Inspection on 07/10/08 for Tynecroft

This inspection was carried out on 7th October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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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 adults (18-65 years) Name: Address: Tynecroft 156 High Street Old Fletton Peterborough PE2 8DP The quality rating for this care home is: two star good 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: Shirley Christopher Date: 0 7 1 0 2 0 0 8 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 29 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Tynecroft 156 High Street Old Fletton Peterborough PE2 8DP 01733348394 01733890042 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hereward Care Services Limited Name of registered manager (if applicable) Ms Diane Rollins Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 16 0 care home 16 learning disability Additional conditions: The registered person may provide the following categories 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 are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is 16 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 29 A bit about the care home Tynecroft is a registered care home for sixteen adults (16) adults between the age of 18 and 65 years who have a learning disabilities.The home has a condition attached to their registration that permits the home to provide care for one named individual over the age of 65. The home operates from three domestic properties, numbers 154,156 & 158 that have been adapted for their current use. Four service users who are less dependent occupy the seperate house, number 154. There are twelve bedrooms in the main building and four bedrooms in the semi-independent part of the home known as 154. The managers office is located on the ground floor (of number 156) and there is also a small office on the upper floor. Each property has an enclosed rear area which has been concreted over. There is a shared garden with easy access through a gate way between the buildings. The home is located in a residential area with a variety of shops and a post office. There is good public transport from the high street that is frequently used by some service users. All service users have access to the homes vechile. The fees for the service were 680.00 a week at the time of the last inspection. Care Homes for Adults (18-65 years) Page 5 of 29 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 29 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this home is 2 stars. This means the people who use this home experience good quality outcomes. CSCI undertook an unannounced inspection on 7th October 2008. We inspected a number of records including care plans, training records and staff files. We met a number of residents to gain their view regarding the care and support that is provided. Three members of the care staff were also spoken with. The Annual Quality Assurance Assessment (AQAA) was completed by the home. This a self assessment process that focuses on how outcomes are being met for people who use the service. Comment cards were also received from residents, relatives and staff. What the care home does well Tynecroft provides residents with a homely and comfortable service. Care and support is well coordinated and changing needs of residents are monitored and recorded. Choice and independence is clearly promoted and residents have access to a wide range activities, day trips and holidays throughout the year. Care Homes for Adults (18-65 years) Page 7 of 29 Staff are well trained and the management team carry out regular supervision to ensure that the staffs development and work practices are well monitored. What has got better from the last inspection Improvements have been made to the administration of PRN medication procedures since the last inspection. A variety of decoration and refurbishments have been made since the last inspection. See the Environment section for details. Care Homes for Adults (18-65 years) Page 8 of 29 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Shirley Christopher 33 Greycoat Street Care Homes for Adults (18-65 years) Page 9 of 29 London SW1P 2QF 02079792000 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 10 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 11 of 29 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 . Prospective residents have their needs assessed to ensure that the home can provide appropriate care and support. Evidence: Since the last inspection the home has reviewed The Statement of Purpose and The Service User Guide to ensure they remain up to date. The deputy manager stated that the Service User Guide is being further developed in a pictorial format to assist residents understanding of the services and support that is provided in the home. Thorough assessments are undertaken, usually by the manager and the deputy who visit the prospective resident to assess their needs. The assessments give a detailed account of the person and the care and support needs that is required. The home also receives reports from the persons care manager and speech and language therapists where appropriate. Relatives are encouraged to be involved where possible and they are invited to provide background information to aid the home’s knowledge of the prospective resident. Informal visits are arranged so that the prospective resident can ‘test drive’ the home Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: prior to moving in. There is a trial period to ensure that the home can effectively meet the resident’s needs. Assessments were seen in two resident files and they contained detailed reports giving clear information regarding the care and support needs that the individual requires. There have not been any admissions to the home since the end of 2007. Care Homes for Adults (18-65 years) Page 13 of 29 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 . Care plans give clear guidance to ensure that resident’s needs can be appropriately met. Evidence: Three of the residents care plans were inspected and they included detailed information regarding the care and support needs for each person. Care plans gave details regarding personal care, communication, decision making, activities and day services, healthcare appointments, mealtimes and personal hygiene. Staff on duty were observed