Inspection on 08/12/05 for Twynhams

This inspection was carried out on 8th December 2005.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Twynhams 21/05/08

Twynhams 16/05/07

Twynhams 19/01/07

Twynhams 04/07/05

Twynhams 12/01/05

Twynhams 06/07/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Twynhams Old Christchurch Road New Milton Hampshire BH25 6QB Lead Inspector Mr Roy Bega Unannounced Inspection 8th December 2005 09:30a Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 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 Twynhams DS0000055837.V269849.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 Adults 18-65. 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. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Twynhams Address Old Christchurch Road New Milton Hampshire BH25 6QB 01425 618950 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) Truecare Group Limited Mr John Rickman Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category of LD must be at least 18 years of age. Date of last inspection 4th July 2005 Brief Description of the Service: Twynham is part of the Truecare Group centrally managed by C.H.O. I.C.E. Ltd. The home provides personal care and accommodation for up to 7 male residents who have a learning disability. The home is located close to local amenities in the New Forest town of New Milton. The house is a two storey detached property with car parking for several vehicles and a garden to the rear. Residents are provided with single bedroom accommodation with en-suite facilities. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report summarises the assessment of the extent to which the National Minimum Standards for Care Homes for adults 18-65 were being met at the time of the inspection Standards not inspected on this occasion will be assessed during future visits. This visit took place on 8 December 2005 between the hours of 9-30 a.m. and 12-30 p.m., a total of three hours. Opportunity was taken to look around the home view records, observe the working environment and speak with residents and staff. Subsequent to the previous inspection the registered manager has resigned. An acting manager has been put in place until the appointment of a replacement. One requirement has been raised resulting from this inspection. What the service does well: What has improved since the last inspection? It was noted that the home was presented with an “Investors in People Award” in October 2005. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 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. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the standards in this section were assessed on this occasion. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the standards in this section were assessed on this occasion. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the standards in this section were assessed on this occasion. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the standards in this section were assessed on this occasion. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23. The home has put residents at risk by not following procedures for adult protection. EVIDENCE: Subsequent to the previous inspection a Protection of Vulnerable Adult conference (POVA) has been held. At the time of this inspection the outcome had not been concluded. The organisation’s Adult Protection procedures were not followed in reporting the incident that placed the resident at possible further risk. Senior management took action in suspending several members of staff without prejudice prior to the POVA conference until completion of investigations. Discussions with staff indicated that whilst the incident has caused some disruption, the interim measures put in place with regards to management of the home have been supportive and acceptable to them and residents. See also section “Conduct and management of the Home,” standards 37 – 43. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 25, 26. 27, 28 and 30. The premises are suitable for its stated purpose. It is accessible, clean, safe and well maintained. Residents are encouraged to personalise their bedrooms EVIDENCE: Residents are accommodated in single bedrooms. On this occasion a sample of 2 residents rooms were inspected. Bedrooms have required floor space, suitable furniture and fittings to meet individual needs and lifestyles. Residents readily showed the inspector their rooms and informed him about the ability to bring in personal “bits and pieces” to make it personal. Evidence was seen in the presence of photographs, posters, ornaments, televisions etc. Residents’ toilets and bathrooms provide sufficient privacy and meet individual needs. Five rooms have en-suite toilet and shower facilities and two bedrooms share a bathroom. Communal space is as at the time of registration. The inspector was informed that residents have requested the possibility of an all season conservatory to the rear of the home that is being seriously considered by senior management. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 14 The home was clean, hygienic and free from offensive odours. Laundry facilities are of a domestic type and meet requirements. Systems are in place to control the spread of infection. Evidence was seen to indicate that all staff have received infection control training. Discussions, records and observations indicated that residents are supported to assist with domestic duties in developing their life skills. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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, and 36. Residents benefit from clarity of staff roles and responsibilities. Residents are supported by an effective staff team whom are well supported and supervised. EVIDENCE: The inspector had the opportunity to speak with and observe staff on duty. They portrayed knowledge of specific residents disabilities with an appreciation of and ability to balance particular and complex needs of individuals and the group. Observations and discussions indicated that staff on duty had a clear understanding of their roles, limitations and responsibilities. Discussions with residents indicated that they have good relationships with current staff in the home stating that they listen, helpful and supporting. Observations, discussions and available records indicated the home has an effective staff team with complementary skills and sufficient numbers to support current residents. At the time of the inspection three care staff were in duty. Two others were out on an activity with 3 residents. The rosta seen indicated this is the norm during waking hours seven days a week. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 16 Discussions and available records indicated that that staff receive one to one recorded supervision meetings every month with their line manager. The inspector was informed that areas covered include, support and professional guidance, identification of training needs and monitoring work with individual residents. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42. Residents, benefit from a well run home. Residents’ benefit from competent and accountable management of the service. Residents benefit from a selfmonitoring review and quality assurance system. EVIDENCE: Subsequent to the previous inspection the registered manager has resigned. An acting manager has been put in place until the appointment of a replacement. However, Truecare senior management have suspended the acting manager and other staff within the organisation without prejudice due to concerns with regards to an adult protection incident. ( See also standard 23 in the section “Concerns and Complaints” of this report) As an interim measure, two deputy managers from other units within the organisation have been seconded to Twynhams to provide leadership and support. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 18 Discussions with staff indicated that this has been helpful in providing stability and a continuum of care for residents. On the day of this visit residents were participating in routine weekly activities. The inspector was also informed that senior management are maintaining regular contact with the home. Residents spoken with portrayed a knowledge and understanding of what has happened but the impression given to the inspector was that it has not affected them directly. Through observations and discussions the inspector was satisfied that management and staff are fully committed to ensure residents needs and wishes are continued to be met. It was noted that the home was presented with an “Investors in People Award” in October 2005. Internal and external audit and quality assurance systems are in place. Discussions and information indicated that residents have weekly one to one meetings with their key worker to discuss any comcerns with regards to the daily running of the unit. Residents informed the inspector that they are listened to and feel suppoprted. Regular monthly resident and staff/resident meetings are held. Minutes of these meetings were seen by the inspector. Residents spoken with assured the inspector that they attend these metings and have a say. As part of the review system, relatives and placing authorities views are also sought to ascertain whether the home is achieving its aims and objectives. The home’s health and safety file was available. Staff are provided with a copy and advised of it’s content as part of the induction process. No unsafe practices were observed during the inspection. Certificates were available for required checks of systems and equipment. Risk assessments where necessary have been completed. Evidence was seen that staff have received training in first aid, food hygiene, fire safety and moving and handling. Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X 3 3 3 3 X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Twynhams Score X X X X Standard No 37 38 39 40 41 42 43 Score 2 2 3 X X 3 X DS0000055837.V269849.R01.S.doc Version 5.0 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 YA23 Regulation 12(6) Requirement Staff are required to receive “refresher” training regarding their role in incidents of adult protection by the stipulated timescale. Timescale for action 20/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Twynhams DS0000055837.V269849.R01.S.doc Version 5.0 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. 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!