Inspection on 10/02/09 for Ty Gwyn Residential Care Home

This inspection was carried out on 10th February 2009.

CSCI found this care home to be providing an Poor service.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ty Gwyn Residential Care Home 09/01/08

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ty Gwyn Residential Care Home 2 Hall Walk Enderby Leicester LE19 4AH     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Chris Wroe     Date: 1 8 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Ty Gwyn Residential Care Home 2 Hall Walk Enderby Leicester LE19 4AH 01162864271 01162866077 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Sun Care Homes Ltd care home 12 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 12 The maximum number of service users who can be accommodated is: 12 The registered provider may provide the following category of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home is within the following category: Learning Disability Code LD Date of last inspection Brief description of the care home Ty Gwyn is a registered home for adults with learning disabilities. The house is a listed building, set back from the road, in its own plot. The home has a large garden which people who live in the home can use. The home is in the village of Enderby. The village offers local amenities including a post office, restaurants, supermarket, and retail outlets. At the time of this inspection the range of fees charged was £290-£634 per week. Extra charges are made for chiropody, hairdresser, optician (when someone chooses private service), college courses, pub lunches, newspapers and magazines. Care Homes for Older People Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited the home on 10th February 2009. We were helped during the inspection by the registered manager, Claire Legate. Our visit to the home lasted seven hours. We asked people to tell us what they think of the home: We sent out surveys to staff, and we received one response. They gave us positive responses to our questions, and told us they felt supported in their work. One healthcare professional who works alongside the home gave us their views about the home. They were very happy about the care being given to people who live in the home. Care Homes for Older People Page 5 of 28 We sent out surveys to people who live in the home. Unfortunately, although the service sent us peoples responses, we did not receive them. We asked for information: The main way we do our inspections is using a method we call case tracking. This means looking at the care given to people in different ways. The ways this was done are: - talking to the people who live in the home - talking to staff and the manager - watching how people are given support - looking at written records. We also looked at the information that the provider (the owner of the home) sent to us. We talked to people about the home: We spoke with two people who live in the home during our visit. People told us that they felt staff were good and helped them. We spoke to two members of staff during our visit to the home, who told us about working in the home and gave us their views. They mainly felt very positive about working in the home. We checked all the standards that the Commission for Social Care Inspection has decided are key standards during this inspection. The information in this report is just about what we checked in this inspection. We have kept details about individual people out of the report, to make sure these things are kept confidential. What the care home does well: What has improved since the last inspection? There is a new manager in the home, who has made changes to make sure that things run better for people who live there. The manager has had training about person centred care and is introducing this more into the home. There are plans to train all staff. There are better arrangements for staffing. There is now a constant staff team and the home does not need to use agency staff. Care Homes for Older People Page 7 of 28 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home benefit from a good admissions process. Evidence: People are given information about the home before they move in. They are able to go and spend some time in the home to see if it will be right for them. One person told us they had gone to the home twice for lunch and once for tea before they decided to move in. Assessments are carried out, to find out what people need to give them a good daily life, and to make sure that the home is right for people. The manager also gets information from family members, social workers and other people who are involved, to make sure that they have all the information they need to provide a good service. Members of staff have had training to help them to meet peoples needs. The training Care Homes for Older People Page 10 of 28 Evidence: matches some of the specific needs that people have - such as, moving and handling to help people to move safely in the home. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home mainly benefit from good attention to health and personal care. Evidence: Staff keep some written records about people who live in the home. The manager and staff have written care plans, which give information about peoples likes and dislikes, and about what care support they need. The manager is planning to do person-centred care plans, which are more focussed on each individual and involve them more - and she has set up training for staff to help them to do this. The manager and care staff keep the care plans up to date as peoples needs change, and people who live in the home are told about their care plans. We saw that some risk assessments have been written. These are records to show how people are able to do things they want to do, whilst being kept safe. We found that some risk assessments had not been done, where there might be some areas of concern, for example where one persons medication might have some dangerous side Care Homes for Older People Page 12 of 28 Evidence: effects that staff need to look out for. Not all staff knew about the risks to look for. When we told the manager about these concerns, she made sure that changes were made quickly. We saw that the manager and care staff in the home are sensitive to the different ways in which residents communicate. We saw that care staff supported people well, and they were able to tell us about