Inspection on 14/01/06 for Tynedale House

This inspection was carried out on 14th January 2006.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tynedale House 12/02/09

Tynedale House 02/03/07

Tynedale House 11/08/05

Tynedale House 09/03/05

Tynedale House 21/07/04

Tynedale House 23/03/04

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 House Tynedale Drive Blyth Northumberland NE24 4LH Lead Inspector Deborah Haugh Unannounced Inspection 14th January 2006 12:15 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 House DS0000035337.V276219.R01.S.doc Version 5.1 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 House DS0000035337.V276219.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tynedale House Address Tynedale Drive Blyth Northumberland NE24 4LH 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) 01670 364660 01670 365869 mfairbairn@northumberland.gov.uk Northumberland County Council SSD Mr Malcolm Fairbairn Care Home 25 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (2), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (2), Old age, not falling within any other category (13), Physical disability over 65 years of age (1) Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th August 2005 Brief Description of the Service: Tynedale House is a purpose built single storey home for older people, situated near to a number of shops and facilities on the outskirts of Blyth. A driveway and turning circle, with pathways offers safe vehicular access to the main entrance and reception area. The home provides 25 long-term places. Tynedale House provides accommodation and care to people over 65 years of age in several care categories. There are a variety of aids and adaptation to allow service users to move freely around the home. All of the bedrooms are currently single occupancy and there are no ensuite facilities and there are communal bathrooms and toilet facilities situated around the home. There is sufficient communal lounges and dining areas. There is public car parking opposite the front of the building. The home does not provide nursing care. The Local Authority provides the service and it is managed by Mr Malcolm Fairbairn. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 14/01/06 at 12.15pm until 5.15pm at the weekend. At the time of this inspection Liz Tuck and Angela Young, senior carers were on duty. There were 22 service users at the time of the visit and staffing levels were checked. Time was spent looking at the kitchen, communal lounges, toilet and bathing facilities to check the cleanliness, maintenance and decoration. Service users shared their views about the home. Time was also spent observing the contact between service users and staff. Three care plans for service users care were examined. Arrangements for care staff training; recruitment, finances and health and safety checked. What the service does well: Service users spoke positively about their relationships with staff and the facilities in the home. Comments included; - ‘I’ve been out to the shop today.’ - ‘This is a quiet community – we all get on.’ - ‘Staff are good.’ - ‘We can have a laugh.’ - ‘Its nice here.’ - ‘It’s alright here.’ - ‘I like to help out.’ - ‘We get a choice of meal, we can have whatever we want.’ - ’I like my room.’ The inspector observed the rapport between service users and staff. Communication is good in the home. Staff demonstrated their knowledge of people’s needs and preferences. Service users were seen to help out in the home such as clearing tables after tea. Staff were respectful and actively encouraged people to make choices and decisions. Moving and handling of one service user was observed and this was appropriate and sensitively completed. Medication arrangements meet the required standard. Senior staff were professional and competent throughout the visit. Service users live in a home, which is well run and managed. Staff were friendly and relaxed with the inspector and were keen to discuss their work and the service users care needs. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 6 Staff receive appropriate training to meet the needs of the service users. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 7 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 House DS0000035337.V276219.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users assessments have been updated to meet their needs. EVIDENCE: Pre-admission and care plan documents now reflect the needs of people admitted to Tynedale House. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 & 9 (NMS 10 was assessed and met the standard at the last inspection) Care plans are in place and staff have the information to meet service users needs but some areas must be addressed. The health needs of service users are met and multi disciplinary working is taking place but some areas must be addressed. The arrangements for the administration of medication are satisfactory so service users are protected. EVIDENCE: 7 & 8) Three service users plans of care were examined and they were found to be positive and appropriately guide the practice of staff. The plans have been reviewed and updated and there is evidence of service user involvement within their plan. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 10 Not all the needs of service users have been assessed (1 person had an incomplete nutritional assessment). Not all of the identified needs were reflected in care plans such as personal care, financial support,social and moving and handling. Basic information on two files were incomplete (GP name and address, a photograph and admission date.) The senior on duty A Young agreed to deal with these. Service users personal preferences are reflected in the care plans. Multidisciplinary team work is in place from psychologists and the Behaviour Analysis Intervention Team (BAIT) and other professionals where necessary such as Speech & Language Therapy Team (SALT). Professional guidance is being followed. 9) An audit of the medication arrangements was completed in the presence of L Tuck. Policies and procedures are in place regarding the management of medication. Staff have received training. Medication is appropriately stored and where able service users look after their own medication in lockable facilities in their bedrooms. Records are maintained of all medication received, administered and disposed of. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 (NMS 15 met and NMS 12 & 13 exceeded the standard at last inspection) Service users have control over their lives. EVIDENCE: 14) Within the context of risk assessments service users are able to maximise their control over their lives. People are able to bring their own possessions with them and handle their own affairs. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home has a satisfactory complaints system in place. Systems are in place to protect service users from abuse. EVIDENCE: 16) Service users feel confident about speaking to staff or the person in charge about anything that concerns them. A complaints procedure is in place. Records of any complaints are maintained and appropriately investigated. 