Inspection on 12/07/06 for Tweed View House

This inspection was carried out on 12th July 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.

Other inspections for this house

Tweed View House 12/07/07

Tweed View House 31/08/05

Tweed View House 28/04/05

Tweed View House 14/10/04

Tweed View House 27/04/04

Tweed View House 10/10/03

Tweed View House 30/04/03

Tweed View House 12/06/02

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

CARE HOMES FOR OLDER PEOPLE Tweed View House Tweed Street Berwick Upon Tweed Northumberland TD15 1NG Lead Inspector Anne Urwin Brown Key Unannounced Inspection 12th July 2006 09:45 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 View House DS0000000513.V304763.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 View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tweed View House Address Tweed Street Berwick Upon Tweed Northumberland TD15 1NG 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) 01289 303550 01289 331764 tlh65@hotmail.com Berwick Care Homes Miss Moira Jane Simpson Care Home 37 Category(ies) of Dementia - over 65 years of age (14), Old age, registration, with number not falling within any other category (22), of places Physical disability over 65 years of age (1) Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2005 Brief Description of the Service: Tweed View is located within walking distance of the centre of Berwick upon Tweed near the railway station and bus station. The building was formerly a hotel and has been adapted to provide residential care for up to thirty-seven older people, fourteen of whom are diagnosed as having dementia. The Home provides accommodation on three floors and a shaft lift is fitted. At the back of the building there are attractive views of the River Tweed and surrounding areas from the building and the garden. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out over seven hours. Before the visit the Inspector used information from the pre-inspection questionnaire to assist in planning the inspection. The inspection involved talking to the Manager, six residents and five staff, a tour of the building and inspection of records. What the service does well: What has improved since the last inspection? What they could do better: A system needs to be in place to ensure regular reviews of care plans are carried out and information is updated as necessary. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 6 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 View House DS0000000513.V304763.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 View House DS0000000513.V304763.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service No service user moves into the home without having his/her needs assessed and been assured that these needs will be met. There have been no service users assessed and referred for intermediate care. EVIDENCE: Records showed that a full assessment is carried out before a new resident is admitted to Tweed View. Staff were clear about the assessment process and said that they had appropriate information provided by the care manager or relatives before an admission. Care management assessments were available for most residents. There is a care plan for each resident that describes his/her daily needs. Records confirmed that no residents have been admitted for intermediate care. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 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): 7, 8, 9, 10 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service Each resident’s health, personal and social care needs are set out in an individual plan of care, although one plan had not been updated to reflect changes for this person. Residents’ health needs are fully met. Residents, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: A format for recording residents’ health, personal and social care needs is in place and individual plans of care are available for each resident. Records show that appropriate information is kept. Key workers update changes monthly, although a care plan had not been updated to reflect changes for one resident. Risk assessments are in place for nutrition, falls and pressure areas. Staff demonstrated a good understanding of residents’ needs during the inspection. Residents said care staff know what their needs are and provide appropriate support. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 10 Inspection of records and discussion with staff showed that residents’ health care needs are identified and met. Evidence was available that good relationships are maintained with health care professionals that ensure residents’ needs are appropriately met. Records showed residents have regular appointments/visits from local dentists, opticians and chiropodists or residents are assisted to visit them if they wish. Records relating to nutritional assessments, falls and pressure sore risk assessments were available in individual files. Appropriate guidance is in place for the administration of medicines. Medicines are securely stored. A monitored dosage system is in use. Staff training in handling medicines has been provided for all senior staff that administer medicines. An issue has arisen since the last inspection when some medicines have gone missing. This matter is now being investigated. As a result of this incident the manager has made arrangements for regular checks of medicines to be done. She is also arranging for checks at staff hand over time to be introduced to further improve security. Guidance for staff includes references to privacy and dignity. Staff showed that they were aware of the need to respect residents’ privacy during the inspection by knocking on doors. Residents said staff respect their privacy and are always respectful when they talk to them. Induction training includes reference to privacy and dignity. Staff spoke respectfully to residents during the inspection. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 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): 12, 13, 14. 15 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service Residents find the lifestyle experienced in the home matches their preferences and expectations, and satisfies their social, cultural, religious and recreational interests and needs. Residents are able to keep in contact with their family, friends and other people from the local community as they wish. Residents are helped to exercise choice and control over their lives. A varied and wholesome diet is provided with choices available. EVIDENCE: Residents said that they are able to make choices about their lifestyle and gave examples like their daily routine, what they do, food and social activities. There is information about residents’ interests within their care plans. There is a residents’ committee who are involved in choosing and booking entertainment. There is a bus trip each month and residents are encouraged to choose where they go. A list of activities provided was available and records are kept of who attends. Evidence was available to confirm that appropriate support is provided to residents with dementia in attending social activities. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 12 Visitors are welcomed and encouraged to visit. Residents use their own rooms or in the public areas of the home when they are entertaining visitors. They said that they could have visitors at any time and there are no restrictions. Residents are encouraged to keep control of their finances for as long as they wish and as long as they have the capacity to do so. Residents said they could bring in furniture and other possessions when they came to live at Tweed View. Menus show a choice is provided at each mealtime. There is a varied diet provided. Residents said that they are satisfied with the quality and quantity of the food. They said that they could have a hot or cold drink when they liked. None of the residents has a special diet at present, but the manager said that specific arrangements can be made as necessary. Food hygiene training has been provided for kitchen staff. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 13 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): 16, 18 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service Residents are confident that their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: Policies and procedures are in place for dealing with complaints. Staff described appropriately the process for helping a resident make a complaint. Three complaints have been made since the last inspection, one was upheld and two were not. Records confirmed that appropriate action was taken to investigate these. Guidance is in place for dealing with allegations of abuse. Staff training in dealing with abuse has been provided for all senior staff and ten care staff. A copy of Northumberland Social Services guidance on Protection of Vulnerable Adults is available in the home. Staff were able to describe how they would deal with an allegation of abuse and showed that they were aware of the home’s guidance. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 14 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, 26 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service Residents live in a safe environment that is well maintained. The home is clean, pleasant and hygienic. EVIDENCE: There is a programme of redecoration and refurbishment in place. The home is well maintained and a handyman is available to carry out day-to-day maintenance. There is some discussion going on with the Fire Office about advice offered at a previous fire inspection. This concerns fire precautions on the first floor and the manager is waiting for further advice before taking action on addressing the issues. Two bedrooms and two toilets have been redecorated since the last inspection. Window repairs are being done, plans are in place to redecorate the main staircase and repaint the exterior of the building. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 15 The home was clean and tidy at the time of the inspection. Procedures are in place for infection control and hand washing facilities are available. Cleaning routines are organised to suit residents’ needs and for one resident this is part of the care plan. Sluicing facilities are available. The laundry is sited in a separate building and appropriate facilities are provided. The washing machine has a programme that meets disinfection standards. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 16 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): 27, 28, 29, 30 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service The numbers and skill mix of staff meets residents’ needs. Residents are in safe hands at all times. Residents are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. EVIDENCE: Staffing is organised to suit residents’ needs. The rota shows that appropriate numbers of staff are available and that there is at least one senior member of staff on each shift during the day. At night there are three waking night staff. Residents and staff said there are enough staff on duty. Staff at Tweed View have achieved more than 50 of staff trained in care. Eleven staff have completed NVQ Level 3, two Level 4. Five staff are working towards completing training in care. Three senior staff have completed work on Level 4, but problems have been experienced with the training agency and they are waiting to have their results confirmed. Guidance is in place for recruitment of staff. Records show that appropriate reference and Criminal Records Bureau checks are carried out before staff begin work at Tweed View. All staff have a statement of terms and conditions of employment. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 17 A staff development plan is in place that identifies priorities for training for each member of staff. Training in the last year has included Stress Management, Vulnerable Adults, Food Hygiene, Fire Safety, Aggression Management, First Aid, Moving and Handling, Food Safety and Infection Control. The management and staff at Tweed View are committed to training and to improving their skills and this is commended. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 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, 33, 35, 38 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service Residents live in well run home that is managed by an appropriately qualified and experienced manager. The home is run in the best interests of residents. Residents’ financial interests are safeguarded. The health, safety and welfare of residents and staff is promoted and protected. EVIDENCE: The manager is experienced and has qualifications in care and management. The deputy manager also has qualifications in care and management. The manager and deputy manager undertake regular training to update their knowledge and skills. There is a job description for the manager that describes her responsibilities and duties. Staff said that there are clear lines of accountability in the home. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 19 Systems are in place for reviewing the service provided that includes the use of resident and relative questionnaires. The information collected from these questionnaires is used when the home’s development plan is drawn up. A development plan for the home is in place that takes into account feedback from feedback residents, visitors and staff. The results of residents’ reviews are available on the notice board in the home. Policies and procedures are regularly reviewed and updated. Training records showed that staff have regular training in safe working practices, including moving and handling, first aid, fire safety, food hygiene and infection control. Guidance is in place for health and safety and records are kept of regular checks of boilers, central heating systems, electrical equipment and water temperatures. Risk assessments are in place for safe working practices. All staff receive appropriate induction and foundation training. Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 21 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 OP7 Regulation 15 Requirement Care plans must be regularly reviewed to ensure that they include up to date information about residents’ needs. Timescale for action 30/09/06 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 Tweed View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 View House DS0000000513.V304763.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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