Inspection on 24/01/06 for Tweed

This inspection was carried out on 24th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 16/01/07

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 Announced Inspection 24th January 2006 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.V261226.R01.S.doc Version 5.0 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.V261226.R01.S.doc Version 5.0 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 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That service users must be aged sixty-five (65) years or over on admission. That a maximum of twenty (20) service users are accommodated. That a maximum of two (2) of the identified double bedrooms can be shared by service users at any time. 30th August 2005 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 service users. All double bedrooms are currently being used as single bedrooms. The communal areas that service users can use, comprise of a separate dining room and a large lounge and snug area on the ground floor. At the time of the inspection there were twenty service users resident. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over six hours in January 2006. 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 and relatives spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. On the day of the inspection there were twenty service users living at the home. The inspection involved a tour of the premises, examination of the home’s records, including service users’ care plans and discussion with the Registered Manager. Two members of staff, seven service users, two relatives and the Trust Manager were also spoken with. The focus of the inspection was on the quality of life for people who live at the home. In order that a balanced and thorough view of the home is obtained, this report should be read in conjunction with previous inspection reports. What the service does well: The comfortable, relaxed and homely environment, which is a feature of Tweed, has evolved over many years and reflects the general stability within the dedicated staff team, the approachable and inclusive management style and the ongoing involvement and support of the Trustees. Effective systems are in place for the admission and ongoing care of service users. Improved care plans, developed from comprehensive pre-admission assessments, ensure that an individual’s needs are met in a structured and consistent manner. A service user recently celebrated her 100th Birthday with a party at the home. From discussions with her and photographs of the event, the evening was clearly very successful and a good time was enjoyed by all. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 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. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 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.V261226.R01.S.doc Version 5.0 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): 1, 3, 4, 5 & 6 Documentation, including a concise and informative brochure, statement of purpose and service users’ guide ensures that prospective service users and their relatives have sufficient information about the home and the services provided. The thorough admission policy and procedures ensure that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. However the assessment of certain service users’ support needs and ongoing care is not always kept under review, as required. 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.V261226.R01.S.doc Version 5.0 Page 9 However it is recommended that the section on registration be reviewed and amended to include up to date details of the CSCI, as the regulatory body. Since the previous inspection, as required and in line with other documentation, the pre-admission assessment format has been reviewed, adapted and improved. In individual care plans that were examined it was noted that the assessment now includes more 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. It was also noted that 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. However, through direct observation and from discussions with staff, during the inspection, it became evident that some service users’ mental health needs were giving cause for concern. Although the behaviour and level of confusion was variable in each case, it was clear from care plans that were examined that individual assessments did not reflect their changing and often complex needs. There was also no documentary evidence that mental health assessments had been carried out, or if they had been they had not recently been reviewed and updated. The concerns related to the possibility that in cases where no reassessment of an individual’s mental condition had taken place, the unidentified condition may be outside the home’s category of registration and consequently the staff would not have the necessary skills, experience or resources to meet their needs. 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. Intermediate care is not provided at Tweed and unplanned or emergency admissions are avoided. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 & 10 Recently improved service users’ care plans are developed from a comprehensive assessment of an individual’s needs and enable staff to meet such needs in a structured and consistent manner. However individual care plans do not always reflect the current support needs of service users. EVIDENCE: As previously documented, service users’ individual care plans have been reviewed and significantly improved since the last inspection. Information is now more readily accessible in individual files, which include separated sections for assessments, objectives, details of action to be taken by staff, progress notes and reviews. However, as discussed, the objectives and action to be taken by staff is to be reviewed in respect of each service user and it is also recommended that the recording format for the current risk assessment be reviewed and improved to make it more readily accessible. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 11 Through direct observation and discussions during the inspection, it is clear that staff at Tweed are aware of and respect service users’ privacy and dignity. Members of staff were seen knocking on doors before entering private rooms and were observed to be professional in their manner and sensitive and respectful when interacting with service users. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 15 Social activities and meals are both well managed, creative and provide daily variety and interest for people living in the home. EVIDENCE: Within a risk management framework, independence continues to be promoted in the home and, wherever possible, service users are enabled and supported to pursue their own lifestyles and individual routines. A structured programme of activities, events and entertainment has been developed and is on display in the entrance foyer. As well as the many organised group activities, time is also given to individuals, who prefer to spend time alone or remain in their room. Service user’s individual social and recreational interests, likes and dislikes are recorded in their care plan. There is also a record maintained of an individual’s participation in organised activities. The four-week rolling menus were examined and found to be balanced, wholesome and nutritious. An alternative to the main meal is always available. The chef confirmed that service users’ likes and dislikes were noted and taken into account and any special dietary needs could be catered for. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 13 Lunchtime, during the inspection, was observed to be relaxed, sociable and unhurried. Service users expressed overall satisfaction with the quality, quantity and presentation of the food that they receive. Individuals spoken with, over an enjoyable lunch, commented favourably on the standard of the meals provided: ‘The food here is very good’. Visiting at Tweed is unrestricted and the Manager confirmed that, in accordance with the wishes of the service users, friends and relatives are welcome at any reasonable time. Service users may see their visitors in the lounge or in the privacy of their own room. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion. All key standards were assessed during the previous inspection carried out on 30 August 2005. EVIDENCE: Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 15 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): 19, 20, 22, 23, 25 & 26 The service is accessible, safe and clean and remains clearly suitable for it’s stated purpose. Service users benefit from pleasant accommodation that is comfortable, generally well maintained and decorated to a satisfactory standard. EVIDENCE: Tweed is an established service and both its location in a residential area of the town and its layout remain appropriate and suitable for its stated purpose. The well maintained décor and good quality furniture and furnishings provide a comfortable, pleasant and homely environment for service users. The physical environment remains largely unchanged since the previous inspection, however it was noted that work has recently started to convert a second floor bathroom into a walk-in shower room. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 16 The character of the building is reflected in the spacious lounge and dining room and in the varied shapes and sizes of service users’ rooms. It is evident and good to see that so many have been personalised, with pictures, family photographs and other items of furniture and personal belongings, reflecting individual taste, choice and preference. New carpets have been fitted in several service users’ rooms and a number of beds have also been replaced. Infection control procedures are in place and clearly adhered to and levels of cleanliness remain high throughout. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 17 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): These standards were not assessed on this occasion. All key standards were assessed during the previous inspection carried out on 30 August 2005. EVIDENCE: Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 18 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, 32, 35 & 38 Service users and staff benefit from the Manager’s open and approachable style of leadership. Staff are aware of and adhere to up to date policies and procedures relating to health and safety, ensuring the health, safety and welfare of service users and staff. EVIDENCE: The Registered Manager confirmed that she has recently completed the NVQ level 4, in Management and Care. The established management team continue to maintain a relaxed, open and inclusive atmosphere within the home. Staff and service users confirmed how approachable and supportive the Manager and the Deputy Manager are. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 19 Service users’ relatives spoken with during the inspection expressed satisfaction with the care provided and confirmed how approachable, kind and helpful the Manager is. Comment cards received by the Commission prior to the inspection supported and reinforced this positive view of the home: ‘I love Tweed and my room – I am very contented’. ‘The Manager is dedicated to our needs in every way and is very much appreciated by me and my family’. ‘The attention to detail provides for a most happy, healthy and stimulating environment’. Monthly monitoring visits to the home by individual Trustees continue and a copy of their subsequent report is forwarded to the CSCI. The Manager confirmed that the health, safety and welfare of service users and staff continues to be of paramount importance within the home and 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. 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.V261226.R01.S.doc Version 5.0 Page 20 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 2 X 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 X 3 3 X 3 3 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 3 X X 3 X X 3 Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP4 Regulation 14 (1) (a) Requirement It is required that the home is able to demonstrate that it has the capacity to meet the assessed needs (including specialist needs) of service users. It is required that the Registered Manager shall ensure that the assessment of a service user’s needs be kept under review, having regard to any changing circumstances. Timescale for action 28/02/06 2 OP4 14 (2) (a & b) 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP1 OP7 Good Practice Recommendations It is recommended that the section in the brochure on registration be reviewed and amended to include up to date details of the CSCI, as the regulatory body. It is recommended that, in individual service users’ care plans, the objectives and action to be taken by staff be reviewed. DS0000021276.V261226.R01.S.doc Version 5.0 Page 22 Tweed 3 OP7 It is recommended that the recording format for the current risk assessment be reviewed and improved to make it more readily accessible. Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Tweed DS0000021276.V261226.R01.S.doc Version 5.0 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!