18) Northumberland County Council is the lead agency in any protection of vulnerable adults. Staff have received training and further training is planned for senior staff in April 2006 regarding investigative skills. Staff spoken with at the time understood the Whistle Blowing Policy and would report any concerns to the management. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21 & 26 The standard of the environment within this home is good providing service users with a safe, clean and homely place to live. However some areas must improve. EVIDENCE: Tynedale House is a purpose built single storey home. There are a variety of aids and adaptation to allow service users to move freely around the home. All of the bedrooms are currently single occupancy and there are no ensuite facilities. Sufficient communal lounges and dining areas are available in the home. The home is divided into units for smaller living groups. There are communal bathrooms and toilet facilities situated around the home. Bathrooms have wooden chairs with plastic covered seats for people to use. The chairs are scratched with little varnish remaining, the seating has talcuum powder in between the cracks of the joints. This potential risk of crossinfection is identified. The seating must be replaced or cleaned/repaired. The Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 14 assisted bath seats were dirty underneath and a potential infection risk. The Isabella bathroom bath sealant must be replaced as it is worn, dirty and a potential for bacterial growth. Metal and plastic catering-style jugs are used in bathrooms and these look institutional and detract from a homely environment. New homely alternatives should be provided. Management memos to staff are placed in bathrooms. This practice should cease and alternative methods/areas of communicating information to staff be sought as the bathrooms should be homely. One of the toilets had a strong odour and it is recommended that used continence pads should be placed in bags and then disposed of in the appointed bins (double bagged) to manage odour. Emergency pull cord lengths must reach down to the skirting board incase someone falls on the floor and needs to summon assistance. The lounges and dining areas were pleasant and comfortable. People were able to relax, surround themselves with their own hobbies/activities. Bedrooms were personalised and reflected the interests of the person living there. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29 & 30 (NMS 28 exceeded the standard at the last inspection) Resident’s needs are met by the number and skill mix of staff at the home and are in safe hands. Robust staff vetting must protect Service users. Staff are trained and competent to do their jobs. EVIDENCE: 27) The staffing levels on the day of the inspection have been increased to reflect the changing needs and registration of the home. The minimum numbers of care staff are 4 mornings 3 afternoons 3 evening and two during the night. Senior and managerial staff are in addition to these numbers. The staffing levels on the day were 6 care assistants in the morning, 5 in the afternoon and 3 waking nights. Senior and managerial staff are still in addition to these numbers. 29) The registered manager was not on duty and confidential staff and recruitment records could not be checked. Staff were familiar with Criminal Records Bureau checks. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 16 30) Senior staff were able to access staff training information and it is evident that staff have receive mandatory training and refresher courses where required to remain competent. In house training has been provided regarding disability awareness. Other training available include dementia care, continence, medication, violence at work/challenging behaviour, vulnerable adults and communicating with older people. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 36 & 38 (NMS 31,32 & 33 exceeded the standard at the last inspection. Service users finances are protected by robust systems Staff are appropriately supervised but not within a standardised format. EVIDENCE: 35) A check of service users monies looked after by the home was undertaken in the presence of the senior carer. Balances were correct and arrangements are robust. Service users if able are encouraged to look after their own affairs. Care plans must identify action where assessments indicate support with finances. 36) At the last inspection examination of staff records and discussion with staff indicated that supervision took place within the recommended timescales. There was variety in how these supervisions were recorded and how issues would be actioned. According to senior care staff the Registered Manager is currently devising standardise pro-forma. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 18 38) The fire log book was examined and appropriate checks are made. Staff have received in-house fire drill training. However fire instruction has not occurred at the required intervals of 3 months for night staff and 6 months for day staff. The records indicate a 5/7-month gap between instruction dates (July- Dec 05). Hoists have been regularly serviced at 6 monthly intervals. The annual Portable Appliance Test (PAT) for electrical equipment was previously tested 12/11/04. The senior on duty said that the Registered Manager has followed up the next test. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 19 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X X X 2 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 2 X 2 Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP8OP7 Regulation 15 Requirement Assessment of nutritional need of identified service user must be completed. Timescale for action 28/02/06 2 OP19OP26 OP21 23(2) 3 OP38 23(4) 4 OP36 18(2) Care plan needs must be consistently completed and identified. (personal care, financial support,social and moving and handling) 31/01/06 The following ares must be addressed; 1. Replace or clean/repair worn seating in bathrooms. 2. Clean assisted bath seats. 3. Replace bath sealant Isabella. 4. Emergency pull cord lengths must reach down to the skirting board. 5. Manage odours in identified toilet (double bag continence pads) Staff must receive fire 15/01/06 instruction at 3 month (night staff) and 6 month (day staff) intervals. To standardise supervision 31/03/06 documentation. OUTSTANDING 1/10/05 DS0000035337.V276219.R01.S.doc Version 5.1 Page 21 Tynedale House 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 Refer to Standard OP19 Good Practice Recommendations Replace metal and stained jugs in bathrooms and provide more homely designs for bathrooms. Remove management memos to staff from service users bathrooms. Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Tynedale House DS0000035337.V276219.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!