Inspection on 13/03/07 for Tynedale

This inspection was carried out on 13th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Tynedale 05/11/07

Similar services:

22 Sandown Road

The Highlands

Turret Villa Retirement Home

Dilston College Of Further Education

West View House

Moor House

Blenheim House

Prince Bishop Court

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

CARE HOMES FOR OLDER PEOPLE Tynedale Tynedale Promoting Indepedence Centre Holburn Lane Ryton Gateshead Tyne and Wear NE40 3PF Lead Inspector Mr Lee Bennett Key Unannounced Inspection 10:00 13 14 and 23rd March 2007 th th X10015.doc Version 1.40 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 Tynedale DS0000066634.V328649.R02.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tynedale Address Tynedale Promoting Indepedence Centre Holburn Lane Ryton Gateshead Tyne and Wear NE40 3PF 0191 4130210 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) Gateshead Council Mrs Daphne Patel Care Home 27 Category(ies) of Dementia - over 65 years of age (6), Learning registration, with number disability (1), Learning disability over 65 years of places of age (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (2), Old age, not falling within any other category (27), Physical disability (5), Physical disability over 65 years of age (7) Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service may from time-to-time admit persons under the age of 65 within the OP category of registration This is the first inspection of this service. Date of last inspection Brief Description of the Service: Tynedale Promoting Independence Centre is a modern, purpose-built service designed to provide short-term care and accommodation for older people, some of whom may have a physical disability. The building is on the site of the former Tynedale residential home for older people, in a village location. The new building was completed in July 2006. The service is operated and managed by Gateshead Council’s Community Based Services (formally the Social Services Department), with input from health services employees, including occupational therapists and physiotherapists. Tynedale aims to provide 4 distinct services, that is: • Intermediate care for people who are receiving rehabilitative therapy; • Short-term ‘assessment’ care for those people being assessed for further services; • Short breaks (respite care) for people who will return to their own homes. • Emergency accommodation. The building provides 27 single rooms, all with en-suite shower and toilets facilities. There are also 2 communal bathrooms, which are fitted with appropriate adaptations to support people with a physical disability. There is a large communal lounge and separate smokers’ lounge on the ground floor. Two small kitchen / dining rooms are provided on the first floor, along with a larger dining room and small lounge. There is an enclosed garden at the rear of the building. Car parking at the front and side of the building includes 2 accessible parking bays, located at the entrance. There is level access into building through electronic doors into the reception area. Tynedale is a short walking distance from local shops, and a short bus or car ride from shops in both the Ryton and Blaydon areas. There is access to local transport a short walk from the home and faces onto Ryton Park. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 5 There is no fee for the first 6 weeks of the rehabilitative service. The weekly fees for assessment and short breaks are £73.25 – £566.44. Additional charges apply for the use of telephone and TV facilities. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This report details the first inspection of Tynedale Promoting Independence Centre. The inspection was unannounced and took place over three days of separate site visits. As this was the first inspection, the home was measured against all the national minimum standards for older people. The inspection included a separate look at the pre-inspection questionnaire (completed by the manager), and comment cards received from service users and their relatives before the inspection. During these visits the inspector talked to service users and their relatives about their stay to get their views and experience of the service. Staff were asked about different aspects of care, including service users’ needs, medication and care planning. A meal was shared with service users. The inspector also discussed the development of the service with the registered manager, looked at care records, staff records, training, and health and safety in the building. A sample of bedrooms, bathrooms, lounges and dining rooms was examined. Comments cards about the service were received from several relatives or visitors. Their views are included in this report. There have been no complaints or adult protection investigations referred to CSCI about the service since it opened in July 2006. What the service does well: The strengths of the service are reflected in the many positive comments received from service users and their relatives. These included comments about the information given to service users: • “I’ve been kept informed about what I have to pay.” How • • • needs are being met: “They’re helping me to get back on my feet.” “You’re well looked after here.” “I’m able to get help if needed.” The meals offered: • “They have meal choices.” • “The meals are lovely.” Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 7 The building and equipment that is provided: • “I have the equipment I need … the physio comes in once or twice a week.” • “The beds are nice and lovely and warm.” Staffs attitude and approach: • “(staff) couldn’t fault the.” • “It’s a wonderful place this … the helpers couldn’t be nicer.” • “The staff are very good at caring and are chatty.” • “They’re very good staff, with lots of little ways to help people.” And some more general comments: • “The service is very good.” • “I can’t complain about anything.” Overall, staff are well qualified, with all carers holding an NVQ level 2 award in care or higher, and service users are happy with the care they receive. Tynedale offers pleasant and homely accommodation, and equality and diversity is promoted. The use of an independent agency (Age concern) to look at the quality of the service is an area of good practice, and this seeks the views and experiences of people staying at the home. What has improved since the last inspection? What they could do better: As Tynedale House is a new service there will inevitably be areas that require attention and could benefit from improvement. As a result of this inspection there were several aspects that need attention, and requirements have been made to ensure minimum standards are met and service users kept safe. Some recommendations have been made to promote good practice. In respect to information given, one service user commented; • “The staff didn’t explain some things like alarm call and fire … they did explain about the pendant.” Staff use a tick list to check off what service users are told about the home on admission. This type of safety information, along with a reminder to provide a copy of the contract and more detailed fees information would usefully be added to this list. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 8 Service users and relatives made comments on areas that could benefit from further work, and some specific suggestions for change. Two relatives said there is a lack of activities in the home, and although work has started to address this, further development in this area would be beneficial, specifically targeted at building service users skills. Meal time arrangements should be reviewed to focus more on helping service users to help themselves, rather than being waited upon. The use of automatic door devices could assist where service users find it difficult to open doors. This should be explored by the home. One service user said: • “The door is too heavy to close.” Several safety aspects in the home needed attention. The registered manager, and her line managers need to regularly review safety procedures and look out for hazards in the home. The programme of staff training needs to ensure that all staff receive the training they need. 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. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Tynedale provides good range of written information about its services, which is available in different formats. This can help them to decide if the home is right for them. A statement of terms and conditions (contract) is available for all service users which provides adequate information about their stay. The availability of a contract can help to ensure that service users and their representatives are clear about what they can expect from the home, and be clear about the rights and obligations. Comprehensive assessments are in place for all service users so the manager and staff can make sure their needs can be met. These needs are reflected to an adequate level within plans of care. This helps to ensure that service users are offered the right type of care at the home. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 11 Staff at Tynedale House are able to demonstrate well how the needs of service users are being met. This can provide people with confidence that their stay will be a positive experience. Pre-stay visits are well arranged and available to most service users so they can see what it is like before they come to stay at Tynedale. Service users who are referred solely for intermediate care are helped to maximise their independence and return home to an adequate level. Good intermediate and rehabilitative care can reduce unnecessary and unwanted readmissions to care services. EVIDENCE: Information, in the form of a ‘service users guide’, is available in each service users room, and can be provided to people prior to a service users stay at Tynedale. To help meet service user’s diverse needs, and to promote equality of access, alternative formats are available, including an audio taped version. Service users confirmed, in the majority of cases, that they were told about important aspects of the service. Staff also have an admissions checklist to prompt them to tell service users about important information regarding the home. (See also the comments in the summary section.) For each service user whose needs were ‘case tracked’, a signed contract is held on their file. However, service users are not given a duplicate copy for their ease of reference. The contract outlines what service users can expect when they stay at the home, what their obligations are and for what additional things they will be charged during their stay. However, the level of these additional charges has not been included. Those service users asked, stated that they are made aware of the charges that apply. Prior to their admission to the home, except in an emergency situation, it is the policy of the home that each service user’s needs are assessed. This occurs before it is agreed that each person’s needs can be met at Tynedale House, and a stay then offered. The case files for several service users were inspected, and these people were staying at the home for a range of reasons, and each person had differing and diverse needs. Two of these service users were staying at the home to allow their needs to be more fully assessed. Staff in the home also undertake a range of assessments to determine if more detailed plans of care are required. These include areas such as medication management, manual handling and diet and nutrition. On the whole these provided detailed guidance on the delivery of care, but where a service users needs had changed or become apparent only after admission care plans or risk Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 12 assessments were not always developed. This was also the case for some important areas identified by social workers. For example one service user had experienced five falls within a one-month period and the manual handling assessment still indicated this as being a low risk area. The manager must therefore review how care plans are developed from the initial assessment, and what triggers there are for reviewing care plans