Inspection on 28/10/05 for Tynron

This inspection was carried out on 28th October 2005.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tynron 12/07/07

Tynron 20/04/06

Tynron 19/05/05

Tynron 09/11/04

Tynron 22/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Tynron Church Road Purley Surrey CR8 3QQ Lead Inspector Deborah Yapicioz Unannounced Inspection 28th October 2005 09:15 Tynron DS0000007213.V259226.R01.S.doc Version 5.0 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 Tynron DS0000007213.V259226.R01.S.doc Version 5.0 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 Adults 18-65. 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. Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tynron Address Church Road Purley Surrey CR8 3QQ 020 8763 0208 020 8763 0962 rbalgobin@surreyoaklands.nhs.uk 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) Surrey Oaklands NHS Trust Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19/05/05 Brief Description of the Service: Tynron is a large detached house situated in a quite residential road in Purley. It is within walking distance of local shops and transport links. Tyron provides residential care for ten adults with Learning Disabilities some of who also have physical disabilities and/or epilepsy. The home also has one respite bed. It is owned, managed, and staffed by the Surrey Oakland’s Trust, a specialist health provider for people with learning disabilities. The home currently has ten service users in residence. There are nine single bedrooms, one of which is used for respite provision and one double bedroom. The bedrooms are decorated to suit the individual tastes of the service users. The home provides spacious accommodation comprising of a large kitchen diner, a communal living and dining room and a large pleasant garden to the rear. The home has their own transport. Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes second inspection for the year 2005/6. The inspection was unannounced and took place on the morning of 28th October 2005. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. The home manager was not on duty at the time of the inspection and Mabel Davis and Vicky Bovey facilitated the inspection. Methods of inspection included meeting with the service users, a tour of the premises, observation of contact between staff and service users and meeting members of staff. Comment cards were received from relatives and friends. Records examined included service user plans, risk assessments, medication records and fire records. The inspector would like to thank the service users and the staff team for their help in facilitating the inspection and to every one who sent back comment cards. What the service does well: What has improved since the last inspection? What they could do better: There has been an ongoing issue around the double room on the first floor, which the previous manager was looking at phasing out. During this inspection one of the service users who shares the double room was very clear that he is still not happy with the situation and wants his own room. The service users Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 6 file confirmed that he has made his wishes known to his care manager and the manager of the home. The previous manager had looked into the option of the service user moving to another home although he has now decided that he does not wish to leave the home. The home manager must inform the service user, his representative and the Commission for Social Care Inspection how The Surrey Borders Partnership NHS Trust plans to address the issue. This should include timeframes for action. Fire drills at the home are not happening as often as they should. Fire drills should be undertaken quarterly, in line with good fire safety guidance. 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. Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 The home provides good information and introduction opportunities for prospective service users and their families to make an informed choice about moving to the home. Each of the service users is issued with an individual contract setting out the terms and conditions of the placement, which safeguards the interests of both parties. EVIDENCE: The home has a service users guide and statement of purpose in place. The service users guide is also in an audiotape format. Service users are only admitted to the home once a full assessment of their needs; compiled by their care manager or other relevant person has been received. A care manager’s assessment was seen on the service users files sampled during the inspection. Compatibility with others already living in the home is also taken into account. Any prospective service user would have a gradual introduction to the home with a series of short visits and overnight stays. The time frame would be flexible depending on the service user. Each of the service users has a personal contract, specifying the terms and conditions of their occupancy that included periods of notice, fees charged, and the cost of ‘extras’ not covered by the basic cost of the placement. The service users are in the process of signing their contracts. Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,10 The service users have comprehensive individual care plans with detailed information on their needs and personal goals. Individual care plans include consultation with service users and are regularly updated by the key-worker to reflect current needs. EVIDENCE: Each of the service users has a Care Plan, which is regularly updated and detailed their care needs and personal goals. The plans follow on from the initial assessments completed by their care manager. These plans cover all aspects of care, such as the preferred routines, their communication ability, health, daily activities issues and community living skills. The service users participate in the day-to-day running of the home, through regular service users meetings. The home operates a key worker system and service users have access to advocates. Service users are given the opportunity to make some decisions in their lives; they choose what to wear and what to eat. Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 10 The home has a confidentiality policy and procedure. The Surrey Oakland’s Trust has a staff training course on handling confidential information, which includes issues around the Data Protection Act. Confidentiality is covered at the house induction and the Surrey Oaklands Trust corporate induction course. The staff members spoken to were aware of the policy and were clear about their responsibilities as a member of the staff team. Service users records are kept in a locked cabinet in the office Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 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 The daily routines and house rules promote residents’ rights and encourage independence. The home has an open visitors policy to ensure friendships and family links are maintained. Dietary needs are catered for with meals that are nutritionally well balanced, nicely presented, and clearly based on the service users food and drink preferences, providing them with daily variation and healthy eating options. EVIDENCE: Not all service users have contact with their families. Some service users have advocates. There was evidence on service users files and from discussion with the service users that the home encourages good links with family and friends who can visit and are visited regularly. When the mother of one of the service users died the staff team at the home supported him to attend the funeral. Family and friends are made aware of the home’s visiting policy and there are few restrictions about when people can visit. The majority of the service users can be visited in any of the homes communal areas as well as the service users bedrooms. However for the two service users who share a bedroom this can be difficult. The menus at Tynron are based on the likes and dislikes of the service users and are decided at service user meetings. The dietary needs of the service users are also taken into account. The meals are checked for nutritional Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 12 balance. The menus seemed varied and also included some ethnic option meals. Snacks and hot drinks are available at any time during the day. Service users are offered an alternative to the main meal on offer if they choose. Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,20 Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ medication is well managed to ensure good health. EVIDENCE: Personal care is provided in private, and timings of this are also flexible, for example service users can have a bath when they wish. The level of support a service user needs would be detailed at their review meetings and their preferred routines are set out in their files and personal records. The home provides consistency and continuity through designated key workers. The home has a policy and procedure in place for the receipt, recording, storage, handling, administration and disposal of medication. The staff team at the home complete a monthly medication checklist. All medication records were complete at the time of the inspection. The Surrey Borders Partnership NHS Trust runs a training course for staff on the safe administration of medicines. The training includes an assessment of competence in this area. There are six staff at the home that have attended training to administer medication. Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 There is complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: The complaints procedure was clear and contained all of the elements required to meet standard 22 including a minimum response time of less than 28 days. The complaints procedure is also in a symbol format. The home has had one complaint, which is being investigated by the homes service manager and the London Borough of Croydon Learning Disabilities team. The home has a copy of the local authority Adult Protection Policy on site. The home has had two adult protection issues since the last inspection. The issues were reported and investigated according to the local authority Adult protection policy. Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,30 The home is homely, bright and clean thus providing the service users with safe, comfortable surroundings that meet their needs. EVIDENCE: Tynron is in a quiet residential area reasonably close to local shops and facilities. The home has a large kitchen diner and a comfortable communal lounge dining area on the ground floor. On the day of the inspection the home was warm, comfortable, bright, well ventilated and free from offensive odours. The overall condition and décor of the home was good however the flooring on the step down to the bathroom from the shared bedroom is lifting and could be a trip hazard. This must be repaired or replaced. The home still has one double room. There has been an ongoing issue regarding this shared bedroom. The service users are clear that they do not wish to continue sharing. The home has explored various ways of achieving this including looking at other residential accommodation and making some structural changes to the home. The length of time taken to deal with this is unsatisfactory and this issue needs to be resolved. (See section entitled Conduct and management of the home) Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 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 The staff team at the home have a range of skills and abilities, which enable them to meet the needs of the service users living at the home. EVIDENCE: On the morning of the inspection there were three staff on duty, which is in keeping with the levels agreed when the home was registered with the Commission. The Surrey Borders Partnership nhs Trust offers a wide range of training opportunities to staff at all levels within the home. New members of staff complete an induction programme covering various subjects including health and safety, fire drills, and introductions to service users and other staff. The staff on duty at the time of the inspection confirmed that they had completed an induction. The staff team at the home are encouraged to complete National Vocational Qualifications at all levels. As well as National Vocational Qualification training the staff team have also completed training in first aid, basic food hygiene, health action planning, epilepsy, manual handling and respect at work training. Training needs are identified in supervision and appraisals. Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 The management style is transparent with clear lines of accountability, which is aimed at ensuring the well being of the service users. EVIDENCE: The home has a change of management in the last twelve months. Mr Rajendranath Balgobin has taken over the position of Manager at the home. There has been an ongoing issue around the double room on the first floor, which the previous manager was looking at phasing out. During this inspection one of the service users who shares the double room was very clear that he is still not happy with the situation and wants his own room The service users file confirmed that he has made his wishes known to his care manager and the manager of the home. The previous manager had looked into the option of the service user moving to another home although he has now decided that he does not wish to leave the home. In April 2004 there were plans to make some structural changes to the home to comply with the service users wishes. The home manager must inform the service user, his representative and the Commission for Social Care Inspection how The Surrey Borders Partnership NHS Trust plans to address the issue. On the day of the inspection fire drills were not up to date. Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tynron Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 2 X DS0000007213.V259226.R01.S.doc Version 5.0 Page 19 Yes 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 YA24 Regulation 13.(4)(a) 23.(2)(d) Requirement The flooring on the step down to the bathroom from the shared bathroom is lifting and could be a trip hazard. The home manager must ensure that it is repaired or replaced. The home manager must ensure regular fire drill are undertaken and recorded. The home manager supply the Commission for Social Care Inspection with a written plan outing the way that the service users will all have single room as has been requested. This must include time scales for action. Timescale for action 28/10/05 2 3 YA42 YA39 23. (4)(e) 12. (3) 28/10/05 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Tynron DS0000007213.V259226.R01.S.doc Version 5.0 Page 21 - 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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