Inspection on 05/10/07 for Tylecote

This inspection was carried out on 5th October 2007.

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 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tylecote 28/10/08

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Tylecote 10 Furness Road Morecambe Lancashire LA3 1EZ Lead Inspector Mrs Jennifer Dunkeld Unannounced Inspection 5 October 2007 2:50pm th Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 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 Tylecote DS0000069590.V345637.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 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. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tylecote Address 10 Furness Road Morecambe Lancashire LA3 1EZ 0152428309 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) Sylvia Peters Miss Nichola Donaldson Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home only - code PC, to people of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD, The maximum number of people who can be accommodated is: 9 Date of last inspection New Registration Brief Description of the Service: Tylecote is situated on Furness Road in Heysham. The home is a Victorian semi detached house and is registered to provide residential care for a maximum of nine adults of both sexes with a learning disability. Accommodation is provided in five single bedrooms and two double/twin bedrooms. The double room is currently being occupied by a couple and the twin room by two residents who have shared the room for many years. Communal areas include a lounge/diner and an additional lounge. A small garden area is provided at the front of the home and a patio area is available at the back for the residents to relax in and have occasional bar-beques. The home is relatively close to all the amenities of Morecambe promenade. The current fees for the home range from £373 to £786.50 based upon the care support needs of the individual. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The first day of this site visit was unannounced, in that the residents, staff manager and service provider were not aware that it was to take place on Friday 5/10/07. The site visit is part of the key inspection of the home. A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. The second day of this visit was announced in order that the manager could be available. The visit was over 2 days lasting for a total of 5.25 hrs. Before the visit took place, the manager was asked to complete an AQAA (Annual Quality Assurance Assessment) this document is required to be completed annually and reflects how the services are provided. A response to surveys was requested from residents, relatives, staff and visiting professionals. The comments contained in the completed surveys included: ‘The management and staff understand my sons needs’ During the site visit 3 of the residents plan of care were viewed as part of the ‘Case tracking process’ this is a method whereby the inspector focuses on a small group of residents. All records relating to these individuals are examined along with the rooms they occupy in the home. Residents are invited to discuss their experiences of the home with the inspector: this is not to the exclusion of other residents who contributed in many ways. The care plan is a document outlining the needs of the individual resident and how these are to be met. Staff records were looked at to see that the necessary checks are made before people commence employment; ensuring only suitable people are employed in the care home. The manager, residents and care staff were spoken with, to gain information about the service people receive. A tour of the home was made, viewing the lounge and lounge/dining room, kitchen, bedrooms and bathrooms. Everyone was friendly and cooperative throughout the visits. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 6 Staff were observed to be caring for people in a polite and professional manner. What the service does well: In the relatively short time that the current provider and manager have been offering support at Tylecote they have made a number of significant improvements to the home, for instance a new 3 piece suite for the residents, replaced the previous TV’s with modern large flat screen TV’s. Provided a DVD player which the residents enjoy and had been watching a film just prior to my arrival at the home. The cooker has also been replaced. The residents are being encouraged and motivated to expand their activities to give them a more fulfilling lifestyle appropriate to their age and abilities. The service provider and manager recognise the importance of having staff appropriately trained for caring for the people who live at Tylecote. Over 50 of the staff have achieved a National Vocational Qualification in care at level 2 or above. There are 3 other staff currently undertaking training for a National Vocational Qualification. Many other training courses are accessed and a record of all training is maintained. Staff complete questionnaires at the end of all training to reflect their understanding of the course content. There is a relaxed, pleasant atmosphere at Tylecote where the residents feel able to be themselves and are accepted for their individual uniqueness. The residents are consulted on all aspects of their care including the meals they are served. Each week they sit together and plan the menu for the week ahead. The manager has developed an in depth Statement of Purpose which provides clear information on the home and the service that they offer. Management is implementing Person Centred Plans (PCP) with residents and their family members, to enable each individual to have a PCP which demonstrates their goals and asperations. Historically the people who live at Tylecote have led a fairly inactive life unless they were able to go out unescorted. The new manager and staff are enthusiatic about enabling people to have a fulfilling lifestyle. The service provider and manager are aware of improvements that are needed around the home and they have enlisted the help of the University of Central Lancashire, architect department. They have got involved and are spending time with service users both individually and as groups and working with Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 