supporting and encouraging residents during the day regarding daily living and organising activities in the community. Risk assessments are completed for each resident to ensure their safety both in the home and when accessing the community. Examples included fire safety, using the kitchen and accessing activities. Risks are regularly reviewed to ensure that residents remain safe without comprimising their independence. The deputy stated that person centred files are being developed with Makaton and Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: photographs showing personal preferences and life history. It is anticipated that this will engage residents with their key-worker in setting goals and agendas for the future. There was evidence of regular care plan reviews with additional reviews where needs have changed. Staff spoken to during the inspection stated that they are also involved in the care planning process and they ensure daily notes are kept up to date regarding how residents have spent there day in and outside of the home. New staff gain thorough knowledge of residents support needs as part of their induction. Care Homes for Adults (18-65 years) Page 15 of 29 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 . Residents are supported and encouraged to participate in activities so that they can have full and active lives. Evidence: Residents are supported to make decisions about their lives and have opportunities for developing independent life skills, both in house and within the community. A number of residents attend day activities organised by local day centres and colleges. A group of residents enjoy the weekly sailing activity, with staff assistance, which is organised by the local Lifeboat Association. One of the residents has one to one sessions activities arranged by the staff at Tynecroft. Staff assist residents to access the community on a regular basis including trips to local pubs, cinemas and restaurants. Residents are involved in shopping trips and regularly visit centres inPeterborough, Stamford, Huntingdon and Cambridge. Daytrips Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: to local seaside resorts are also organised dur in the year. Holidays are organised throughout the year and recent examples included trips to Great Yarmouth, Blackpool and Yorkshire. All holidays are risk assessed to ensure resident’s safety. Residents are encouraged to remain in contact with their families and friends. Visitors are welcome at the home whenever residents want to see them. Staff support residents to keep in touch with their friends and families and during the inspection a member of staff was accompanying a resident on a trip to meet with his girlfriend. Residents are fully involved in the choices of meals and a weekly menu is organised to include personal preferences as much as possible. An alternative meal is offered if anyone does not like what is on the menu. Residents are encouraged to help with the preparation of the meal where possible and washing up afterwards. . Care Homes for Adults (18-65 years) Page 17 of 29 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents’ personal and healthcare needs are appropriately met. Evidence: Residents are assisted with personal care in the way they prefer and have regular contact with a variety of healthcare professionals GPs,breast screening, nurses,psychiatrist, optician, dentist and chiropodist. Staff assist residents to access hospital appointments and records of healthcare appointments are recorded in individual care plans, At present none of the residents manage their own medication. Medication administration records were inspected and were accurate. Improvements have been made to the recording of PRN medication as detailed in the last inspection of the home. Staff who administer mediaction receive ongoing training via Boots with in house updates. The deputy and onwe of the senior carers monitor medication administration and ordering to ensure that there is a consistent approach. It was noted that temperatures of the medication stored need to be implemented to ensure safe practice. The deputy stated that she would action this immediately. Comments received from residents and their relatives regarding the care provided Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: included; I like to watch televisdion and listen to my music. If I am not happy I talk to my keyworker or my parents I have no complaints, I like it here I do a weekly timetable with my key worker Since my daughter has been in the home, which is a few years, there is very little to improve I am grateful and do appreciate all of the hard work and dedication all of the staff have shown in caring for my brother Tynecroft is a great place. My uncle has a very fulfilled life there. I regularly ask him if he is happy and he always replies yes. I feel totally at ease as I know he is being well cared for Comments received from residents and their relatives regarding the care provided included; I like to watch televisdion and listen to my music. If I am not happy I talk to my keyworker or my parents I have no complaints, I like it here I do a weekly timetable with my key worker Since my daughter has been in the home, which is a few years, there is very little to improve I am grateful and do appreciate all of the hard work and dedication all of the staff have shown in caring for my brother Tynecroft is a great place. My uncle has a very fulfilled life there. I regularly ask him if he is happy and he always replies yes. I feel totally at ease as I know he is being well cared for Care Homes for Adults (18-65 years) Page 19 of 29 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 . The home has a satisfactory complaints process to ensure that concerns are dealt with appropriately. Evidence: The home ensures that all concerns are fully investigated and dealt with appropriately. This was confirmed in comments received from residents and their relatives. There have been no complaints received since the last inspection either in the home or by CSCI. A record is kept of all concerns raised. It was also clear from conversations with staff met during the inspection that they had a clear understanding of their responsibilities in safeguarding adults and would have no hesitation in reporting any incident or allegation of abuse. Records of training show that care staff