Care Home: Tanfield House

Similar services:

• Townley Road, 2-3
• Foxley Lane (121a)
• Tudor Lodge
• Stacey Street Nursing Home
• Delrose House Ltd
• Clovelly House Residential Home Ltd
• Abbey Road [53]
• Cherry Tree House

What the care home does well Information is given to each resident in the form of a pack that includes their daily plan of care, the statement of purpose, a care plan summary, an activities profile, information about their medication and general information about the local community. The current residents are African and African Caribbean men and the staff team reflects the gender and culture of the residents. The food prepared in the home meets the dietary, religious and cultural needs of residents. Residents have access to activities and classes arranged by the African Caribbean Resource Centre. A care manager commented on the survey form that the home provided "a comfortable environment for the residents", "treated them as individuals and encouraged independence" and that there was a good channel of communication. They also said that the home "provides a safe environment in which to grow as an individual". Both members of staff and residents said that the managers are very supportive and "good on a personal basis". What has improved since the last inspection? The home has now met all the statutory requirements identified during the last key inspection in August 2007. The rotas are now more informative and show what hours the manger is working on site so that members of staff are quickly able to seek advice and support when needed. The rotas also reflect all of the members of staff on duty so that staffing levels can be monitored. The recruitment process has been strengthened and the manager now ensures that members of staff do not start working in the home unless a pova first check has been carried out, pending the return of a satisfactory enhanced CRB disclosure. References now include a reference from an applicant`s most recent employer. These measures help to prevent unsuitable people working in the home. Members of staff now have access to accredited medication training to ensure that they have the depth of knowledge necessary to support residents. Amending the pre-admission process so that a full record is kept of each visit to the home by the prospective resident helps the manager to determine whether the home can meet the person`s needs. During this inspection the manager gave examples of how feedback arising from the quality assurance systems in place, including comments from residents, has been used to make improvements in the service. The manager also demonstrated how the complaints procedure now includes information about how and when feedback is given to the complainant about the outcome of an investigation. Some refurbishment has taken place in the home to maintain a pleasant environment for residents. What the care home could do better: Although medication had been given to a resident there were gaps in the recording of the administration. This needs to be addressed so that records are complete and up to date. All the bathing facilities in the home need to be in working order to allow residents some choice of bath or shower and of location in the home so repairs must be dealt with promptly. The home continues to encourage members of staff to undertake NVQ training and due toa turnover of staff there are now some new members of staff working in Tanfield House that have recently started their NVQ level 2 training. In order to build on the core of qualified members of staff the new members of staff need to complete their training. CARE HOME ADULTS 18-65 Tanfield House 80 Randall Avenue Neasden London NW2 7SS Lead Inspector Julie Schofield Key Unannounced Inspection 14th August 2008 10:05 Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 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 Tanfield House DS0000036103.V367073.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 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. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tanfield House Address 80 Randall Avenue Neasden London NW2 7SS 020 8452 6616 020 8830 5826 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 Lucille Rabor Amanda Rabor Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 5 15th August 2007 Date of last inspection Brief Description of the Service: Tanfield House (80 Randall Ave) is situated on the corner of Randall Avenue and Tanfield Avenue and is close to the shops in Neasden. Tanfield Avenue is on a bus route and it is relatively close to the North Circular Road. The nearest underground station is Neasden. It is a large semi-detached house with a small garden at the front of the house and a garden at the rear of the property. The garage at the side of the house has been converted into an office for the nursing agency that is also operated by the company. There is parking space available on the street outside the house. The home is registered for 5 adults with mental health problems and there are bedrooms on both the ground and first floor with bathing and toilet facilities on both floors. Communal space is situated on the ground floor and consists of a lounge and a separate open plan kitchen /dining area. There is a small office/sleeping in facility on the first floor and an office on the ground floor. At the time of the inspection there was 1 vacancy. The registered manager of Tanfield House is also the registered manager of Jude House, which is another care home owned by the company and situated in Randall Avenue. Details of the fees charged may be obtained, on request, from the manager of the home. Fees reflect the needs of the individual resident. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is a 2 star. This means the people who use this service experience good quality outcomes. The inspection took place on a Thursday in August. The visit started at 10.05 am and finished at 6.00 pm. During the inspection we spoke with the registered manager, the general manager and with members of staff. We also met and spoke with one of the residents. Records were examined and the care of residents was case tracked, a tour of the building took place and compliance with the statutory requirements identified during the previous key inspection in August 2007 was checked. We sent survey forms to residents, members of staff, health care professionals and stakeholders and at the time of writing the report we had received replies from 3 residents, 1 care manager and 1 member of staff. We would like to thank everyone for their assistance and for their comments during the inspection. We have also received the Annual Quality Assurance Assessment (AQAA) that the CSCI sends to services for the service to complete. The information contained in the AQAA has also been used to inform this inspection. What the service does well: Information is given to each resident in the form of a pack that includes their daily plan of care, the statement of purpose, a care plan summary, an activities profile, information about their medication and general information about the local community. The current residents are African and African Caribbean men and the staff team reflects the gender and culture of the residents. The food prepared in the home meets the dietary, religious and cultural needs of residents. Residents have access to activities and classes arranged by the African Caribbean Resource Centre. A care manager commented on the survey form that the home provided “a comfortable environment for the residents”, “treated them as individuals and encouraged independence” and that there was a good channel of communication. They also said that the home “provides a safe environment in which to grow as an individual”. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 6 Both members of staff and residents said that the managers are very supportive and “good on a personal basis”. What has improved since the last inspection? What they could do better: Although medication had been given to a resident there were gaps in the recording of the administration. This needs to be addressed so that records are complete and up to date. All the bathing facilities in the home need to be in working order to allow residents some choice of bath or shower and of location in the home so repairs must be dealt with promptly. The home continues to encourage members of staff to undertake NVQ training and due to Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 7 a turnover of staff there are now some new members of staff working in Tanfield House that have recently started their NVQ level 2 training. In order to build on the core of qualified members of staff the new members of staff need to complete their training. 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. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 8 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 Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2,4 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment of the needs of the resident, prior to admission to the home, enables the home to determine whether a service tailored to the individual needs of the resident can be provided. A programme of preadmission visits to the home enables the prospective resident to sample life in the home and to decide whether the service provided is acceptable. EVIDENCE: We looked at the case file of a resident that had been admitted to the home since the last key inspection in August 2007. There was a wealth of information that had been provided to the care home, prior to the admission of the resident. The manager said that this information had been requested as part of the admission procedure. The information included a comprehensive assessment of need completed by the resident’s social worker, including a risk assessment. There was also a copy of the report prepared for the Mental Health Tribunal, a CPA care plan, a discharge summary and an Assessment of Risk form. Any restrictions on choice, freedom, services or facilities were clearly identified and recorded. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 10 An assessment of the needs of the prospective resident had also been undertaken by the manager and was contained in the resident’s portfolio. There was evidence that the care plan developed by the home, with the involvement of the resident, is based on the assessment of need. An integral part of the pre-admission process is a programme of visits to the home, by the prospective resident. There was a record of these visits on the case file and included information about the content of the visits. This addressed a statutory requirement made during the previous key inspection. Observations made by members of staff were recorded, any comments made by current residents were noted and comments made by the prospective resident were also included in the records. The record of each visit concluded with an assessment of the outcome of the visit. We saw that on the first visit the social worker and a member of staff from the hospital accompanied the prospective resident. It was recorded that the prospective resident commented that the home was quite nice and central to most amenities. At the end of the process the manager completes a Potential Client Pre-Admission Assessment and she had recorded that a number of satisfactory visits had taken place and that she would confirm, with the funding authority, that the home could meet the needs of the prospective resident. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Comprehensive care plans have been drawn up for each resident so that the service provided can meet the individual needs of the resident. The home is able to demonstrate that changes in the needs of residents are identified and addressed through a system of regular review meetings. The resident’s right to make decisions about their life in the home is respected. Responsible risk taking contributes towards the resident leading an independent lifestyle. EVIDENCE: Three case files were examined. It was noted that each contained a care plan that focuses on the mental health problems of the resident. There were also care plans covering personal care needs and general health needs. Monthly evaluations are carried out and it was noted that these were up to date. There Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 12 were also daily plans for support worker in respect of the care and support needed by the resident. There was evidence that regular CPA meetings took place. There were also regular review meetings convened by the home and placement reviews by the funding authority. A member of staff ticked that they were “always” given up to date information about the needs of the people they supported, when they completed the survey form. A care manager completing a survey form about the service