peoples different needs and wishes. People who live in the home told us that they are happy with how the staff care for them. One person said that the staff look after us well. People who live in Ty-Gwyn are given good access to healthcare. One healthcare professional who gave us their views about the home said: The service has an excellent person centred approach towards individuals. Rights, choice, independence and social inclusion are followed and implemented where possible. Care standards, I believe, are excellent and needs met to a high standard. Staff have good knowledge about individuals and health/social care. People are supported to see their GP if they need to, and to get healthchecks, like optician visits, and dental treatment. We found that medicines are stored safely and staff mostly keep good records of medication. The manager told us that she checked medication records, so she had seen where there were any mistakes and made sure staff had extra training if they needed it. All staff who give out medicines have had training about how to handle them safely. Care Homes for Older People Page 13 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home benefit from a good lifestyle. Evidence: We learnt from care records about the different activities that each person is involved in. We also spoke to people to find out what they enjoy. Some of the things people enjoy include going out to the pub for lunch every week, going for walks, studying courses at college or doing paid work. One person told us about their outing to the pub: I like a pint of shandy with my meal. There are activities held in the home also for people to get involved in, such as art and craft, board games, cake-making, and dancing, and every afternoon staff try to help people to get involved in doing something. One person told us they borrow books from Age Concern to read. People who live in the home told us they have choices about what they do each day. While we were at the home, one person had a vistor, who was made welcome. Other people were out at day centres. One person told us they helped out with the laundry sometimes or drying dishes. People are supported to go to church if they would like to, and members of the local church invite residents to any events. Care Homes for Older People Page 14 of 28 Evidence: We saw that the manager and staff try to enable each person to live in the home to live with dignity and choice. Staff respond well to the ways in which each person communicates their wishes and needs. People are supported to join in with activities in ways they are able to. One of the lounges has sensory equipment in it, which gives something for people who are not so able to move around or get involved in activities. We saw meal records, which showed that residents have varied nutritional meals. The care staff do the cooking in the home. They have had training in food hygiene, to make sure they work safely. People told us they enjoy the meals in the home - one person said their favourite was cauliflower cheese. Staff help to feed some people, and we saw that this was done calmly and patiently. Other people have aids to help them to eat independently. Most people eat at tables in the dining room, and we saw that some people chat with each other while they eat. We did see that meals are plated up and brought out to people, and it might be good for staff to think about ways to give people more choice and control - one way of doing this might be to bring dishes out so people can be supported to help themselves. Care Homes for Older People Page 15 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in this home are not sufficiently protected from the risk of harm. Evidence: People who live in the home told us that they feel able to talk to the manager or to staff if they have any concerns. One person said: If Ive got any worries or problems I talk to Claire - she listens well. The home has not received any formal complaints since we last inspected. People who live in the home tell us they feel safe and well cared for. We have not had any reports about any serious incidents affecting the welfare of people who live in the home since our last inspection. While looking through records, we saw that in at least one instance, someone was taken into hospital on an emergency basis, which we should have been told about. We made sure the manager understands what needs to be reported to us. Care staff have had training to help them to understand how to safeguard people who live in the home and protect them from harm. One member of staff was able to tell us about action they would take if they ever had any worries about the safety of people living in the home. The manager told us that when staff go out with residents, the cost of their Care Homes for Older People Page 16 of 28 Evidence: refreshments is shared by people who live in the home. This is not made clear in any of the written information given to people, like the service user guide. So that people know the arrangements and can have a choice, this information needs to be made clear and explained to people. We had some concerns about how the manager checked staff before they were employed, to make sure they were safe to work with people. This is detailed in the section about Staffing. Care Homes for Older People Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home mainly benefit from a good environment, but some attention to safety is needed. Evidence: There have been some improvements made to the home since we last inspected. One person told us their room had been re-decorated, and they liked it. People have their own things in their bedrooms. People who live in the home can use two lounges, one of which is a dining room also. There is sensory equipment in one lounge, and pictures and photos of things that people who live in the home have been doing. There is a large garden at the back of the home, which people can use - and there is a room outside, which is used for day activities when the weather is warm. When we looked around we found that the home was clean and tidy, and people told us it was always that way. There is a small laundry, with a washing machine which is fit for purpose. Bathroom and toilet areas were clean and fresh. While we visited the home, the boiler was being serviced, and fire safety equipment was checked by the supplier. We saw records of ongoing safety checks in the home. Care Homes for Older People Page 18 of 28 Evidence: There are some improvements that still could be made in the home. The manager knows about these and is working through things. A new maintenance worker has started at the home, and is working through jobs. Some bedrooms are still waiting to be re-decorated, and some furniture needs repairing or replacing. We saw that some handles have fallen off chests of drawers - these should be replaced to make sure people have good useful furniture. We saw two areas of risk that need to be looked at. One window in a first floor bedroom opens wide, which could create a potential risk to safety of people who live in the home. We also saw a radiator in one bedroom which did not have a safety cover this could again create a risk to someone. These areas must be looked at - the manager told us she would do this without delay. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home may be put at risk due to lack of thorough recruitment processes. Evidence: Staff in the home have training to help them to do their job well. Training topics include how to give medication safely, moving and handling, and National Vocational Qualifications (NVQs) in care. One person who lives in the home told us that they feel staff look after them well. A member of staff commented to us that the home provides all the care that our service users require to make their lives with us... happy and secure. Staff told us they felt they worked well as a team, and we saw this happening when we visited the home. Staff work shifts, from 8am to 3pm, from 3pm to 10pm and from 10pm to 8am. At night there is one waking member of staff on duty, and the manager or deputy manager are on call. The manager and staff described to us staffing levels meet the needs of people who live in the home, and we found nothing to tell us that this was not so. We had some concerns about the way in which some newer members of staff had Care Homes for Older People Page 20 of 28 Evidence: been employed in the home. Some staff have been employed and begun working in the home before all checks about their safety and suitability had been confirmed. The manager and provider had not received full confirmation from the Criminal Records Bureau before three members of staff began work, and references were not complete in all cases. This is a very important issue, which could put people who live in the home at risk. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home benefit from generally good management. Evidence: The manager is continuing to develop her own skills. She has completed her National Vocational Qualification Level 4 in care and is working towards the Registered Managers Award. Staff and people who live in the home told us the manager is supportive. One person who lives in the home said about her: Claire is lovely. We found that the manager is focussed on making improvements in the home and in the care given to people who live there. The only concern about how the home is managed is about safety checks on new staff (as detailed in last section) and this must be improved. There are different ways that the manager and provider (owner of the home) find out whether the home is giving a good service. People who live in the home told us they get involved in residents meetings. Staff said they are able to contribute their ideas in Care Homes for Older People Page 22 of 28 Evidence: staff meetings. Questionnaires are given to people who live in the home, and to others who are involved with the home, and ideas for making things better are taken up. The owner of the home deals with payment of fees. The manager supports people to look after their money, and will hold small amounts for safekeeping - although people who live in the home can look after their own money if they choose to. There are policies in the home which tell staff about safe ways of working - such as how to keep people safe from the spread of infection. Staff have training to help them to work safely. There are regular checks made of equipment in the home to make sure that it remains safe to use. Care Homes for Older People Page 23 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 29 19 The provider must ensure that no employee begins work in the home until the required checks have been made and satisfactory clearance received from the Criminal Records Bureau. This is to ensure that all staff who are employed in the home are safe to work with vulnerable people. 13/03/2009 2 29 19 The provider must ensure 13/03/2009 that no employee begins work until two satisfactory written references have been received about the person. This is to ensure that all staff who are employed in the home are safe to work with vulnerable people. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 Risk assessments must be 31/03/2009 put in place where there are risks to peoples safety, to ensure that all staff are aware of the risks and that proper steps are taken to minimise risks to people who live in the home. Page 25 of 28 Care Homes for Older People This is to ensure everyone in the home is able to live as they choose and kept safe. 2 18 13 The arrangements for how 31/03/2009 staffs refreshments are paid for on outings must be clearly explained to people who live in the home. This is to ensure that people can give their informed consent to the arrangement. All serious incidents affecting the welfare of residents must be reported to us. This is to provide an extra protection to ensure that peoples welfare is safeguarded. 31/03/2009 3 18 13 4 19 13 Risk assessments must be 20/03/2009 carried out to ensure that people are safe from any potential hazards in the home environment (such as window openings and hot radiators) and action taken to protect people from harm. This is to ensure that people are kept safe from potential dangers. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 15 It is recommended that staff give consideration to how to Page 26 of 28 Care Homes for Older People enable residents to have greater choice and control over meals, where possible, for example by enabling them to take their food from dishes rather than have meals plated up. 2 24 It is recommended that items of furniture which are broken or faulty, such as drawers with missing handles, are repaired, so that people are given dignity in their living environment. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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