CARE HOMES FOR OLDER PEOPLE
Tynedale House Tynedale Drive Blyth Northumberland NE24 4LH Lead Inspector
Mary Blake Key Unannounced Inspection 09:15 2 & 6th March 2007
nd 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.V304885.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V304885.R01.S.doc Version 5.2 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.V304885.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14th January 2006 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 residents 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.V304885.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a key unannounced inspection, the first of the year and took place over two days. A general tour of the premises was carried out. Case tracking was undertaken, this involved following the care of individual residents. Residents care records; pre-admission documentation, staff and maintenance records were examined. The manager, senior care, two carers, two ancillary staff and twelve residents and four relatives were spoken to. 8 resident/relative questionnaires were received prior to the inspection. These were generally very positive. What the service does well:
Staff were kind and considerate when helping residents. Residents explained the admission process; this includes a gradual introduction to the home and a detailed pre-admission assessment. This helps new residents adjust and settle into their time at the home. Individual care plans are well detailed, regularly reviewed and updated. Staff were involved in planning and evaluating care and the plans this helps staff give residents the care they need. The management overviews these plans and this helps to provide a consistent staff approach. The home has strong links with supporting health professionals, who give good health support to residents Arrangements for residents to maintain contact with their family and friends are good. Residents and relatives confirmed that visitors are always made welcome and kept informed and involved. Residents described good relationships with the staff and said they were all polite and helpful commenting “five star” “all the staff have always been excellent”. Staff were friendly and relaxed and showed a good understanding of residents needs. Meals are varied, well balanced and nicely presented offering good choice and nutritious food at all meals. All of the residents spoken to were pleased with
Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 6 the quality and choice available. Meals were seen as a relaxed and social occasion. Hygiene practices were good protecting the health of residents and staff. The home is well staffed with a skilled, consistent and trained staff team giving security to residents. Staff recruitment and training records were clear and concise and contained all relevant information. The vetting process helps protect residents. The staff have a good understanding of residents individual needs. More than fifty percent of staff are qualified to National Vocational Qualification in Care level 2 (NVQ) or above providing residents with a trained, skilled staff team. The residents were very complimentary about the staff. The home is well managed with an experienced and trained person who adopts an open and approachable style for residents, staff and families. There are good systems in place to obtain the views of residents and action any issues they identify. What has improved since the last inspection? What they could do better:
Risk assessments must be completed and updated for all residents this will help identify and help reduce risk for residents. Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 7 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 House DS0000035337.V304885.R01.S.doc Version 5.2 Page 8 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.V304885.R01.S.doc Version 5.2 Page 9 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): 3, 4 & 5 6 intermediate care is not provided Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home undertakes a detailed pre admission assessment and liaises with the residents and family prior to their stay. Residents and relatives have opportunities to visit before their stay. EVIDENCE: Care plans had good information to ensure that the home can meet the needs of the prospective resident. The Manager is involved in the decisions and in the majority of instances visits the residents himself prior to their stay.
Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 10 Residents spoke of visiting the home or attending the day centre prior to their and that this was useful to reduce anxiety and make the settling in process easier even Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 11 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 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are having their needs met by the staff in the home and the staff are skilled in providing the care in a sensitive and dignified manner. This is shown in the documentation and care plans in place. EVIDENCE: Two care plans were examined and they were of a satisfactory standard. Relevant risk assessments were undertaken for nutrition, moving and assisting, continence promotion and mental health status. Risk assessment in relation to falls were not consistently completed or reviewed. Generally the plans are regularly reviewed and updated. The care plans showed that the residents have access to all NHS services and facilities. A number of assessment tools are in use, and they were reviewed
Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 12 and were dated and signed by the author. Daily reporting of residents care was generally satisfactory, and the changing health care and mental health care of residents was reviewed and up dated. The medication systems and policies are currently under review and were not assessed at this inspection. Staff were treating residents with respect and dignity. Personal care was given in privacy. Staff used residents preferred name at all times. Residents and relatives were complimentary about the staff in the home and felt that they were able to have privacy in their own rooms Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 13 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): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are satisfied with the flexibility of their routines for daily living and activities. Arrangements for residents to maintain contact with their family and friends and the local community are suited to each individual’s needs and vary accordingly. There is a social programme in place, which is under review. The food served is good and the residents are happy with the quality and the quantity. EVIDENCE: Residents take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. All residents said that they are able to make choices about how they spend their day. The residents’ bedrooms were personalised and residents said they were happy with the decoration and furnishings. Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 14 Residents have visitors at any time and are able to use their own rooms, the small lounges or the larger, busier lounge to receive them. Residents enjoy going out individually and in small groups and go to local shops, pubs and attend church. The meals served were good and all of the residents enjoyed the food, which was well cooked. Staff support was on hand. The tables were nicely set and breakfast and lunch was seen as social occasions. Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 15 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): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures residents and relatives aware of the complaints policy by making it available in a variety of places. Complaints are managed satisfactorily and the necessary action taken. Staff had completed training in the Protection of Vulnerable adults and this is necessary to ensure that residents are protected. EVIDENCE: The complaints procedure is displayed in the home and available within a number of places. The records of the complaints made to the home was examined and was satisfactory. The residents and relatives said that they knew problems were dealt with and how this would be done. Staff were aware of the whistle blowing policy and informing the Manager of any incidents or issues of which there are concern. Staff had completed Protection of Vulnerable Adults training. Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 16 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): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents live in a safe environment. There are good communal areas. There are suitable toilets and baths. The bedroom areas are personalised and comfortable. The home is clean, hygienic with no offensive odours. EVIDENCE: The location and layout is suitable for the residents who live here. There are lounges and dining rooms that are pleasantly decorated and furnished. Residents were able to use a range of lounges and there was a range of television and audio equipment available for their use. Bedrooms were
Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 17 well decorated and personalised. All previous requirements relating to the environment had been met. The home was very clean with good hygiene practices evident Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 18 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): 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager ensures there are adequate numbers of staff on duty that have appropriate skills and experience to care for the residents. Staff recruitment records were clear and concise and contained all relevant information. The vetting process helps protect residents. Staff training was well organised with a high percentage of staff completing NVQ training this improves staff skills to meet residents needs. EVIDENCE: Staffing rotas showed that there are enough staff are on duty to meet the necessary staffing levels. When sickness and staff holidays occur home staff usually cover, agency staff are not used. In additional there is good ancillary support. Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 19 Residents commented, “Staff are always available” “ they give you time” “ nothings a bother”. There is an in house training programme in place and more than 83 of the staff having National Vocation Qualification in Care level 2 in care or above. The training programme is up to date for all staff and significant amounts of training are being given to the staff in health and safety, statutory and care practices. Training certificates or copies are not held within the home this should be addressed. Staff said that they are undertaking or had completed NVQ level 2 or over and the home has an induction and training programme for all staff working in the home. There had been minimal staff turnover. Staff recruitment files were previously examined and were satisfactory. Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 20 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): 31,33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which is well run and managed by an experienced, trained person. There are systems in place to organise the home taking into account the needs and wishes of the residents. Good quality assurance systems are established. Resident’s financial interests are safeguarded. The health, safety and welfare of residents and staff are promoted or protected and the manager ensures safe working practices in the home in line with the company policies and procedures. Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 21 EVIDENCE: The residents and staff made positive comment about the Registered Manager and staff team; they gave examples of improved practices and of the staff team taking time to listen and respond to any concerns they may have. Monthly proprietor visits are undertaken with good written reports and any issues addressed. The home has an annual development plan. Other Quality assurance systems have been set up and a policy has been developed, these were comprehensive. Monthly client satisfaction questionnaires are undertaken covering areas such as care and food. Accidents are recorded effectively with accident analyses being completed and risk preventions being undertaken to safeguard residents. The system for checking resident’s monies was satisfactory. System testing had been undertaken and maintenance certificates are available. Fire drills had been completed at the recommended time of six monthly for day staff and three monthly for night staff. Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 22 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 23 No 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 OP7 Regulation 13(4) Requirement All care plans must contain completed and updated risk assessments Timescale for action 01/04/07 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 Refer to Standard OP33 Good Practice Recommendations To review within the Quality assurance system obtaining the views of stakeholders and publishing the results of all surveys. Tynedale House DS0000035337.V304885.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 House DS0000035337.V304885.R01.S.doc Version 5.2 Page 25 - 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!