7 management to see what individuals would like, need and benefit from. This is an on-going project within the house, that residents, staff and family members can participate in. The management has introduced a key worker system to ensure individual needs are met. The residents spoke enthusiastically about their key worker. The management have developed a complaints procedure with the use of pictures which enhances the readers comprehension. What has improved since the last inspection? What they could do better: The provider and manager are working together to ensure the services provided at Tylecote continue to develop and improve for the benefit of the people who live there. A Service User Guide needs to be developed and be available in formats that enable the residents to comprehend it’s content. The manager has not always been able to devote all her time to Tylecote due to supporting the new manager in another care home belonging to the same provider. The staff stated that the manager is ‘often called away.’ The manager gave assurance that this has eased and she is now able to focus on managing Tylecote. The homes Statement of Purpose needs updating as this reflects the manager works 37.5 hrs in the home. However the manager said she works 35 hrs managing Tylecote but one of these days is home based working. 5 of the 6 staff surveys received by the Commission for Social Care Inspection reflect there is a need for more staff to enable them to have time with the residents. They feel that much of their time is spent carrying out domestic tasks, which takes them away from meeting the needs of the people who live there. In addition to the above the majority of surveys received from the residents reflect that they would like ‘More activities’ ‘More trips out’ and ‘I would like to Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 8 go out more’. The level of staffing has an impact on the time that is available for activities. As stated earlier in this report the some of the people who live at Tylecote have historically led an inactive life and as such have become institutionalised. The manager and staff are endeavouring to broaden their opportunities for a more fulfilling lifestyle. This of necessity takes time to motivate and encourage participation in activities appropriate for their age and interests. This is apparently beginning to have a positive affect upon the residents as they are saying they want more outings and activities. For some people there maybe a need for a reassessment to ensure the funding provided meets their new needs. The staff records should be securely maintained in the home available for inspection at all times. The home has a homely appearance, however the bottles of bubble bath currently on the bathroom windowsill may need to be securely stored. Risk assessments for each individual need to be carried out. Some people may wish to have their bubble bath in their own room. Others may be at risk if bubble bath is not securely stored. The staff recruitment process is good but the application form needs to ask for full employment history including dates so that the reasons for any gaps in employment can be explored. The manager has developed a good system for the management of residents finances where they are unable to manage their own. However this would benefit from having 2 signatures for all transactions. As previously stated the homes complaints procedure has been developed using pictures to aid the readers comprehension. This needs to be given to the residents and/or their family. Offering each resident a postcard stamped and pre addressed to the individuals social worker or to the Commission for Social Care Inspection stating their name and address and that they would like to discuss a concern, would be another way of enabling people to have their concerns listened to. 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. The summary of this inspection report can be made available in other formats on request. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 9 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 Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1 and 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. No one is admitted to Tylecote without being assured that his or her needs will be met. EVIDENCE: There is a detailed Statement of Purpose about the home and a Service Users Guide is to be developed in a format, which will enable residents and future residents to be aware of the services on offer at Tylecote. This should include the homes complaints procedure. A detailed assessment is carried prior to anyone being admitted to the home. Prospective residents would be invited to meet the other residents and have a meal, followed by an overnight stay. This was evident from the daily notes about one person who had been for an initial visit. From the initial assessment a plan of care or a Person Centred Plan would be developed ensuring the persons diverse needs and aspirations can be met. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 11 The residents stated they were happy at Tylecote and apart from wanting to go out more often, they felt their needs were well met. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents make decisions about their lives and the choices they make are respected EVIDENCE: The manager gave the following information: ‘Needs are documented throughout the care process and we ensure that we receive input from specialist services such as: speech and language, occupational therapy, psychology and behaviour intervention team etc. Following this input, we implement and monitor any strategies, programmes or support guidelines and ensure that we complete the necessary documentation. We have regular reviews to ensure that we meet peoples needs and promote Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 13 their choices throughout their care service. All staff members are committed to promoting choice in service delivery and to ensuring that they meet peoples individual needs.’ The care plans viewed as part of the ‘tracking process’ gave clear information as to the individuals’ diverse needs and how these are to be met. Risk assessments were seen on the files of the individuals. However some of these need to be more explicit as to what the support required is. For example one risk assessment form states the person ‘Needs support moving from room to room’. The precise support required needs to be defined in the appropriate section of the form. For instanced, does the person need a wheelchair, or linking arms with carer etc. This information was available on the initial assessment form, but needs transferring to the Risk Assessment form. One resident explained how she likes to go to church on Sundays and she is enabled to do this. The following comments were included on the completed surveys from the residents: ‘I am happy’ ‘I always make decisions about what I do each day’ ‘The staff listen to me’ Completed surveys from the staff included the following comments: ‘We ensure that each resident is treated with respect and as an individual’ Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents would further benefit from following a range of activities of their choosing with support as necessary EVIDENCE: Some people are able to access community facilities unescorted and as such have a fairly fulfilling lifestyle of their choosing. Some of the people who live at Tylecote have become institutionalised through historic practices. They have a fairly sedentary lifestyle irrespective of age. They need motivating, encouraging and supporting to follow new interests and activities. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 15 This isn’t going to happen overnight and people will need lots of encouragement from the staff. They will need opportunities to experience new activities in order to make an informed choice. There maybe a need for some people to have a reassessment to ensure their funding meets their new needs. One resident will need lots of support and encouragement as she has become used to just sitting and not going anywhere. Another resident spoke of a pottery class she would like to go to when a place is available. The surveys received from some of the residents included the following comments: ‘I would like to go out more in the week and at weekends’ ‘I need more activities’ ‘More trips out would be good’ ‘I like going to college’ 5 of the 6 staff surveys received made comments in relation to staffing levels. These included: ‘We could do with more staff’ ‘More staff especially in the mornings would be ideal’ ‘We need more time to spend with the residents’ ‘We need more staff so the residents can go out more’ ‘We have a lot of domestic work to do which means don’t have time with the residents’ The above was discussed with the manager who has said that they are looking to employ a cleaner for a few hours each day, which will free up care staff enabling them to do more with the residents. The people who live at Tylecote have their rights to have meaningful relationships upheld, indeed one couple share a bed-sit within the home. The Daily notes for each individual reflect their current activities, for instance some people go to college. The notes also reflected ‘out for a walk’ and ‘Out for a meal’ Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 16 The residents are consulted on all aspects of their care including the meals they are served. Each week they sit together and plan the menu for the week ahead. Some of the residents also help in shopping for some of the produce needed for their meals. The menus reflected a healthy balanced diet. Whilst it is a set menu, the residents confirmed that if it is something an individual doesn’t want that day an alternative meal is given. People are fully consulted about their dietary likes and dislikes. Where a resident cannot communicate for themselves their family are consulted. One care plan viewed as part of the tracking process states ‘has a good appetite and also likes to have an occasional glass of wine when relaxing in the evening. Indeed on the first day of this visit a fellow resident came home from the shops and said to the resident ‘I’ve got you and me this for tonight is it alright’ it was a bottle of wine. This reflects the freedom the residents have to choose what they want to have. This group of residents have been together for a number of years and function as a family. For instance if one resident is not eating his meal, his fellow residents encourage him and he responds to them sometimes when he has declined for the staff. The manager is aware of people’s rights to choose the food they eat but is conscious that some people need their weight to be monitored, in all to be healthy. A less sedentary lifestyle will be of benefit to people who are overweight. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are met at Tylecote EVIDENCE: The manager provided the following information: ‘We are supported in providing individual health care needs by a range of health care professionals such as: Speech and language, diabetic nurses, continence advisors, community psychiatrist, psychologist, dietician etc. Each service user is registered with an individual GP. We ensure that each service user is supported in promoting and maintaining their health by supporting individuals to manage appointments and maintain medical records. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 18 Service Users have been encouraged to choose their own key worker member of staff.’ The care plans reflect the diverse and individual health care needs, including the following: Continence advice; Behaviour Intervention Team Psychology and psychiatric input The residents spoke of how they are helped to go to the see their doctor when necessary. The staff have accessed training in the following areas: Medication Awareness Health care training such as Epilepsy. The manager has developed policy and procedures in all aspects of medical and health care. Service users are supported to administer and manage their own medication following a risk assessment. Medication is currently stored in a wooden cupboard ion the kitchen. The manager is aware that this is not ideal and has obtained a metal cabinet that is to be secured to the wall in a suitable location. There is an audit trail of all medication received and administered. Staff are aware of the need to sign the MAR (Medication Administration Record) sheet, at the time of administration. