and ten double bedrooms, of which only two should be used for double occupancy at any one time. The home is registered to accommodate up to a maximum of twenty one service users. The communal areas comprise of a separate dining room and a large lounge and snug area on the ground floor. Information about the service, including the Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective service users or their relatives, on request, as part of the admission process. The range of weekly fees, as of 16 January 2007, is £350 - £395. Additional charges, not included in the fees, include hairdressing, chiropody, reflexology and newspapers. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over five hours in January 2007. It found that all of the National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. On the day of the inspection there were twenty one service users living at the home. The inspection involved a tour of the premises, examination of the homes records, discussions with the registered manager and Trust Manager and consultation with two members of staff and seven service users. The focus of the inspection was on the quality of life for people who live at the home. Since the previous inspection, following an application from the home, the registered number of places has been increased from 20 to 21. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. What the service does well: Tweed has a long tradition of providing good quality individual care and support for service users, through careful and continuous assessment of need. The relaxed, homely and welcoming environment has evolved over several years and reflects the stability and commitment within the staff team and the open and inclusive management style. Effective systems are in place for the admission and ongoing care of service users. Communication and consultation with service users’ family members is effective and ongoing. Relatives have the opportunity to partake in individual assessment, care planning and reviewing processes. Staff receive effective induction and foundation training, regular supervision and are clearly valued and supported by the management team. Tweed DS0000021276.V324062.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. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 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 Tweed DS0000021276.V324062.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective service users have the opportunity to visit the home and know that it is able to meet their individual care and support needs. EVIDENCE: As well as the detailed statement of purpose and service user guide that are in place, an informative brochure has also been developed for the benefit of prospective service users and their relatives. Details include the history and location of the home, aims and objectives and information regarding staffing, activities, accommodation and facilities provided. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 9 It was noted that the statement of purpose has not been amended to accurately reflect the recent increase in the registered numbers of places. Following a referral to the home, the manager confirmed that she carries out a thorough pre-admission assessment including all personal care and support needs, any mental health and mobility issues, social and cultural needs and family involvement. Within the last twelve months there have been eight service users admitted to the home. In several files that were examined there was documentary evidence of a full and comprehensive needs assessment having been carried out. It was noted that the assessment recording format includes detailed information regarding the physical, emotional and social care needs of prospective service users, to enable the manager to make a more informed decision as to whether an individual’s specific care and support needs can be met within the home. In assessments that were examined it was evident that they are routinely dated and signed by both the manager and the service user. Any significant changes in the condition or needs of a service user are recorded, following a review, in a simple but effective colour coded system. The manager confirmed that prospective service users are invited to visit the home, look around and meet with staff and existing service users. To help further establish their suitability and whether their needs can be met, they also have the opportunity to stay in the home for a short period, prior to moving in. Having moved into the home, the Trust Manager confirmed that there is a ‘flexible’ trial period, of continual assessment, during which time the suitability of the service and the compatibility of the service user can be established. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive care plans enable staff to meet the assessed needs of service users in a structured and consistent manner. Service users are protected by the home’s medication policies and procedures. They are treated with respect and encouraged to make decisions about their day-to-day living. EVIDENCE: Comprehensive, high quality care plans have been developed for each service user and are clearly and directly linked to the individual’s assessed needs. Service users’ individual plans that were inspected were found to be accurate, generally well maintained, and up to date. Plans that were examined contained details of any actions or interventions to be taken by staff, so ensuring consistency of approach. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 11 The manager confirmed that care plans continue to be regularly monitored and updated on a monthly basis. A more thorough review of the plan is carried out every five months. It was evident that service users and occasionally their relatives are very much part of the assessment process and are directly involved in the development and reviewing of individual care plans. It was noted that they also sign the plan to this effect. The home has recently introduced a key-worker system. As part of their induction programme, the manager confirmed that all staff receive instruction on the principles of dignity and respect. This was evident, through discussion during the inspection, and from direct observation of staff interacting sensitively and professionally with service users. All service users are registered with a local GP of their choice and have access, via the surgeries, to a range of local community health services, including district nurses, physiotherapists and occupational therapists. Nutritional screening is undertaken as part of the initial assessment procedure. Satisfactory records relating to the receipt, administration, dispensing and storage of service users’ medication are in place and were found to be up to date and well maintained. Following personal risk assessments, the manager confirmed that there are currently seven service users who take responsibility for the control and administering of their own medication and have signed a disclaimer to this effect. In each case it was noted that individuals have been provided with a lockable facility in their room for the safe storage of medicines. These arrangements are closely monitored, reviewed monthly and recorded in the individual’s care plan. There are currently no controlled drugs held in the home. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are enabled and supported to maintain contact with family and friends as they wish. They benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: Independence is promoted within the home and, apart from mealtimes, routines are both flexible and varied. Service users are encouraged and supported in making choices affecting their day-to-day life. A weekly and monthly programme of structured activities is in place and reflects individual choice and interests. As previously documented, service users’ social and recreational interests and preferences are now recorded, as part of the pre admission assessment process. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 13 External entertainers and musical activity coordinators continue to visit Tweed on a regular basis. On the morning of the inspection, service users were enjoying a gentle musical keep fit session in the lounge. As well as organised group activities and supported outings, the manager confirmed that time is also given to individuals who prefer to spend time alone or remain in their room. The manager confirmed that, in accordance with the wishes of the service users, visitors to the home are welcome, at any reasonable time. However, they are asked to respect mealtimes. Service users may see friends or relatives in the lounge or in the privacy of their own room. This was supported by positive comments received from service users’ relatives: ‘I would like to comment on the courtesy and friendship always offered to family and friends when visiting, no matter what time of day’. The standard of catering at Tweed remains high. Service users are provided with a varied, wholesome and nutritious diet. At lunchtime a choice of meals is available and special diets are catered for. A menu is displayed in the hallway, reflecting service users’ preferences and including seasonal variations. Positive comments received from service users indicate a high level of satisfaction with activities available and with the choice and standard of the meals provided: ‘Different classes and entertainments are tried and, if well supported, are arranged on a regular basis. There are special attractions at holiday times’. ‘The food here is very good and there is always a choice’. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The open and inclusive atmosphere within the home enables service users, staff and visitors to express any concerns, confident that they will be listened to and acted upon. Service users are safeguarded from abuse through relevant staff training and robust policies and procedures. EVIDENCE: A detailed and up to date copy of the ‘concerns and complaints’ policy and procedure is in place in the entrance hall, for the benefit of service users and visitors to the home. Service users and members of staff, spoken with during the inspection, described how the manager operates an ‘open door policy’ and is clearly considered to be very approachable and understanding. They confirmed that they would have no hesitation in speaking to her or making a complaint if necessary and each person was confident that they would be listened to: ‘The manager is so kind and helpful. We have every confidence in her’. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 15 Residents’ meetings are held regularly every three months and provide service users with the opportunity to raise and discuss any issues or concerns that they may have. The home continues to ensure as far as is practicable that service users are safeguarded from all forms of abuse. Recently updated policies and procedures relating to Adult Protection, including a policy on ‘Whistle Blowing’ are in place. The manager confirmed that staff are also made aware of these key policies and procedures as part of their induction, foundation and National Vocational Qualification (NVQ) training and they are reinforced during staff meetings. This was supported by minutes from previous meetings and confirmed by staff, spoken with during the inspection. The manager also confirmed that updated, refresher training relating to abuse and adult protection procedures has been arranged for all staff for later this month. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from accommodation that is safe, comfortable, well maintained and decorated to a satisfactory standard. EVIDENCE: It is evident that there has been little change in the physical environment at Tweed since the last inspection and standards remain satisfactory throughout. During my ‘guided tour’ of the premises it was evident that the well maintained décor and good quality furniture and furnishings provide a comfortable, pleasant and homely environment for service users. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 17 Of note was the recently converted walk in shower room on the second floor, which has clearly been refurbished to a high specification. It was pleasing to hear from service users and staff that this room has proved to be very popular and evidently is now used far more than previously when it was a bathroom. The manager confirmed that independence and individuality continue to be promoted within the home and this is evident from the personalising of service users’ individual rooms, which clearly reflects individual tastes and interests. Positive comments from service users, spoken with during the inspection, reflected a high level of satisfaction with the home and the services provided: ‘We’re very happy here and couldn’t want for more. It’s a lovely room and it’s always kept clean and tidy’. ‘There is a relaxed happy atmosphere in the home’. As with many of the environmental standards, the situation regarding shared space remains largely unchanged. Adequate communal areas are provided to meet the individual and collective needs of the service users. All communal areas, including the lounge and dining room are decorated and furnished to a high standard. Furniture and lighting throughout the home is domestic in character. A programme of routine maintenance, refurbishment and renewal is in place. Infection control procedures are in place and levels of cleanliness remain high throughout the home. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is sufficient trained and competent staff on duty at all times to meet the assessed needs of the service users. Robust recruitment procedures and appropriate staff training ensure the safety and protection of service users. EVIDENCE: The stable and dedicated staff team remains clearly able to meet the identified, individual and collective needs of service users within the home. All new employees are provided with a comprehensive job description and staff spoken demonstrated a sound understanding of their individual role and responsibilities. The manager confirmed that care staff employed at Tweed have the relevant skills and are deployed in sufficient numbers to meet the current care and support needs of the service users. This was further evidenced by the current rota, viewed during the inspection, that details which staff are on duty at any given time and includes their designation. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 19 The manager stated that appropriate induction, foundation and core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with staff and supported by training records, examined during the inspection. There are currently eleven care staff who hold the National Vocational Qualification (NVQ) level 2 or above, in care. This represents an impressive 95 of all staff employed at the home. The manager continues to operate a thorough and robust recruitment procedure and all prospective staff are seen and interviewed by her before commencing work in the home. Personal files relating to recently appointed members of staff, examined during the inspection, were found to be generally well maintained, containing necessary information, including employment history, two references and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from effective management and thorough quality assurance systems. Satisfactory health and safety policies and procedures, within the home, help to ensure the protection of service users and staff. EVIDENCE: The atmosphere in the home remains relaxed, friendly and welcoming. Staff, spoken to during the inspection felt valued and supported by the manager and confirmed her open and approachable style of leadership and clear and positive sense of direction. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 21 Since the previous inspection the manager confirmed that she has achieved the Registered Manager’s Award (RMA), which she now holds in addition to the NVQ level 4 in management and care. The home continues to operate effective quality monitoring systems, including satisfaction questionnaires for both service users and their relatives. Positive responses from the most recent surveys indicate a high level of satisfaction with the home and the care and support provided: ‘Tweed is a first class care home, very well run and with superb caring staff’. ‘I am sure it is possible for homes to do all the right things but Tweed goes one better and does all the right things but with the addition of genuine love and care’. ‘Just hope that I can spend the rest of my days here’. The manager confirmed that the health, safety and welfare of service users and staff remains of paramount importance within the home. Staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. A new fire alarm panel and emergency call system is shortly to be installed. Fire alarm systems, including emergency lighting, are tested weekly and regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X X 3 Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 23 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. 1. Refer to Standard OP1 Good Practice Recommendations It is recommended that the statement of purpose be reviewed and amended to include updated details of the registered number of places. Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. Extracts may not be used or reproduced without the express permission of CSCI Tweed DS0000021276.V324062.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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