and risk assessments, particularly in areas such as falls prevention and pressure care. Tynedale is designed and is registered to meet a diverse range of service users needs. This includes the needs of people who are physically frail and disabled, have dementia care, mental health and / or learning disability related needs. Each persons needs are outlined within their care plan, and it is through this that any cultural, ethnic, religious and other beliefs and preferences can be identified, acknowledged and addressed. This is also supported by the Council’s equal opportunities policy, and training received by staff. Furthermore, staff have a range of personal and professional experiences, and are quite diverse in respect of age, gender and culture. Given the type of services provided at Tynedale House, not all service users will have the opportunity to visit the home before they stay there. For example some service users may move there because of an emergency at home, or they may be moving out of hospital for a period of convalescence and rehabilitation before returning home. In these circumstances a pre-visit cannot always be arranged, and may not be appropriate. Other service users have had the opportunity to visit the home and meet staff before their stay, and those using the service for respite (short breaks) often return there. When the service first opened it held a number of open days for neighbours, care professionals and other interested people. One of the specific purposes of Tynedale is to provide intermediate care (to provide help to people after leaving hospital, but before returning home). This is to allow them to regain their strength, skills and confidence after leaving hospital, and reduce the likelihood of unnecessary re-admissions to hospital. To assist in this aspect of care, facilities are provided for a range of healthcare workers, such as occupational and physio-therapists. There is currently no physical separation of accommodation for these service users from others, but given the overall purpose of the home (where there is no long-stay provision) this is not problematic. Some separate kitchen and dining facilities have been incorporated into the home for the use of service users on programmes of rehabilitation, and to allow kitchen skills to be assessed. Each service user (including those in receipt of intermediate care) has an individualised care plan, which describes a number of goals including those aimed at promoting the skills and independence to assist with their return home. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 13 Joint work with other services and agencies who provide care to service users once they leave the service (such as the Council’s own domiciliary care agency and other independent care providers) has yet to be fully developed. Such links if developed would improve continuity in the planning and delivery of care. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 14 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ care plans are in place and, given the length of each service user’s stay and numbers of people using the service, reflect their observed needs to a good level. Effective care planning can offer guidance to care staff regarding care practice and ensure consistency where necessary. Service users’ health care needs are clearly identified through assessment and observation, and areas such as pressure care and falls prevention are subject to adequate assessment, planning, supervision and care practice. Care staff are good at seeking medical advice where it is needed. Medication storage and administration arrangements are adequate. The effective management of service users’ medication can help contribute to their general health and wellbeing. Staff undertake appropriate care practices that help to preserve service users’ privacy and dignity. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 15 EVIDENCE: Each service user, whose needs were case tracked, had a plan of care developed. These generally reflect service users assessed and observed needs, and describe how staff are to work with service users to help them to maintain or develop skill and work towards specific goals. The purpose for each person’s stay is indicated by a colour coding system. Overall these plans are up to date and provide guidance specific to each individual person, however some clear gaps are evident (see the comments in the section above). These included areas such as falls prevention and skin care. Several health needs are assessed (such as those relating to diet, weight and medication) and these areas of closely monitored if necessary. This is to ensure that service users remain well and that their health improves. During their stay at Tynedale, temporary arrangements are put in place for service users to access a local GP if this is needed. This allows service user to have access to local primary health care if needed. For those people staying at Tynedale for ‘intermediate’ or ‘rehabilitative’ care, planned access to occupational and physio-therapy is arranged. Staff provide written details of all contact with health care professionals whilst service users stay at the home. Each service user is provided with facilities to store and manage their own medication and medication assessments initially prompt staff to ask if service users can manage their own medicines, either independently or with some help. This is important as service users will often need to continue to manage this aspect of their own care once they leave Tynedale. The involvement of a pharmacist is also sought where necessary to assist in providing ways to allow service users to do this, such as by the provision of ‘dosset boxes’ (containers with partitions where medicines are put into different sections for different times of the day and days of the week.) Where staff administer medication on behalf of service users, locked storage is provided. A spacious storage room is used for this, which was noted to be clean and hygienic. The recommendations made by the local police authority around the security of medications have not yet been implemented to ensure the safe custody of medications, and must be. An audit of medication stocks held by the home was undertaken. Medication stocks and records made by staff were generally accurate, nevertheless for one service user there were gaps in the medication administration records (MAR) with no recorded explanation given. For another service user there was no stock available for their prescribed medicine. Stocks of prescribed medicines must be obtained promptly for all service users. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 16 Service users confirmed that their privacy and dignity is maintained, and staff were observed to treat service users and speak with them with due respect. The provision of en-suite facilities also promotes individual privacy. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 17 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements to provide activities and occupation are adequate but have scope for further development within the home. The development of a planned, structured and well delivered activities programme can lead to a more interesting and stimulating lifestyle for service users, and contribute to programmes of rehabilitation. Service users are able to maintain family and other contacts to a good degree should they wish. This can help ensure they do not become isolated during their stay. Service users are actively encouraged by staff to a good degree in exercising choice and control over their lives. This can help promote their independence. Service users receive a good, varied and well presented, choice based, menu. Independence in the preparation, serving and clearing away of meals is poorly promoted. A well balanced diet can make an important contribution to the general health and wellbeing of service users. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 18 EVIDENCE: The activities planned by the home was an area that was commented on by relatives, and in an independent quality assurance report by Age Concern. This identified that some people were disappointed by the activities on offer and some service users and relatives expressed dissatisfaction at the lack of activities provided for them during their stay. As a result of thiese comments work has begun to broaden the range of activities and occupation provided. Those activities planned are now advertised on the notice boards in the home, and include activities outside of the home. During the inspection service users were being asked if they would like to attend a trip to a local preserved railway, and a trip to ‘Safety Works’ (a centre that provides safety advice for the local community) was also planned. One service user stated to the inspector that they enjoyed the bingo that was on offer, and culturally themed suppers have also taken place. Given the purpose of Tynedale, further consideration needs to be given to how the activities and occupation available promotes service users independent living skills. By linking the purpose of the home to individual needs, and thereafter planning a package of activities that meets these needs the staff team at Tynedale will be help contribute to effective intermediate care and rehabilitation. Throughout the inspection visitors were seen to come and go regularly, and the visiting times are clearly displayed. Several visitors were spoken with, and those who also commented by questionnaire stated that they were able to visit their relatives easily. Staff make visitors welcome. Service users choices were promoted in several ways, such as by asking if service users want to participate in activities, and by giving several meal options. However, much more control and independence could be given during meal times, as service users receive their meals ready plated, with little scope offered for self-service. The registered manager was given advice in this respect, and examples of good practice offered. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 19 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clear complaints procedure is available and can allow service users’, and their relatives, confidence in the process, and provide opportunity for the management team to improve the service provided. Service users legal rights are protected. Staff are well aware of local adult protection procedures and how these can be implemented to effect to help contribute to the protection of service users from abuse. EVIDENCE: There have been no complaints or adult protection referrals passed onto or raised directly with the Commission for Social Care Inspection. Service users and other people visiting the home have access to the homes complaints procedures, and service users and their relatives confirmed that they are aware of who to raise concerns with. There have been no complaints recorded as being received. Numerous compliments have been received, along with many thank you cards, where service users and their relatives have expressed their satisfaction with the service. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 20 To protect service users’ rights, staff are informed, through NVQ and direct training, to be aware of people’s basic human rights. Each person’s right to confidentiality is preserved through secure records storage arrangements. Staff are also made aware of how service users rights are protected through local adult protection arrangements. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to safe and comfortable indoor and external space. The home is maintained to a good standard. Service users have excellent access to en-suite washing and WC facilities. This can help support their privacy and dignity. A good level of specialist equipment is provided to assist with service users’ independence. Service users’ bedrooms suit their needs to a good standard. This can enable sufficient space for manual handling tasks, and improved levels of privacy by access to individual en-suite facilities. The home is kept clean to a good standard. A clean and well-maintained home can help promote a positive image for, and is respectful to service users. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 22 EVIDENCE: Tynedale is a newly built care home that has been specifically designed and built to provide short-term accommodation for older people, including people who are physically frail and disabled. It is an airy, bright, modern building, set within it’s own grounds. Accommodation is provided over two floors, with bedrooms for individual accommodation, each with an en-suite shower and toilet. Some of these are larger than others, to help meet the needs of service users who need to use wheelchairs and other mobility equipment. Communal areas are large and have homely decorations and furnishings. There is a small lounge designated as a smoking area for service users. To assist people who have a physical disability, en-suite facilities are easily accessible, some with left hand, others with right hand facilities. Hand-rails are provided throughout and accessible bathing facilities are also available. Access within and outside of the building is level, and a lift allows access between floors. The needs of people who have poor sight have been considered by the use of contrasting decoration schemes. Clear signs (to show what different rooms are for) and colour schemes have been used to help people with dementia to find their way around. One service user commented that she found it very difficult to use her bedroom door because of it’s weight. This resulted in her becoming dependant upon other people to allow her to leave the room. If the use of assistive technology was further explored for some areas of the home this would allow physically frail and disabled people to independently access their rooms. Bedrooms have been well equipped, with wardrobes, chest-of-drawers, writing table, easy chairs, digital TV and a large buttoned telephone. All bedrooms, WC and bathing areas are lockable from the inside to help ensure safety and security. There are two small kitchen areas in the home to allow service users to use domestic style facilities, but at the time of the inspection one was closed due to the need for maintenance work and the other little used for the preparation of meals, as these are automatically offered to everyone in the communal lounge. Largely these are used for the preparation of light snacks and beverages. To assist with fire safety, ‘door-guard’ devices have been fitted throughout the building. These automatically release on the sound of the fire alarm. However, these have resulted in carpets being marked, and do not always hold to door open when the weight of people passing through the doorway causes the timber floor to drop slightly. At the time of the inspection one fire door had become stuck, and some were being blocked open by the positioning of Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 23 lounge and dining chairs. This practice compromises the safety of service users, staff and other people visiting the service. Car parking is provided to the front and side of the building, and there is a concealed entrance from the public highway. If using a car there is poor visibility onto the road when exiting the car park. This presents a road safety hazard. This problem was raised with the Registered Person before the home was registered and a recommendation made to seek the advice of the local highways authority. The home was noted to be clean and tidy throughout. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 24 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are adequate to allow service users’ needs to be met. The staff team benefits from an excellent level with care qualifications, which can help ensure that a competent staff team is available to meet service users’ needs. Service users are protected by the home’s recruitment procedures, which are implemented to a good standard. This can help ensure that unsuitable candidates do not gain employment in the home. Levels of staff training are adequate in allowing staff to become knowledgeable of current best practice. A comprehensive training programme can offer staff opportunities to review and improve their practice to benefit service users. EVIDENCE: For the 27 service users there are no fewer than three care staff on duty through the day, and two care staff at night. There is always a designated senior member of staff on duty, and the team is supported by a manager and three assistant managers. An on-call member of staff is available at night, to cover four homes across the Gateshead Area. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 25 Gateshead Council has a centralised human resources department that deals with the recruitment of staff. The majority of staff working at Tynedale have worked in other Council care home, however those who have been newly recruited are subject to a range of recruitment checks, including the receipt of two references, a Criminal Records Bureau disclosure and a detailed job interview. All of the care staff are qualified, to NVQ level two or higher, and training is available to cover a range of care related topics. To aid planning and to monitor levels of training a matrix has been developed. This has highlighted the gaps in staff training both for individual staff and specific topic areas. For example, many staff have not undertaken manual handling, food hygiene, or health and safety at work training since working at Tynedale and for some time previously. However, staff have received training from a service user led body called ‘New Vision’. This has helped them to look at the way people with learning and other disabilities are discriminated against and sometimes ‘labelled’. This training can promote a good anti-discriminatory approach among staff, and is an area of good practice. Training specific to learning disabilities, that looks specifically at the causes and impacts of learning disabilities does not form part of the training programme and should be implemented to raise staffs awareness in this area, as most have previously worked in older people’s settings. A training plan has yet to be developed for the next six months. Such a plan can help detail how and when staff are to receive training relating to health & safety and care related responsibilities of the service. Some staff have attended training regarding equality and diversity and related issues. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 26 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed to a good standard, with an open ethos adopted. This can allow staff and service users to readily approach the management team. Good quality assurance arrangements, that actively seek service users views, are adopted by the homes managers. The service is financially secure to a good standard. Staff are supervised to a good degree and in good detail. This can ensure that staff are accountable and supported in the work they do. Good record keeping arrangements mean that service users interests can be safeguarded. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 27 Health and Safety is implemented adequately. Effective health and safety management can help keep service users, staff and visitors free from unnecessary harm. EVIDENCE: The registered manager has undergone an assessment and interview by the Commission for Social Care Inspection to ensure her ‘fitness’ for her role. She has worked within various care home settings for many years, and has worked in both caring and management posts. She has undertaken several courses to extend her knowledge, which are relevant to the purpose of the home and her management responsibilities. These have included study for a post graduate certificate in managing public services, and attending palliative care, positive dementia, health and nutrition, infection control, falls prevention and medication courses. The registered manager herself adopts an open style, and staff in the home are aware of the management structure within and beyond the home. A ‘line manager’ undertakes regular monitoring visits, that form part of the quality assurance of the home. Age concern provide an external quality check, and have sought the views of service users once they have left the home. The home’s line manager also undertakes regular (monthly) quality inspections. From these visits plans of action are developed to address the comments made. Service users views are further sought at regular meetings held with staff. The records kept at the home, that were inspected, were up to date, detailed, and held in a safe and secure manner. Financial records are subject to the scrutiny of the home’s line manager and the Council’s financial officers. Staff in the home do not hold or manage service users finances. Several health and safety matters were identified during the inspection, including the safe storage of hazardous and corrosive dishwasher chemicals. An immediate requirement was issued to highlight this to the registered manager. Otherwise, and with the exception of the road and fire safety issues already referred to, the home was found to be free of hazards to the safety of service users and staff. Tynedale DS0000066634.V328649.R02.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 2 3 2 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 4 3 3 3 2 3 STAFFING Standard No Score 27 2 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 4 3 2 Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 5(1)(b) Requirement The registered person must ensure that the home’s statement of terms and conditions (contract) specifies the level of additional charges that apply during a service users stay. The registered person must ensure that the recommendations made by the local police authority are implemented to ensure the safe custody of medicines held in the home. The registered manager must ensure that staff administering medication provide a clear written explanation of why medicines have been omitted. The registered manager must ensure that stocks of prescribed medicines are obtained for service users. The registered manager must ensure that fire safety devices and doorways operate in a safe and effective manner. The registered person must seek the advice of the local highways DS0000066634.V328649.R02.S.doc Timescale for action 01/09/07 2 OP9 13(2) 01/07/07 3 OP9 13(2) 01/06/07 4 OP9 13(2) 01/06/07 5 OP19 13(4)(c) 01/06/07 6 OP19 13(4)(c) 01/07/07 Tynedale Version 5.2 Page 30 7 OP35 18(1)(c)(i ) authority, and in partnership with other Council Departments, implement any the recommendation they make. This is to ensure that people leaving the concealed car park exit, and other road users of Holburn Lane, are kept safe and the risk of a road traffic accident occurring is reduced. The registered manager must develop a plan to ensure that all staff receive the care and health and safety related training necessary for them to undertake their job roles. 01/08/07 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. 3. Refer to Standard OP2 OP7 OP12 Good Practice Recommendations The registered manager should ensure that each service user is given a copy of the home’s statement of terms and conditions (contract) governing their stay. The registered manager should ensure that care plans are updated to reflect the changing needs of service users. The registered manager should develop a programme of activities and occupation that reflects the purpose of the home and enables service users to maintain and reestablish the skills needed to return home. The registered manager should review meal time arrangements to effectively promote self help. The registered manager should explore the use of assistive technology to allow easily access for disabled and physically frail people to independently access and exit their rooms. The registered manager should arrange training on the causes, effects, culture and current good practice in the field of learning disability. The registered manager should arrange for those staff who have not so far participated in it training on Equality and DS0000066634.V328649.R02.S.doc Version 5.2 Page 31 4. 5. OP15 OP22 6. 7. OP35 OP35 Tynedale Diversity. Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 32 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Tynedale DS0000066634.V328649.R02.S.doc Version 5.2 Page 33 - 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. 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