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are included in decisions about their lives in the home and know their views are listened to. The residents are safeguarded EVIDENCE: There is a complaints procedure in place, which is written with the aid of pictures to enable the residents to understand it’s content. There is a complaints book to record any complaints, which may come to the manager’s attention. The book is entitled ‘Comments, Concerns and Complaints’. The only comment to date in this book states: ‘Services being provided to my relative are more professional than before. Relative is more settled and happy. Did not want to spend time with Mum during the summer holidays.’ This reflects her contentment at Tylecote. No complaints have been received by the home or the Commission for Social Care Inspection since the registration with the new provider. The staff receive training in relation to ‘Safeguarding Vulnerable People’. The staff spoken with were aware of the action to take should they suspect abuse has occurred. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 20 In a completed survey one relative stated: ‘My son is extremely vulnerable and this is recognised by the management and staff’ The management have developed a good system for the protection of resident’s finances; the record having 2 signatures for all transactions would further enhance this. The complaints procedure needs to be given to each of the residents and/or their family, to ensure they know how to make a complaint. The surveys received from 3 of the residents reflected they did not know how to make a complaint. During the visit to the home the residents stated they did not have any complaints but if they did they would tell the staff or the Nichola (manager). Offering each resident a postcard stamped and pre addressed to the individuals social worker or to the Commission for Social Care Inspection stating their name and address and that they would like to discuss a concern, would be another way of enabling people to have their concerns listened to. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The residents live in a generally safe and hygienic home, which gives them contentment within their environment. EVIDENCE: The manager gave the following information: ‘Record of maintenance is kept. There is a cleaning schedule. Three year Maintenance and decorating programme is being compiled with the assistance of Central Lancashire Universitys architect’s department involving Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 22 all service users and reflects personal choice in service users bedrooms and communal areas. Some work is already underway. Some new furniture has been purchased. All electrical, gas equipment regular maintained.’ A look around the home revealed the home was clean. The resident’s bedrooms were much their room and reflected their individual interests and personalities. A new three-piece suite enhanced the appearance of the main lounge. As did the large flat screened TV. A new TV has also been purchased for the lounge/dining room. A number of residents had been watching a DVD just prior to the visit and stated that they like the new DVD player. Tylecote has a homely appearance, however the bottles of bubble bath currently on the bathroom windowsill may need to be securely stored. Risk assessments for each individual need to be carried out. Some people may wish to have their bubble bath in their own room. Others may be at risk if bubble bath is not securely stored. The toilet seat in the bathroom on the 1st floor has become porous and as such needs to be replaced, for hygiene reasons. The fire procedure for the home has been developed with the use of pictures to enhance the residents understanding of it. This coupled with regular fire drills ensures the residents know what to do should a fire break out. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31 and 36. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home operates a good recruitment policy, which ensures that only people who are suitable for this type of work are appointed. EVIDENCE: The manager provided the following information: ‘The home operates a good recruitment policy, which ensures that only people who are suitable for this type of work are appointed.’ 3 staff files were viewed, these reflected that appropriate checks have been taken including Criminal Record Bureau clearances to ensure the right type of people are employed to meet the needs of the people living at Tylecote. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 24 The manager was advised of the need to ensure there is a full employment history on the staff application form including dates of employment, enabling the exploration of the reasons for any gaps in employment. Some of the residents are involved in the interviews for new staff, this is good practice and one that reflects the rights of people with a learning disability. The residents concerned were proud of their involvement in staff selection. Staff supervision takes place on a regular basis and evidence of this was seen on the staff files viewed during the inspection. The service provider and manager recognise the importance of having staff appropriately trained to care for the people who live at Tylecote. Over 50 of the staff have achieved a National Vocational Qualification in care at level 2 or above. There are 3 other staff currently undertaking training for a National Vocational Qualification. Many other training courses are accessed and a record of all training is maintained. Staff complete questionnaires at the end of all training to reflect their understanding of the course content. The training records viewed reflected the following courses had been attended: Induction People Handling and Risk Assessment Drugs and Their Side Effects Fire Awareness Epilepsy Awareness Food Hygiene and Infection Control Adult Protection. The residents made the following comments about the staff: ‘We have some good staff’ ‘I like all the staff’ ‘Where’s Paula like Paula’ ‘I like my key worker, she is good to me’ and ‘The staff are all very good’ The home employs male and female care staff in recognition of equality. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents would further benefit from management ensuring there are adequate staffing numbers to fully meet their needs. EVIDENCE: The manager provided the following information: ‘The Manager has NVQ Care level 4 and Registered Managers Award. The Manager has also obtained a certificate in Management of Health Social care through The Open University. All service users have risk assessments and guidelines which are reviewed on Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 26 a 6 month basis, or as and when required should the need arise earlier. The home has a comprehensive statement of purpose which is avaliable on request which details the conduct and management of the home.’ The manager has not always been able to devote all her time to Tylecote due to supporting the new manager in another care home belonging to the same provider. The staff stated that the manager is ‘often called away.’ The manager gave assurance that this has eased and she is now able to focus on managing Tylecote. The staff gave an example of a situation they felt might have been resolved sooner had the manager been available in the home for longer periods of time on a regular basis. The homes Statement of Purpose needs updating as this reflects the manager works 37.5 hrs in the home. However the manager said she works 35 hrs managing Tylecote but one of these days is home based working. 5 of the 6 staff surveys received by the Commission for Social Care Inspection reflect there is a need for more staff to enable them to have time with the residents. They feel that much of their time is spent carrying out domestic tasks, which takes them away from meeting the needs of the people who live there. In addition to the above the majority of surveys received from the residents reflect that they would like ‘More activities’ ‘More trips out’ and ‘I would like to go out more’. The level of staffing has an impact on the time that is available for activities. As stated earlier in this report the some of the people who live at Tylecote have historically led an inactive life and as such have become institutionalised. The manager and staff are endeavouring to broaden their opportunities for a more fulfilling lifestyle. This of necessity takes time to motivate and encourage participation in activities appropriate for their age and interests. This is apparently beginning to have a positive affect upon the residents as they are saying they want more outings and activities. For some people there maybe a need for a reassessment to ensure the funding provided meets their new needs. The manager has taken on board the comments made in relation to the staffing levels and has consulted the service provider about recruiting a cleaner to work in the mornings freeing up the care staff to be able to spend time with the residents. The staff records should be securely maintained in the home available for inspection at all times. These are currently stored in an office in another home. As stated in the ‘Environment section of this report: Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 27 ‘Tylecote has a homely appearance, however the bottles of bubble bath currently on the bathroom windowsill may need to be securely stored. Risk assessments for each individual need to be carried out. Some people may wish to have their bubble bath in their own room. While others may inadvertently swallow the contents of the bottles and as such need them to be securely stored.’ In the relatively short time this home has been under new management many improvements have been made as outlined throughout this report. Given a longer span of time to implement the changes they wish to make, this service will develop to be able to fully meet the needs of the people who live there. The management and staff are enthusiastic and determined to offer an excellent service. The manager has recently got married and needs to formally inform the Commission for Social Care Inspection of her change of name. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 28 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 Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 X 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 X 3 X X 2 X Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 29 N/A 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. 2. Standard YA9 YA12 Regulation 13(4)© 16(2)(n) Requirement The manager must ensure risk assessments are explicit. The manager must ensure the residents are enabled the residents to have a programme of activities The manager must ensure the residents are enabled to take part in local, social and community activities The manager must produce a Service users Guide in a format that enhances the understanding by the residents. The manager must ensure the Service Users Guide contains the homes complaints procedure. A copy must be given to each resident and/or their relatives. The manager must ensure the damaged toilet seat is replaced as it has become porous. The manager must ensure risk assessments are carried out in relation to bubble bath bottles being left accessible to people who may inadvertently swallow the contents. The manager must ensure the DS0000069590.V345637.R01.S.doc Timescale for action 30/11/07 30/11/07 3. YA13 16(2)(m) 30/11/07 4. YA1 5(1) 31/12/07 5. YA1 5(1) 31/12/07 6. 7. YA30 YA24 YA42 13(3) 12(1)(a) 30/11/07 18/10/07 8. Tylecote YA37 10(1) 30/11/07 Page 30 Version 5.2 9. YA37 18(1)(a) 10. YA42 17(3)(b) 11. YA37 9(2)© homes Statement of Purpose accurately reflects the management hours of the home. ensuring the home is effectively managed. The manager must ensure 30/11/07 there are sufficient staff employed to meet the needs of the residents The manager must ensure the 30/11/07 staff records are available for inspection in the home at all times. The registered manager must 31/10/07 formally inform the Commission for Social Care Inspection of her marriage and subsequent change of Surname 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 YA23 YA34 Good Practice Recommendations The manager should ensure there are 2 signatures for all financial transactions for money that is managed by the home on behalf of residents. The manager should ensure the homes staff application form includes a full employment history, including dates. Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Tylecote DS0000069590.V345637.R01.S.doc Version 5.2 Page 32 - 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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