Care Home: Tavey House

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What the care home does well The home provides residents with good admission procedures and processes. There is a written information available a - Statement of Purpose that is provided to new and existing residents, and confirms a set of care values including privacy and dignity. The Inspector observed staff caring for residents with kindness and care, gently encouraging residents to take their meals and drinks. The Registered Manager told us she has built good relations with local GP practises and District Nurses. Residents health and personal social care needs are well met. Residents are supported to enjoy a good lifestyle; and involve residents in all areas of their life, and actively promote the rights of individuals to make informed choices. A new resident was consulted around the colour scheme they would like in their bedroom. Residents wishes and preferences are listened to and acted upon. The recruitment procedures ensure the delivery of good quality services to residents. Residents and their supporters told us, "They take care of me very well." "They have a nice approach with residents." " Staff are always welcoming." The home is decorated and presented to a high standard with many new furnishings. The home was found to be fresh and clean and provides good standards of hygiene. There is an ongoing maintenance programme which ensure residents live in safe and comfortable surroundings. The Registered Manager is competent to run the home and is knowledgeable and competent in many areas. The views of people who use the service are listened to and valued. The home maintains a good health and safety performance and keeps residents and staff safe. What has improved since the last inspection? Care plans have been updated. Wheelchair footrests are in order and provide for the safety and welfare of the individual. These improvements will help provide better health and personal care for each resident. Staff that have responsibilities for administering medication are receiving accredited medication training. This will protect residents health care needs. Residents needs to be met by care staff being employed in sufficient numbers and appropriate skill mix to work at Tavey House. Residents are supported and protected by the homes recruitment policy and practises; and staff recruitment records are now held in the home for all persons employed. This will ensure residents best interests are safeguarded. There are better procedures for infection control with the use of protective clothing, and good cleaning schedules. What the care home could do better: A residents religion or spiritual needs should be sought and included in the assessment and care planing process. This will ensure a residents needs and preferences are understood and met. All staff to receive an individual training and development assessment and profile. From this, training for each staff member can be planned and delivered. This will ensure residents are cared for by well trained staff. Adult Protection training for care staff remains outstanding since our last visit. However the Registered Manager has undertaken significant adult protection training following on our last visit. Providing adult protection training for care staff will help to prevent residents being harmed or placed at risk of harm. Key inspection report Care homes for older people Name: Address: Tavey House 4 Grove Road Whetstone Leicester Leicestershire LE8 6LN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Helen Abel     Date: 2 2 0 5 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Tavey House 4 Grove Road Whetstone Leicester Leicestershire LE8 6LN 01162848606 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: MARS CARE SERVICES LIMITED care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated can be 12 The registered person may provide the following categories 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: Dementia - Code DE Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Tavey House is a detached property that is set back from Grove Road in Whetstone Road in Leicestershire. The service is for 12 residents over 65 years and over with varying degrees of dementia. There is a stair lift for access to the first floor. There are 8 single rooms and 2 twin rooms. There is one shower with toilet, one single toilet and two en-suites on the ground floor. There is one communal bathroom with toilet and three en-suites on the first floor. All rooms are fitted with washbasin and an emergency call system. Residents are encouraged on admission to bring with them Care Homes for Older People Page 4 of 27 12 12 Over 65 0 0 Brief description of the care home ornaments, pictures and any other items to make them feel at home. Pets are not encouraged. Inspection reports will be placed in the hallway. Fees range from £340 to £410. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was a Key Inspection that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for Older Persons. Helen Abel Link Inspector undertook this visit. The Inspector spent time planning the areas to focus on before the visit took place. This was based upon information gained from reviewing the homes service history the last inspection, received surveys and the homes Annual Quality Assurance Assessment (AQAA). The people living at Tavey House prefer to be called residents. The primary method of inspection used was case tracking that involved selecting three people and reviewing the care that they received through inspection of the written information available on their care plans. Discussions took place with residents, visitors, staff and the Registered Provider and Registered Manager. Care Homes for Older People Page 6 of 27 Our visit was unannounced and took place on Friday 22nd May at 5pm and lasted over three hours. In addition policies and procedures and records in relation to residents, staff recruitment, medication and upkeep of the home were viewed. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: A residents religion or spiritual needs should be sought and included in the assessment and care planing process. This will ensure a residents needs and preferences are understood and met. Care Homes for Older People Page 8 of 27 All staff to receive an individual training and development assessment and profile. From this, training for each staff member can be planned and delivered. This will ensure residents are cared for by well trained staff. Adult Protection training for care staff remains outstanding since our last visit. However the Registered Manager has undertaken significant adult protection training following on our last visit. Providing adult protection training for care staff will help to prevent residents being harmed or placed at risk of harm. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides residents with good admission procedures and processes. Evidence: There is good written information available about Tavey House in the Statement of Purpose. This short document set out the aims and objectives, philosophy of care, services and facilities, terms and conditions of the home. When the document is next updated information should be included around the name, relevant qualifications and experience of the registered provider. The homes admission procedure is clearly outlined in the Statement of Purpose. Potential residents will have their needs assessed before entering the home. This will ensure residents have the best information on which to make an informed choice. The Inspector discussed with managers ensuring residents needs and preferences around their religious needs are understood and met. This should be sought at Care Homes for Older People Page 11 of 27 Evidence: assessment and included in the care plan and delivery of care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health and personal social care needs are well met. Evidence: Residents case tracked care plans were in good order. They set out in detail action which needs to be taken by care staff, to ensure all aspects of an individuals care needs are met. Care plans were found to be agreed to and signed off by residents or their family members. Daily records were clear and detailed the residents daily life. Residents were being regularly weighed and records confirmed their health care was being monitored. All residents have a risk assessment where risks are identified and strategies of dealing with them are planned. Opportunities are given for physical activities where appropriate, and interventions are carried out for residents who are at risk of falling. Access to the following services are arranged when required, specialist nursing, dental, pharmaceutical, chiropody and any other therapeutic services. All residents have access to hearing and sight tests and appropriate aids when required. The Care Homes for Older People Page 13 of 27 Evidence: Registered Manager confirmed the home had built good relations with local GP practises and District Nurses. This ensures residents care needs are well met. One resident was observed as needing extra support whilst using their wheelchair. The Registered Manager had spent considerable time arranging for suitable resources from outside agencies. This had been very well organised and now means the resident will benefit from improved seating, comfort and general well being. A visitor told us, The home tells me about my relatives health. They keep me well informed and will ring me if they need to. The homes philosophy of care is set out in the written information and confirms a set of care values including privacy and dignity. The Inspector observed staff caring for residents with kindness and care, gently encouraging residents to take their meals and drinks. Medication administration were very well organised with many of the staff currently receiving medication training. A staff signature sheet was evident in the medication records to help track staff signatures against medication administered. This ensures safe medication processes and practises. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported to enjoy a good lifestyle; and involve residents in all areas of their life, and actively promote the rights of individuals to make informed choices. Evidence: The Registered Provider and staff team confirmed the many opportunities for residents to exercise their choice in relation to their lifestyle experienced in the home. The Residents Consultation and Discussion book details all the many meeting with residents. Residents have been consulted and given their views on decoration plans for their bedrooms, carpets and paint colours for communal areas, food choices, the purchase of ornaments and small furniture, entertainers, and staff training. The new uniform choice for staff was also raised with residents. A new resident was consulted around the colour scheme they would like in their bedroom. Residents wishes and preferences are listened to and acted upon. Evening tea was being served to residents and staff were observed sensitively and individually supporting residents. Residents had preferences around cups and these were being met. Residents are helped to exercise choice and and control over their Care Homes for Older People Page 15 of 27 Evidence: lifes. A barbecue was being organised for residents and their families and friends. An activity person has been arranged. She attends each Thursday morning and is starting to get to know the residents preferences and capacities. Regular visits from ministers or clergy have been arranged. Residents maintain links with the local community. Fresh products were found to be available with residents being regularly consulted about their choices. Three full meals are served each day. Meals are also catered to mark special occasions and festivals. The menu plan for the week of our visit showed a variety of nutritionally balanced meals. It was noted sandwiches were being served for tea five days of the week. The Inspector suggested providing a more varied tea time where possible. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home welcomes complaints and suggestions. Residents and others say they are happy with the service provided and feel well supported. Evidence: The written information about the home confirms how people can raise a concern or complaint. The complaint procedure is clear and gives the details of the person who will deal with the complaint and about timescales. The complaints procedure is forwarded to a prospective resident and their family upon their admission. Systems are in place to keep records of complaints. Comments received told us, My mum is very well cared for- good. I am getting good support with mental health needs and medication. I am very happy with what the home has done for my dad with the care and attention they give him. I have no complaints. The home has a policy on Adult Protection and Prevention of Abuse. All staff members are aware of these policies and procedures. There has been no recent training in adult protection training for care staff although challenging behaviour training is planned. Staff members are experienced in handling physical or verbal aggression presented by the residents. To ensure residents are further protected adult protection for care staff should be arranged. See Staffing section. Care Homes for Older People Page 17 of 27 Evidence: The home does not hold any monies or valuables on behalf of the resident, although safe storage is available if required. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Tavey house is appropriate for the particular lifestyle and needs of residents and is homely clean, safe and comfortable. Evidence: The home was found to be maintained to a high standard. The communal areas have been particularly improved upon with modern new carpets, lounge furniture, fresh bright decor, potted plants and new lighting in place. Many of the bedrooms have been redecorated with residents always consulted around colour schemes, carpets and curtains. Toilets and bathrooms have been updated and are presented to a good standard. People living in shared bedrooms are provided with a screen privacy and the rooms reflect the chosen decor and personal belongings of both people. The managers confirmed they are still following the planned refurbishment programme for Tavey House. There is an ongoing maintenance programme which ensure residents live in safe and comfortable surroundings. There were secure daily cleaning programmes in place; and clear procedures for staff to follow for the control of infection, using disposable gloves, aprons and good handwashing proecdures. Most areas of the home were viewed and found to be clean Care Homes for Older People Page 19 of 27 Evidence: and fresh and mean residents benefit from living in a clean and hygienic home. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and others have confidence in the staff who care for them. The recruitment procedures ensure the delivery of good quality services to residents. Evidence: Staff recruitment records were sampled and all the required checks were in place before staff start work at the home. Staff received an induction within six weeks of appointment and ongoing regular supervision. Residents are protected by the homes recruitment policies and practises. Some staff training is planned ahead until July 2009 for Dementia Care and Challenging Behaviour. Care staff are progressing National Vocational Qualifications (NVQ) in Care Level 2. The Registered manager has enrolled on the Registered Managers Award with a local college. Residents receive care from appropriately skilled staff. The Inspector discussed with manager drawing up an individual training and development assessment and profile for each staff member. As mentioned earlier in this report, training around Protecting Vulnerable Adults should be arranged for care staff (POVA) and be ongoing. Residents will benefit from being cared for by trained and more competent staff. Following on our visit the Registered Provider agreed suitable training would be arranged. Care Homes for Older People Page 21 of 27 Evidence: Comments received told us, They take care of me very well. They have a nice approach with residents. Staff are always welcoming. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Registered Manager is competent to run the home and is knowledgeable and competent in many areas. The views of people who use the service are listened to and valued. The home maintains a good health and safety performance and keeps residents and staff safe. Evidence: The Registered Manager Mrs Banu Lokat was present for part of our visit. She is a qualified Social Worker with specific mental health training and is fit to be in charge. The Registered Manager is in the process of completing the Registered Managers Award and has undertaken periodic training to update her knowledge, skills and competence, whilst working alongside care staff, and managing the home. The manager and other senior staff are familiar with the conditions and diseases associated with old age. There are clear lines of accountability within the home and the senior management team. The Registered Provider was present throughout our visit and is frequently at Care Homes for Older People Page 23 of 27 Evidence: the home at different times of the day. He also undertakes training around care and spoke enthusiastically of the achievements and future developments at Tavey House. Residents individually and in groups take part in consultation meetings on a regular basis. Residents family, friends and other professionals have the opportunity to write their views in a comments book, which is available on site. The Inspector found a wide range of evidence showing the home listens to residents across all aspects of life at Tavey House. Client satisfaction surveys have been sent out to residents and their supporters and the Registered Provider is currently collecting the feedback. This information should be published and made available to current and prospective residents and their representatives and inform future planning of the service. Health and safety checks are taken seriously and undertake all the required checks to keep residents and staff safe. Information was passed to the Registered Provider around residents holding tablets for cleaning dentures and where these items are kept in the home. The managers will be considering the safety issues. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 18 13 Providing adult protection training for care staff will help to prevent residents being harmed or placed at risk of harm. 02/09/2008 Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 4 Residents should be confident the home they enter will meet their needs. Ensure residents needs and preferences around their religion are understood and met. This should be sought at assessment and included in the care plan. Residents will benefit from trained and competent staff. All staff should have an individual training and development assessment and profile. This should be linked to the aims and objectives of the home. 2 30 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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