given to their client said that the home “always liaises with the mental health team and attends the CPA and medical reviews”. None of the residents receive support from advocacy services although they may receive assistance and support from a member of their family. No one from the company is an appointee for any resident as each resident has control over their finances. However, the home will help a resident if the resident is having problems with their benefits etc and they will help them with budgeting. Records are kept of these transactions and were available for inspection. Each of the 3 residents that completed the survey form agreed that they could do what they wanted during the day, the evening and at the weekend. Two of the 3 residents ticked that they “always” made decisions about what they did each day and 1 resident ticked “sometimes”. However, one resident added that they would like to be kept informed if repairs in the home were taking longer than first thought. Each file contained risk assessments, tailored to the individual needs of the residents. The hazard was stated, identified risks listed, a risk rating was awarded and the action to be taken was specified. Risk assessments covered areas including provision of keys to the bedroom door and front door, noncompliance, budgeting, restlessness and smoking in the bedroom. Risk assessments were subject to regular evaluations, which were up to date. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Using community resources gives residents the opportunity to enjoy an interesting and purposeful lifestyle. With staff support, residents are encouraged to maintain contact with their families and to enjoy fulfilling relationships. Residents are encouraged to make decisions and their wishes are respected. Residents are offered a varied and wholesome diet, which meets their religious, dietary and cultural needs. EVIDENCE: We spoke with the manager about the daily routines of residents. One of the residents follows their own lifestyle and spends a lot of this time in the community. Although another resident also follows their own lifestyle, due to a visual impairment, they prefer to spend time in the home. Residents are Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 14 encouraged to keep regular hours and to get some exercise by going out to do their personal shopping etc. Residents choose whether they want to attend drop in centres. One of the other residents attends a counselling session and the fourth resident attends the African Caribbean Resource Centre and has joined the English and the Maths sessions. An OT runs group and 1:1 sessions in the home and in the community for residents on 2 days per week. Sessions include working with computers, arts and crafts, cookery, shopping and outings. Residents recently received Certificates of Achievement during an Open Day held in one of the other Randall Care Homes. The certificate included a section where the resident had previously summarised their achievements since living in Tanfield House and there was a section that the managers completed where their views of the achievements of residents were summarised. Residents are encouraged to use community resources and facilities so that they don’t become insular. All of the residents travel independently in the community and use public transport, taxis or they walk to where they are going. They use shops, post offices, cinemas, leisure centres, the library, the mosque or the church, restaurants and pubs. The names of residents are entered on the electoral roll and they vote if they wish, either in person or by using a postal ballot. Residents have the opportunity to take part in activities outside the home and outings. A cinema trip is arranged every 2 weeks for residents living in all of the Randall Care Homes and the manager said that sometimes 1 or 2 residents from Tanfield House take part. Trips have also been made to the bowling alley. There is a walking group that leaves the Randall Care Homes on 3 days of the week and residents are welcome to take part. After asking residents where they would like to go an outing to Brighton had been arranged for the day after the inspection. However, none of the residents from Tanfield House wanted to go. A week’s holiday has been organised for September and the residents have chosen the venue but again no one from Tanfield House agreed to go. Within the home residents are able to choose whether they want to socialise with other residents or whether they want to take part in any activities. Residents do sit together and talk with each other. They also watch television in the lounge or they can watch television or listen to music in their rooms. There are board games and cards if they wish to use these. Residents are encouraged to maintain contact with their family and a resident that we spoke with said that members of his family visited him on a regular basis. Residents can entertain residents in their rooms or in the lounge areas. One resident goes to stay with his family for overnight stays. Relatives are invited to social events and to parties. A recent example of this was the Open Day that the company held in the garden of one of their other care homes. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 15 Residents are encouraged to take part in the domestic routines in the home and each resident is expected to keep their own room clean and tidy and to do their laundry. Some of the residents will help with the preparation of a meal, after encouragement and motivation by the members of staff on duty. A resident that is partially sighted and enjoys making a cooked breakfast, does so under supervision. The home has a no smoking policy within the building and it was noted that residents observed this and went into the garden when they wished to smoke. We saw that residents were able to decide whether to socialise with other residents, whether to spend time in their room, what to wear, what to eat, when to go to bed and when to get up in the morning etc. We saw that the home has a 5-week rolling programme of menus. These were varied and included African Caribbean foods. There was also a separate menu for a vegan resident. The home provides meals for a resident who is diabetic. The home encourages a programme of healthy eating and is introducing a lot of fresh vegetables. The meals for each of the Randall Care Homes is cooked in one of the care homes and each of the homes take a turn. Where the meal is cooked is recorded on the staffing rota. Records are kept of the food eaten by each resident. Residents are offered a cooked meal in the evening and a lighter meal at lunchtime and a choice is available. Halal meat is used in the home, as one of the residents is Muslim. Mealtimes are flexible. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Discreet and caring support is given to residents by members of staff so that the privacy and dignity of the resident is respected. The health and well being of residents is promoted through regular health care checks and appointments. Residents’ general health and well being is promoted by members of staff that assist residents to take prescribed medication. Completing the record of the administration would assure residents that the instructions of the resident’s GP and psychiatrist are being followed. Accredited training for members of staff assures residents of the competence of staff in dealing with medication. EVIDENCE: Residents are self -caring and no direct assistance is required with personal care tasks. Sometimes staff may need to prompt a resident so that they maintain a clean and tidy appearance and this is carried out discreetly and with regard to the feelings of the resident. The manager previously said that staff Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 17 iron one of the residents’ clothes, as they are unable to do this for themselves. The staff team consists of male and female members of staff and includes African and African-Caribbean staff. The current residents are African and African-Caribbean men. The home provides each resident with the support of an occupational therapist that visits the home twice a week. The home has a system of key working. A care manager commented on the survey form that all staff members treated their client with privacy and dignity and that they work with him in a manner that takes into account his feelings. There was evidence in the case files that residents received support with their health care needs. Where appropriate, a member of staff is available to accompany a resident that has an outpatient appointment at the hospital. There were records of regular appointments with the psychiatrist, GP, CPN, optician, chiropodist and dentist. There was evidence of access to routine screening e.g. blood tests. Residents have medication reviews. A care manager commented on the survey form that the health care needs of their client were “always” properly monitored and attended to by the home. Medication records were inspected and it was noted that there were 2 gaps in the recording for a resident at 6pm on the 8th August where the member of staff had not initialled that the administration had taken place although the medication had been given. The GP and the psychiatrist are made aware of any resident’s refusal to take medication. Medication is administered from blister packs. The storage of medication was safe. All members of staff administering medication have received accredited training to give them a basic knowledge of how medicines are used and how to recognise and deal with problems in use. A resident that we spoke with acknowledged the importance of taking his medication and said that it stabilised him. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are aware of their right to complain if the care that they receive is not satisfactory. An adult protection policy and protection of vulnerable adults training for staff contribute towards the safety of residents. EVIDENCE: A complaints procedure is in place in the home. A copy is placed in the service user guide and this document is given to each resident, as part of the admission procedure. There is also a copy on the back of the residents’ bedroom doors and on display in the kitchen. The procedure includes contact details for the Commission for Social Care Inspection. The complaints record book was examined and it was noted that a neighbour has made 3 complaints about noise coming from the home, since the last inspection. One of these complaints was also made to the CSCI. The neighbour has raised concerns about noise levels, occurring late at night and in the early hours of the morning. The manager has investigated the complaints and feedback has been given to the complainant. This addressed a statutory requirement identified during the previous inspection. It was noted during the inspection that residents were accustomed to an “open door” policy with the managers and that they were also able to discuss their concerns, at any time, with Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 19 members of staff on duty. Previously residents have confirmed that if there was anything that they were not satisfied with they felt able to speak to someone in the home and mentioned the name of the registered manager and residents completing a survey form repeated this. The home prefers to deal with matters before complaints develop and has a system of meetings, which are recorded, taking place between the resident and manager and/or key worker. There are also residents meetings where concerns can be raised and the minutes of these were available for inspection. Members of staff confirmed that they knew what to do if someone had concerns about the home. A protection of vulnerable adults procedure is in place. This includes a link to the whistle blowing procedure. The manager said that no allegations or incidents have been recorded since the last inspection. There was evidence on the staff files that protection of vulnerable adults training had taken place. A refresher course for members of staff took place in 2008 and certificates of attendance were on the staff files examined. During a discussion with a member of staff he confirmed that he had undertaken training in adult protection procedures and was aware of his duty to report any disclosures of abuse to the manager. The home had a copy of the local authority’s interagency guidelines in the event of abuse. The home has also purchased a training video. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which is comfortably furnished and provides a pleasing environment for residents to relax in and enjoy. Good standards of cleanliness provide residents with hygienic surroundings. EVIDENCE: A partial site inspection took place as residents locked their bedroom doors when they left the home. It was noted that the home was decorated and furnished in a “homely” manner and that some refurbishment had taken place since the last key inspection. We saw that the carpet on the stairs and landing had been replaced. This addressed a statutory requirement identified during the previous inspection. The carpet near the laundry room and in the first floor Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 21 office had also been replaced. There was new flooring in the kitchen. A new fridge, lounge suite and dining table and chairs had been purchased. We saw that there are steps down from the kitchen to the garden and steps down from the 2 ground floor bedrooms into the garden. The home would therefore not be suitable for residents that use a wheelchair or that have certain mobility problems. However, access to the home is suitable for the current residents. A resident told us that one of the showers was not working. The home is generally well maintained and a resident said the house “was in a good position. There are shops nearby and transport”. We noted during the partial site inspection that the areas inspected were clean and tidy and free from any offensive odours. Laundry facilities are located on the ground floor and do not involve carrying laundry through any areas where food is stored, prepared or eaten. The facilities consist of 2 washing machines and a tumble drier. There was evidence in the staff files examined that members of staff have recently received training about infection control procedures. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a service provided by carers that have demonstrated their skills and understanding through the achievement of qualifications. The rota demonstrates that there are sufficient members of staff on duty to support the residents and to meet their needs. Recruitment practices promote and protect the safety and well-being of residents. The training programme enables members of staff to broaden and to develop their knowledge and skills and encourages good working practices. EVIDENCE: A discussion took place with the manager regarding the qualifications of members of staff working at Tanfield House. The general manager that supports the home is and RN. There is an RMN that also supports the home. Both of these members of staff have shifts recorded on the rota. The assistant manager has an NVQ 3 qualification, one carer is currently studying for their NVQ level 3 and 4 of the 5 remaining members of staff are currently studying Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 23 for their NVQ level 2 qualification. A member of staff that was on duty during the inspection confirmed that he was undertaking NVQ level 2 training. Almost half the members of staff recorded on the rota have an NVQ level 2 or level 3 qualification or an equivalent qualification (or higher). When we looked at training records we saw that each of the 3 files examined included evidence that the member of staff had attended a 2-day mental health training course. We saw a copy of the current rota. The hours worked by the manager, on site, were recorded. This addressed a statutory requirement identified during the previous inspection. The staffing levels identified on the rota i.e. 2 members of staff on duty on the early shift and 2 or 3 members of staff on duty on the later shift were sufficient to meet the existing needs of the current residents. A member of staff that completed a survey form ticked that there were “always” enough staff on duty to meet the individual needs of all the people using the service. This addressed a statutory requirement identified during the previous inspection. The manager or an RMN may be counted as part of the shift working in the home. At night there is 1 member of staff on waking night duties. There is also information on the rota about the 24-hour call system for contacting a manager when advice or support is needed. At the bottom of the rota there was a note of the hours worked in other Randall Care Homes, by members of staff working in Tanfield House. This allows managers to monitor the total weekly hours worked by individual members of staff. The staff team reflects the cultural and gender composition of residents. There was evidence that regular staff meetings take place and the minutes of the meeting were available. There was also evidence that the manager followed up non-attendance with the individual members of staff. The home has a recruitment and selection policy and it is linked to their equal opportunities policy. We looked at the staff files of 3 new members of staff. We saw that each file contained a checklist at the front of the file so that required checks and references could be logged. Inside each file there was an application form with a photograph of the member of staff. There was a pova first check, an enhanced CRB disclosure, 2 references and proof of identity (passport details). Where necessary the right to work and to reside in the UK had been checked and copies of documents were on file. Files also contained a job description and a contract. The pova first check and a reference from the most recent employer addressed statutory requirements identified during the previous inspection. Staffing records also included a training profile and this was updated each year. Certificates of achievement or of attendance for training courses were on file. These demonstrated that members of staff received mandatory training that is refreshed on an annual basis e.g. manual handling, food hygiene, infection control, first aid and fire safety training. Members of staff had also recently received training specific to their role e.g. mental health, health and safety, protection of vulnerable adults and medication training. When Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 24 completing a survey form a member of staff agreed that they had received training that is relevant to their role, helps them to understand and meet the individual needs of residents and keeps them up to date with new ways of working. Each of the staff files examined included evidence of completion of an Induction Programme Record. This met the Sector Skills Council’s Common Induction Standards. When asked on the survey form whether the induction covered everything that the member of staff needed to know to do the job when they started the member of staff ticked “mostly”. They added, “ All that they took me through has been very helpful in the course of performing my duties”. A copy of the Training and Development Plan for Tanfield House, from April 2008 to March 2009 was available. It included listing a course of training, deciding who needs this training and within what timescale, who can provide the course, the cost, how the effectiveness of the training is to be evaluated and the progress made. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The registered manager continues to develop her knowledge through further training and this contributes towards understanding the needs of residents and staff. Incorporating information obtained through quality assurance systems into the planning and development of the service ensures that the service continues to meet the needs of the residents. Regular servicing and checking of equipment used in the home ensures that all items are in working order and safe to use. Training in safe working practice topics enables members of staff to safeguard the health, safety and welfare of the residents. EVIDENCE: Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 26 The registered manager has completed her Registered Manager’s Award and has shown evidence of this on a previous inspection. She has also attended Sector Skills Council’s management training. She is currently studying part time for a degree in psychology and said that she has now almost completed the course. As she is also the registered manager of another care home in Randall Ave there is an assistant manager post in each of the 2 care homes to help her with the management role. In addition there is also a post of general manager for the company to support all of the 4 care homes that it operates. Since the last key inspection the manager has undertaken short training courses or training sessions to update her skills and knowledge. These have included training in safeguarding adults, first aid, manual handling, fire safety and infection control. The manager has been described as approachable and one of the residents that completed a survey form commented that he was “grateful that Amanda has taken me under her wing”. We discussed quality assurance systems in place in the home with the manager. She said that residents’ meetings are held on a regular basis and a record is kept of these. This addresses the statutory requirement identified during the previous inspection. In addition to this the other methods of obtaining feedback from the residents about the quality of the service include meetings with the resident’s key worker or with the manager (on a 1-1 basis), during review meetings, on an informal basis with an “open door” policy to the office and by the use of survey forms. When asked for examples of how any feedback has been used to develop the service provided the manager said that residents are now given a copy of their care plan, changes have been made to the menus and the venue for activities outside the home and for outings are chosen by residents. We then looked at opportunities for members of staff to give feedback and the manager said that comments could be given at staff meetings, during supervision, on an informal basis and by the use of survey forms. She gave examples of changes that had been made as a result of feedback including adapting the supervision recording form to include a section for comments from the member of staff and for amending the appraisal form so that it included a self-assessment by the member of staff. Survey forms are also used during the admission process so that the new resident can give their comments and we saw the form completed by the resident that had joined the home since the last key inspection. The comments made were positive. We saw a core survey form that had been completed by a resident and noted that they had not been happy with the décor in their room. The room has now been redecorated. We saw a form that had been completed by a relative of a resident. This contained positive comments. The manager said that the information from all of the forms would be collated at the head office, which is in the office next door to Tanfield House and will be used to inform an action plan. Residents will be informed of the content of the action during residents’ meetings. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 27 We looked at the maintenance and servicing records for the equipment and systems in use in the home. There were valid certificates for the checking/servicing of the fire alarm system, fire extinguishers, portable electrical appliances, the electrical installation and the Landlord’s Gas Safety Record. There were records for the testing of the fire alarms on a weekly basis and for carrying out a fire drill (including an evacuation of the home) on a weekly basis. These were up to date. The Fire Risk Assessment was dated June 2008. There was evidence in the training records that members of staff have received training in safe working practice topics in 2008 i.e. food hygiene, first aid, fire safety, manual handling and infection control procedures. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 28 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 Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 29 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 YA20 Regulation 13(2) Requirement Timescale for action 15/09/08 2 YA24 23(2) 3 YA32 18(1) To assure residents that medication is administered according to the instructions of the GP the records must be up to date and complete. To assure residents of 01/10/08 bathing facilities that they can use the shower that is not in working order needs to be repaired. To assure residents that 01/01/09 the staff team supporting them have the necessary skills, knowledge and understanding required, the members of staff that are currently studying for their NVQ level 2 qualifications must satisfactorily complete their training. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 30 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 YA7 YA14 Good Practice Recommendations That residents are kept informed if repairs taking place in the home are taking longer than first thought. That the staff team continues to encourage residents to take part in activities outside the home or on the outings that are arranged. Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Tanfield House DS0000036103.V367073.R01.S.doc Version 5.2 Page 32 - 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!