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Inspection on 18/05/06 for Tyneview Nursing Home

Also see our care home review for Tyneview Nursing Home for more information

This inspection was carried out on 18th May 2006.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a high quality of clinical care and there is good liaison with clinical specialist and other health professionals. Service users feel that they are well looked after by the staff and speak highly of the care they receive. Staff members engage service users in conversation when carrying out care and staff members put elderly service users at their ease. The manager and her staff are flexible in relation to service user`s individual needs and wishes and try to ensure the service responds to the individual`s needs and wishes. Lifestyles are tailored to service users preferences as well as possible taking into account the service users capacity and abilities.

What has improved since the last inspection?

There have been few discernable improvements since the last inspection and all of the requirements from that visit are still outstanding.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Tyneview Nursing Home Cuthbert Street Bensham Gateshead Tyne & Wear NE8 1AF Lead Inspector Mr Tom Moody Unannounced Inspection 18th May 2006 10:00 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 Tyneview Nursing Home DS0000018181.V292992.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. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Tyneview Nursing Home Address Cuthbert Street Bensham Gateshead Tyne & Wear NE8 1AF 0191 477 2835 0191 478 9400 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) Mrs Beverley Anne Tarplee Mr Martin Lang Ms Elizabeth Malley Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37), Physical disability (1), Physical disability of places over 65 years of age (37), Sensory impairment (1), Sensory Impairment over 65 years of age (24) Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service user category PD and SI refer to one specific service user only. 12th January 2006 Date of last inspection Brief Description of the Service: This home is registered as a care home providing nursing and personal care for older people. It is a building that has been converted to its present purpose as a care home. The building has three main floors with some further changes of level within these. The home is built on rising ground and the main entrance is at first floor level. It has a passenger lift giving access to all floors. It is situated in an urban setting close to a busy road junction and is accessible by public transport with several major bus routes running by the home. There are no grounds that can be used as recreational space but it has ample car parking. There are a limited range of facilities, such as pubs and shops, within walking distance of the home and it is a short drive to the town centre. The home’s elevated position provides views of the River Tyne and Newcastle to the North and West. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit for this inspection took place over one day on 18 May 2006. One inspector carried out the inspection, although they were accompanied by a member of CSCI’s ICT staff during the inspection. The manager of the service was present during the site visit. The views of people living at the home were gathered by using comment cards and, during the day of inspection, by talking to them, their visitors and by reading documents. Positive feedback was received from all of those whom the inspector spoke to. The manager was interviewed and documents were examined, including care plans. A tour of the home took place. A mealtime was observed but the inspector did not sample the food at this inspection What the service does well: What has improved since the last inspection? There have been few discernable improvements since the last inspection and all of the requirements from that visit are still outstanding. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 6 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. Tyneview Nursing Home DS0000018181.V292992.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 Tyneview Nursing Home DS0000018181.V292992.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): 1, 2, 3, 4, 5, 6 All service users entering the home have their needs accurately assessed by social care and health service staff. The home makes it’s own assessment in addition to this. Most service users and their family have information about the home and have the opportunity to visit the home before they come to stay, unless there are exceptional circumstances. This allows them to make an informed choice about staying in the home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has some emergency admissions mainly in relation to intermediate care admissions. Service users guide has been in use for some time and provides a suitable level of information. The majority of service user comments indicate relatives and service users receive adequate information. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 9 Contracts are present in care plans and the manager told the inspector that each service user receives one. Care plans show that an assessment is made by specialist nurses and socialwork staff, as well as the home manager. This home is one of a limited number in Gateshead that provided intermediate care. These service users are sometimes admitted without the home assessing their needs. In these circumstances, this is done by other professionals. The manager spoke of completing service users assessment as soon as possible afterwards. Records confirm this. Discussions with the manager indicated that service users from this service go home or some other low level placement other than hospital care. Service users confirmed this and those service users who had been admitted at short notice commented positively on how well they had been dealt with during this process. Some of them were to have permanent placements in the home and said they were happy with this arrangement. Service users visitors stated they had been given “good” information about the home before putting their relative there. One service user stated she had been happy for her relatives to make the arrangements but she wanted the final say on her placement. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 10 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, 10, Service users health care needs are largely met but the risk assessment documentation has highlighted deficiencies in equipment. Service users have access to all healthcare services that they need. The home has appropriate policies and procedures to ensure service users receive their medication in a safe way but staff must adhere to this guidance. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans are well written and contain all the information necessary to ensure service user’s needs are met. Care plans indicate that safer alternatives to bed rails are used whenever possible and this equipment is in place in service user’s rooms. Some bed rails are still used and examples were found where these were not secure. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 11 Self assessment indicates engagement with a number of different health care agencies. The manager confirms this and there were clinical specialists visiting the home at the time of the inspection. The home has appropriate policies, storage and practice to ensure service users receive their medication in an appropriate way. Records are well kept and storage is secure. There was evidence that procedures were not always observed. Medication pots were found with scraps of paper bearing service user’s names. This is indicative of secondary dispensing and none adherence to local policies and professional guidelines. The manager frankly acknowledged this and agreed to take remedial action. Service users are treated with respect by staff and, practice and procedures in the home ensure their privacy. There have been 12 deaths in the home in the last year. This is not excessive and there are no untoward concerns raised by any of these. The self assessment records a high number of falls but the majority of these are minor and reflect a good level of recording. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 12 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): 12, 13, 14, 15 The home endeavours to provide a lifestyle that matches service users needs and preferences. Meals are of good quality and the timing and choice can be varied to meet service users needs. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users rooms contained their own treasured items and evidence of recreational interests such as books, jigsaws and tapes. Religious symbols and pictures were displayed in some rooms. Staff confirmed that visiting is unrestricted and relatives were observed, visiting the home during the day. Some service users have been provided with tea-making equipment to allow them control over when they take tea and to enable them to offer refreshment to their friends and relatives. Care plans contain good clinical information efforts have been made to include more information about social care or service user’s life history. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 13 The manager and staff members do have a good knowledge of service user’s background. The activities co-ordinator was present during the day of inspection and was conducting a quiz. A number of service users were taking part. Service users said, “There’s plenty to do here.” “Everything I want is here.” One service user commented on “having people to talk to”, in the home. The menus were appropriate and demonstrated choice was available. The cook confirmed that service users can have a choice other than that which is on the menu. Home cooked food was being served and cooked on the day of the inspection. All service users who were spoken to confirmed that the food was good. Comments such as, “I enjoy my meals here” were typical. Service users requiring help at mealtimes were aided by staff in a skilled and appropriate way. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 14 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, 17,18 The homes policy on adult protection reflects the multi agency approach to adult protection, and local procedures and staff know how to use it. This should ensure the protection of service users. Service users and their relatives are confident in the process and how staff will operate it. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: Service users and relatives said that they were happy raising issues with staff and they expressed confidence that the manager would deal with issues. The home’s policies and procedures in this area are appropriate. The home is using the local authority’s definition of abuse derived from the No Secrets Guidance. Staff have an awareness of what constitutes abuse and how to follow policies. Complaints are accurately recorded although there are few recorded complaints. Discussion with the manager showed that she is aware of service user’s legal rights and this ensures that service users are not disadvantaged. SelfTyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 15 assessment indicates an awareness of which service users are subject to power of attorney or guardianship. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 The environment is maintained but some areas still need attention. These are outstanding from the last report. Similarly, the home has some good equipment but there are some areas that are deficient. Therefore, although the home is, in the main, safe, some hazards to the service users are present and need to be eliminated to ensure service user’s safety. Rooms are comfortable, furnished to service users tastes, and the home is kept clean. Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home has adequate communal and bedroom space although some bedrooms are odd shaped. As well as the main lounges there is a smaller communal areas overlooking the car park although few service users seem to Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 17 use this. The views from the main lounges, are impressive although these are quite large and open. Some of the chairs, in various areas of the home, are becoming badly worn and need to be replaced. As noted in the previous reports, one lounge door was wedged open and would be dangerous in the event of a fire. Action still has not been taken in spite of this being a requirement from previous inspections. This must be addressed to ensure the safety of service users, relatives and staff. Bedrooms contain personal items belonging to the occupants. The home has obtained a variable height bed but the remainder of the divans in use do not allow the safe deployment of bed rails. Some bed rails were unsecured and could pose a hazard to the user. There was no loop system in any area to help service users with hearing problems. In the past service users have pointed out that the television, on the other side of the lounge, was too far away to be heard properly. This is another outstanding requirement from earlier inspections. There are a number of moving and handling aids in the home and it has electronic scales. There are adequate numbers of toilet and bathing facilities but floor covering in the shower areas is becoming badly stained and looks unclean as a result of this. Shower traps were open and unsecured, could allow smells into the room. This is outstanding from previous inspections. The home has no gardens or grounds that can be realistically used as an amenity area for service users. The home was clean and tidy in all areas and no unpleasant odours were detected in areas other than the shower room. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The manager ensures that the home operates safely and sufficient numbers of staff, who are appropriately trained, are available to meet service users needs. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: Staff nurse and Manager both state that the manager has “supernumerary hours” in which to complete management and administrative tasks. The home had sufficient staff to meet service users needs on the day. The call system was answered promptly. Service users confirmed that they rarely had to wait for attention. Records are kept of training and individual development. The recruitment policies and procedures are appropriate and the manager operates these correctly. Duty rotas submitted as part of self-assessment indicates a reasonable level of staffing and that Staff turnover is low. Self-assessment indicates staff have had in-service training and further training is planned. The notice board displayed a number of advertisements for training events and the manager confirmed staff attendance at some of these. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 19 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): 31, 32, 33, 35, 38, The manager is experienced and competent and the home is well managed. The manager is usually professional in her approach and service users benefit from the way she carries out her duties. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The home manager was present at this inspection. She is an experienced nurse registered on more than one part of Nurses and Midwives Council register. She has been approved as the registered manager by previous registering authorities and has NVQ level 4 in management. Self-assessment indicates there is a quality assurance system. Discussion with the manager revealed that the quality assurance system is not yet operating. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 20 The example seen was comprehensive but complicated. Alternatives to this were discussed with the manager. The manager said she uses staff meetings to receive feedback of the homes performance and staff are able to put forward their views. The staff group is cohesive and they say they feel part of a team. The staff said that the manager is approachable and supportive. Service users also say that the manager is approachable and that she is well regarded. The imaginative use of alternatives to bed rails is a good example of the managers active, problem-solving approach. It is unfortunate that the lapse in medication standards blemishes, what would otherwise be, an excellent performance in this area. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 21 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 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 3 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 3 18 3 2 3 2 2 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 22 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 OP19 Regulation 16, 13 Requirement The home must have suitable variable height beds and beds that are capable of have bed rails fitted securely to them. The home must have suitable variable height beds and beds that are capable of have bed rails fitted securely to them. The home must have suitable variable height beds and beds that are capable of have bed rails fitted securely to them. The home must have suitable variable height beds and beds that are capable of have bed rails fitted securely to them. Fire precautions must be observed in all areas of the home. The floor coverings in bathroom, toilet and shower areas must be appropriate and kept in good repair. As should sanitary fittings. DS0000018181.V292992.R01.S.doc Timescale for action 28/06/06 2. OP22 16, 13 28/06/06 3. OP38 16, 13 28/06/06 4. OP8 16, 13 28/06/06 5. OP19 23, 13 28/06/06 6. OP21 23 28/06/06 Tyneview Nursing Home Version 5.1 Page 23 7. OP22 16, 23 The home must provide equipment suitable for service users with physical or sensory deficit. All staff must adhere to local policies and professional guidelines when administering medication. 28/06/06 8. OP9 13 (2) 28/06/06 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 The home adopt an easily practiced quality assurance system that takes into account service user’s views. Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Tyneview Nursing Home DS0000018181.V292992.R01.S.doc Version 5.1 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. 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