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Inspection on 24/05/05 for Tyneview Nursing Home

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

This inspection was carried out on 24th May 2005.

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. 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?

Risk assessment documentation has improved and is well kept.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Tyneview Cuthbert Street Bensham Gateshead NE8 1AF Lead Inspector Tom Moody Unannounced Tuesday 24 May 2005 at 10:00 am 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 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 B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tyneview Nursing Home Address Cuthbert Street Bensham Gatshead NE8 1AF 0191 477 2835 0119 478 9400 Telephone number Fax number Email 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 Ms Elizabeth Malley Care Home 37 Category(ies) of OP Old Age (37) registration, with number PD(E) Physical Disability over 65 (37) of places SI(E) Sensory Impairment over 65 (24) Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10 November 2004 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 B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over one day in May 2005. Care practice was observed and the inspector spoke to staff, service users, relatives, visiting professionals and the manager. The premises were looked at, as well as examples of documentation. A meal was observed but the inspector did not eat with service users on this occasion. What the service does well: What has improved since the last inspection? What they could do better: The home is an adapted building and has some design shortfalls. The upper flights of stairs still squeak and make a lot of noise when they are trodden on. Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 6 Although this has been remedied on lower flights the upper stairs should be silenced. Not all fire precautions were observed and one fire door was wedged open. The décor tends to be unco-ordinated and looks a little dated and worn in places. Some of the soft furnishings are also worn, especially the chairs in the lounges. There are shortfalls in specialist equipment. There is no loop induction system for service users with hearing aids. There are no variable height beds in the home and the divans in use cannot be safely fitted with bed rails. Care planning could be improved by including a more detailed life history of service users. The home needs to appoint a deputy to relive the manger of some responsibility. 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 B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 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 standard(s) 3, 4, 5, 6. All service users entering the home have their needs accurately assessed. Most service users and their family 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. EVIDENCE: The manager states that service users in the home have gone through the community care assessment process. Care plans show that an assessment is made by specialist nurses and social-work staff, as well as the home manager. According to the manager, in some circumstances, such as emergency admissions, it is not always possible for staff at the home to make a preadmission assessment. In these cases the assessments, made by the referring professionals, are always available to the manager. Care plans confirm this. Relatives and service users confirm that they are invited to view the home before coming to stay. Care plans indicate they are involved in decision making during the initial placement and at the six-week review. This home is one of a limited number in Gateshead that provided intermediate care. The manager spoke of service users from this service to progressing to Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 9 home or some other low level placement other than hospital care. Discussions with service users confirmed this. Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 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 standard(s) 7, 8, 10, Service users health care needs are largely met but the risk assessment documentation highlights deficiencies in equipment. Service users have access to all healthcare services that they need. Service users are respected and their dignity is upheld. EVIDENCE: The service user’s care plans are detailed and indicate that their healthcare needs are assessed. The manager stated that the home is visited regularly by a number of clinical specialists and the Parkinson’s clinical nurse specialist was visiting during the inspection. The care plans support this and there is evidence of a number of health-care specialists being involved in service users care, as well as GP’s dentists and opticians. The manager identifies training needs in staff files and these indicate staff have attended a number of training courses. The manager pointed out that local placing authorities use the home to provide intermediate care and to place service users with complex problems. The continuation of this arrangement would indicate satisfaction with the home’s record on providing this care. Care plans show that service users social and recreational needs are also assessed. Some staff members appear to know much of the service users history but all of this detail is not recorded. All of the service users who were Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 11 spoken to confirmed that they were well looked after and that they were happy with the care they received. One commented on how much their condition had improved, saying that, “I couldn’t have received better care in the hospital.” Care plans contain risk assessments and these highlight deficiencies in equipment such as bed rails, which cannot be safely fitted to ordinary divan beds. Staff were observed to knock at service users bedroom doors. Service users were addressed respectfully by care staff. A visiting clinician was seen to consult with a service user in their own room and this took place privately. The manager confirmed that this is normal practice. Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14, 15. The home endeavours to provide a lifestyle that matches service users needs and preferences and contacts are maintained with the community. Service users can exercise a good degree of control over their lives and the home promotes this. Meals are of good quality and the timing and choice can be varied to meet service users needs. 