have undertaken safeguarding training. Care Homes for Adults (18-65 years) Page 20 of 29 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 . The environment is comfortable and meets the needs of residents. Evidence: Tynecroft provides residents with a comfortable and well maintained home in which to live. The home is comfortably furnished and feels very homely. There a number of communal lounges in the the three houses that make up the home. Residents are provided with television, DVD, karaoke machine and games facilities. All bedrooms are for single occupancy and have a hand basin. Residents can choose the decoration for their room and they can personalise their room with items of furniture and personal belongings to meet their own preferences. Rooms seen during the inspection were bright and cheerful and clearly met individual residents wishes and preferences. Since the last inspection one of the shower rooms has been refurbished and one of the kitchens has been redecorated. The home has a part time handyman who carries out minor repairs in the home. All other major repairs and redecoration work is actioned via the organisations maintenance department. The operational manager audits maintenance issues as part of the monthly management visits. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Staff and residents work together to do the housework in the home which is well presented and kept clean and tidy. It was noted however, that the rear courtyards do not provide residents with a great deal of choice apart from the central courtyard area which has seating and some plants. It is recommended that the staff and organisation research ways in which these courtyard areas could be re developed in a more attractive and creative way to offer greater choice for residents. Care Homes for Adults (18-65 years) Page 22 of 29 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 . The home’s recruitment and training processes ensure that residents are safe and protected from harm. Evidence: The staff rota displayed in the office evidenced that there are sufficient numbers of staff on duty. There are four care staff in the morning and three in the afternoon and one sleep in staff night time. The manager works mainly 9-5 shifts during the week. Staff shifts overlap to ensure that that staff have the opportunity to discuss resident and house issues in the handover meetings. There are also two staff who provide daycare to residents during the day. Staff records show that staff are provided with a wide range of training. All staff have received training in manual handling, food safety, fire safety, first aid and Protection of Vulnerable Adults. NVQ (National Vocational Qualification) training is also well established in the home. Staff have also had opportunities for specialised training such as communication and autism awareness. Dementia training is also being organised to assist staff in supporting residents with changing care and support needs. There is a training matrix, which shows training achieved and dates for Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: updates/refreshers. Training is organised via the organisations training co-ordinator. Staff spoken to confirmed that they had received an induction, ongoing training and regular supervision to ensure their safe practise. Three staff files were inspected and they contained all the relevant recruitment information. There was evidence of two references, an application form and satisfactory CRB checks (Criminal Records Bureau) to ensure that residents are protected from harm. Comments received in staff surveys included; I was able to begin my role with confidence as my induction and training was very good. I have worked at Tynecroft for six months now and I have found the staff and people I support have been fantastic to work with and I really enjoy working here. I have regular supervisions, but I also can approach my manager with anything I wish to discuss between these supervisions. The management of this home is really good and the staff are always considered and treated with respect. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 . The manager provides supportive leadership and guidance to staff so that residents receive good quality care. Evidence: This home is well run and the manager provides good leadership to the staff team who deliver a good standard of care and support for residents in the home. Staff members spoken to confirmed that they felt fully involved in the home and that the manager was supportive and encouraged them to participate in the development of the service. Comments in the AQAA (Annual Quality Assurance Assessment), completed by the manager, showed that the home seeks proactive ways in which to enhance resident’s lives. Residents have involvement in their care plans to ensure that care and support is provided in the way they prefer. This includes the promotion of healthcare and lifestyle choices. It was clear from conversations during the inspection with residents that the manager and staff team work hard to provide support to residents in making choices as much as possible so that they can have a fulfilled life in the home. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: One of the operational managers visits the home on a monthly basis to ensure management processes and care are audited and well delivered. Reports of these visits are kept in the homes office, these were not inspected on this occasion. The fire records seen showed that the fire alarms are tested weekly and emergency lighting are tested on a monthly basis. The fire system is tested by anauthorised contractor at regular intervals during the year. Accident and incidents are recorded. Staff receive training in topics related to health and safety. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes  No  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 Adults (18-65 years) Page 27 of 29 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 Description Timescale for action 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 Description Timescale for action 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: 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 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 © (2008) 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. 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