Inspection on 20/07/05 for Tweedmouth House

This inspection was carried out on 20th July 2005.

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

Tweedmouth House 26/09/08

Tweedmouth House 18/04/07

Tweedmouth House 17/01/06

Tweedmouth House 10/03/05

Tweedmouth House 26/07/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Tweedmouth House 4 Main Street Tweedmouth Berwick upon Tweed TD15 2HD Lead Inspector Suzanne McKean Unannounced 20 July 2005 09:30 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 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. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tweedmouth House Address 4 Main Street Tweedmouth Berwick upon Tweed TD15 2HD 01289 330618 01289 330492 chris@tweedmouthhouse.fsnet.co.uk Mrs P Thomlinson Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs P Thomlinson CRH 55 Category(ies) of DE - Dementia (1) registration, with number DE(E) - Dementia over 65 (16) of places OP - Old Age (38) Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10 March 2005 Brief Description of the Service: Tweedmouth House Nursing Home is a converted Grade II listed building comprising of three large traditional houses with some a modern extension to the rear of the building having been made to add to the premises size. It is situated in a very pleasant part of Berwick overlooking the river and with walking distance of local shops and amenities and near to the end of the old bridge connection this part of the town to the main shopping area of Berwick.The home is registered as a care home to accommodate fifty-five persons including seventeen places for those with a dementing illness and thirty-eight for older persons. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a period of 6 hours on one day by the inspector, who has visited the home on a number of previous occasions. The Registered Manager/Proprietor Mrs Thomlinson and Mr Thomlinson were present during the visit which allowed the examination of all of the necessary records including those which were being stored securely in line with the homes policy on confidentiality. Eight residents were spoken to directly during the visit and four visiting relatives, the inspector also spoke to seven of the staff the in process of the inspection visit. During the inspection the records examined included, four care plans, some training records and the fire log as well as complaints and accident records. The inspector also viewed two staff files including the process for their recruitment and selection. What the service does well: What has improved since the last inspection? At the last inspection only one requirement was identified regarding changing the toilet area to give more privacy, this is currently being done and the proprietor is taking the opportunity to make significant improvements to this area as part of the ongoing refurbishment. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 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. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 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 standard(s) 3, 6 The assessment undertaken prior to admission is detailed and the staff are being given training to meet the needs of the residents in the home. The manager ensures that prior to any admission the home has the necessary equipment for and information regarding the perspective resident. The home is not registered for and therefore does not provide intermediate care. EVIDENCE: Four care plans were examined and each has comprehensive pre-admission assessments, which were undertaken by the Manager or the senior staff in the home. Three residents who were asked had met a member of the care home staff prior to admission and a relative interviewed felt that they had been involved in the process prior to the admission of their family member. The residents also have a care management assessment, which is provided, to the home on admission and from these documents an individual care plan is produced. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 10 Individual care planning is undertaken and the care is being delivered in line with these plans. The residents are having their nursing needs met within the home and their general health needs met by the primary health care team as they would within the community. The staff are aware of the need to maintain residents privacy are doing so as part of their delivery of care. EVIDENCE: Each resident has an individual plan of care, which is based on the admission assessment and is then added to during the placement. Four care plans were examined and they were completed to a good standard. There was evidence that relevant risk assessments are available for the prevention of falls, nutrition, wound care, moving and assisting, continence promotion and mental health status. The plans showed that they are regularly reviewed and updated and that reviews are regularly held with residents and their representatives. The care plans showed that the residents have access to all NHS services and facilities. There was a good range of pressure relieving mattresses in use for the prevention of pressure sores. The home has no residents who have Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 10 pressure sores and there is good evidence that preventative care is delivered to those who would be at risk. The residents were positive about the way the staff provided the care and two who were asked felt that the staff were kind and helpful and treated them with respect. The bedroom doors have locks for which the resident can hold the key should they wish to. The toilet areas on the ground floor which was cubicle type is currently being made into a bathing area and a separate assisted toilet area which will provide a more private area. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 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 standard(s) 15 The food being served is being prepared safely by knowledgeable staff and offers choice to the residents. The home offers the resident a balanced diet and there is sufficient quantity of both food and fluids to meet their needs. Staff are aware of the importance of a balanced diet and the way it is served. EVIDENCE: The kitchen was clean and well organised, the recording of food, fridge, and freezer temperatures were in place and completed appropriately. There was an ample supply of frozen, tinned, dried and fresh food available all of which was appropriately stored. The kitchen staff were aware of residents specialist needs including how to fortify foods for those who have poor appetites or those who have lost weight. The residents are offered a choice of three meals a day and residents on the day were seen eating heartily one asked said that the “food is really nice”. The meal being served was ample portion size, hot and well presented. The inspector tasted the food and found it tasty. Residents were offered assistance in a discreet manner. Residents were offered second helpings and alternatives to the main and dessert course were available. A variety of cold drinks were available throughout the meal and hot, cold drinks and biscuits were available throughout the day. Some residents chose to have a glass of sherry or wine with there meal and a number have their taste of alcohol in the evening. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 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 standard(s) 16, 18 The home ensures that the residents and relatives are made aware of the complaints policy and that it is available in a variety of places. There is a system for managing and dealing with complaints, which makes it possible for them to be investigated and action taken to address any issues identified. The residents are protected by ensuring that the staff are given Protection of Vulnerable Adults training and whistle-blowing as well as reporting concerns to the Manager. EVIDENCE: The complaints procedure is available in the service users guide and a copy is being displayed in the home. There has been one formal complaint made and it was determined that the response was appropriate and included the response to the complainant and the action taken in response to the issues raised. Four of the residents who were interviewed during the visit who were able to express their views were asked about the way in which they would have any problems dealt with, each were able to identify the way this would be done. Three relatives who were visiting the home was aware of the complaints procedure but had not needed to use it. Written guidance is in place regarding the protection of vulnerable adults. Staff confirmed that they knew about the guidance and could identify the action they would take if they were made aware of or had any concerns regarding this issue. Staff are being given training on protection of vulnerable adults. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 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 standard(s) 19, 26 The home is well decorated and is safe for the residents to live in. It is being maintained in a satisfactory way and there is a programme in place to ensure that the redecoration and maintenance is undertaken. The necessary specialist equipment is provided in the home and when required appropriate advisors are brought in to offer advice and assess residents needs e.g. Physiotherapy. EVIDENCE: A tour of the premises was conducted both with staff and alone to assess the general condition of the home. It is tidy and organised in such a way to make sure that the residents are able to use the home safely. It is a converted row of three houses and is well maintained. The home is clean and was odour free on the day. The residents’ bedrooms were personalised reflecting individual choices and preferences and three residents asked about their bedrooms said they were happy with the decoration and that they were kept clean by the staff. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 14 The proprietors are currently undertaking an extensive programme of refurbishment and redecoration to a very high standard. This includes an area of the home which has been taken out of use to improve the bedroom provision and put in a passenger lift as well as giving easy access into the garden area from the first floor areas. The laundry was clean, organised and well equipped. The staff were seen to be following infection control policies throughout the day and there is no evidence that there are any issues around cross infection. It is recommended that the home consider providing liquid soap, disposable hand towels and bins to dispose of them in the residents bedrooms/on suites for staff to be able to wash their hands before leaving the room. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 The home is staffed with appropriate numbers of staff and there are qualified nurses on duty in sufficient numbers to meet the needs of the residents. The staff are recruited and selected using a system which ensures that they are able to care for the residents and have not been identified as posing a risk to their welfare through Criminal Record Bureau and the Protection of Vulnerable Adults List. EVIDENCE: Staffing rotas showed that the Manager/Owner is staffing at levels in excess of the agreement with previous regulatory authority, the NCSC. This ensures that they exceed minimum requirements and that enough staff are on duty to meet the needs of the residents. There are currently six shift periods when there is an additional qualified nurse on duty. The registered manager and the unit manager for the dementia care unit are also in addition to the staffing numbers although they undertake shifts within the rota if necessary. It was noted that when sickness and staff holidays occur these occasions are usually covered by home staff. Two staff records were examined and were complete including two references and a completed application form, the requirement to have a CRB and POVA check in place is applied to all of the staff in the home. The interviews are recorded in the diary and it is recommended that these be made more formal and kept within the staff file. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 16 The home also have two nursing working in the home while undertaking their adaptation training which is supervised practice with academic study which allows overseas qualified nurses to be registered with the Nursing and Midwifery Council. There are also student nurses placed in the home for periods by the training University who get practical experience of care but are supernumery. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35, 38 The Registered Manager, Mrs Thomlinson, ensures that she has systems in place to make sure that the home is managed effectively taking into account the needs and wishes of the residents. She is continuing to consult the residents, staff and other interested parties to review the service provided and manage the staff in a way to improve care delivered. She has recently completed the Registered Managers Award as is awaiting the certificate. The personal allowance money held for residents is managed appropriately. EVIDENCE: There is a policy for supervision, for care staff and the records to support the Managers confirmation that she attempts to ensure safe working practices for moving and handling, first aid, food hygiene and infection control were in place and, although the record needs to be brought up to date. The home has in place arrangements to ensure that persons working at the care home receive suitable training in fire prevention and by means of fire Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 18 drills and training in the procedures to be followed in the case of fire. There is a system in place to review health and safety in the home involving the staff for which records are available. Records were examined of the staff meetings which take place regularly and the contents of these suggest that there a broad spectrum of relevant issues discussed. During the visit there was a staff meeting taking place which was well attended by both on duty staff and some who were off duty, the content and the style were effective. The Manager also facilitates meetings with the relatives and residents as appropriate. The personal records kept in the home of residents who are receiving assistance to manage their finances were examined and are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place, and there is a small float available for the staff to access. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 4 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x 3 x x 3 Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 20 No 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 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. 2. Refer to Standard OP29 OP26 Good Practice Recommendations It is recommended that a formal record of staff interviews are recorded and kept in the staff file. It is recommended that he home provide liquid soap, disposable hand towels and bins to dispose of them in the residents bedrooms/on suites for staff. Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 Tweedmouth House B53-B03 S636 TweedmouthHouse V234460 200705 Stage 4.doc Version 1.30 Page 22 - 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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