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. Some service users were engaged in their own activities such as crossword puzzles or art-work. The manager confirmed that visiting is unrestricted and a number of relatives were observed in the home during the day. The manager spoke of the development of a local park and said that the home would make use of this. She also confirmed that local facilities such as shops and pubs were used by service users, although this depended upon the availability of staff for escorts, and that the home is visited by a local minister of religion. Some service users were rising late from their beds and the staff confirmed that this was at their own request. One service user said that they were able to change their room to another more suited to their taste. 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. One service user, who was in the army, is still in the habit of Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 13 rising early. They had an early breakfast and were able to have a bacon sandwich as a “NAFFI” break at mid morning. 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 and that they enjoyed their meals. The cook confirmed that mealtimes were flexible and late risers could have their lunch at a later time. Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 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 standard(s) 16, 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. EVIDENCE: The 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. Service users and their relative said that they were happy raising issues with staff or the manager and they were confident that any issues would be dealt with. Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19, 20, 21, 22, 23, 24, 25, 26. The environment is maintained regularly but some areas need attention. Although the home has some equipment there are some areas that are deficient and although the home is, in the main, safe, some hazards 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. 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. The views from the main lounges, are quite impressive although these are quite large and open. One lounge door was wedged open and would be dangerous in the event of a fire. Bedrooms are reasonably well furnished and contain personal items belonging to the occupants. There are no variable height beds in the home and the divans in use do not allow the safe deployment of bed rails. There was no loop system in any area to help service users with hearing problems. One service Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 16 user pointed out that the television, on the other side of the lounge, was too far away to be seen or heard properly. Soft furnishings are worn in some areas. Same chairs are worn and damaged and in one lounge the carpet is rippled and may pose a tripping hazard. There are adequate numbers of toilet and bathing facilities but floor covering in some toilet areas is separating from the walls and could allow dampness to penetrate. The home has no gardens or grounds that can be realistically used as a amenity area for service users. The home was clean and tidy in all areas and no unpleasant odours were detected. Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 30. The manager ensures that the home operates safely and sufficient staff are available to meet service users needs. Staff are well trained and up to date in their knowledge. EVIDENCE: The homes manager is competent and recruitment policies and procedures are appropriate. The recruitment processes are thorough and carried out properly. The home has recently lost the deputy manager and she has not yet been replaced. Staff receive regular updates in their mandatory training. Staff confirm they have induction and training updates. A number are engaged in NVQ training programme. Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 36. 38 The manager is experienced and competent and the home is well managed. The manager is professional and ethical and service users benefit from the way she carries out her duties. The home is run in service user’s best interests and staff are supervised. EVIDENCE: Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 19 The home manager 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. The staff group is cohesive and they say they feel part of a team. The staff state that the manager is approachable and supportive. Service users say that the manager is approachable and they confirm that they are able to raise problems or issues with staff members. Discussions with the manager, and her staff, reveal that they are aware of service users needs and preferences and try to accommodate them. This is also evident in care plans. Staff and manager have a relaxed but respectful attitude to one another. The manager confirms that the home carries out staff supervision and records are kept. The risk assessments that have been done identify hazards such as loose bed rails. It is important that these are addressed by the registered owner. Fire check doors should not be wedged open. Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 2 3 2 2 3 3 3 3 STAFFING Standard No Score 27 x 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 x 2 Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 21 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 8, 38 Regulation 16 (2), 13 (4) 23, 13 (4) 23 16, 23 Requirement 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. floor coverings must be appropriate and kept in good repair. the home must provide equipment suitable for service users with physical or sensory deficit. Timescale for action 21 / 08 / 05 21/ 08/ 05 21/ 08/05 21/ 08 /05 2. 3. 4. 19, 38 21 22 5. 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. Refer to Standard 8 28 Good Practice Recommendations a more detailes life history would improve care plans. a suitable deputy should be appointed as soon as possible. Tyneview B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Baltic House Port of Tyne South Shields Tyne and Wear 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 B52-B02 S18181 Tyneview Nursing Home V222758 240505 Stage 4.doc Version 1.30 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. 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