Care Home: Tealbeck House

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What the care home does well The home provides good care for people and supports them to maintain their independence. There is good information available about the home. Staff were seen helping people retain their independence in daily tasks. A person living at the home said, "The people who work here are really good". There is a good programme of ongoing training and development. This ensures that all staff have the skills and knowledge they need to carry out their work. People are encouraged to bring personal belongings with them and to make their rooms homely. The home provides people with their own kettles and fridges so that they can have drinks and snacks whenever they want. All the people spoken with said the food at the home was very good. There is a choice at each mealtime. Staff were observed in the dinning rooms at lunchtime assisting people who needed it and being available throughout the lunchtime period. This statement was made by the expert by experience "All social aspects i.e. visits to the town or church were within easy access, games, organised by staff were held during the morning i.e. a light quiz and a word game- making as many words as possible from one long word. These are normal daily stimulations in all daily newspapers, and I was pleased that these took place whilst I was there, because morning time is the best time for stimulating the brain during the ageing process". A small hairdressing department is available for appointments. Even own mobile hairdressers can be booked. A bar is opened at lunchtimes and the evenings. A glass of wine can be ordered with lunch. People from the sheltered housing accommodation adjacent to the House can also come in and enjoy a drink. The expert by experience said "If all legislative paperwork is correct, and the price comes down a bit, (but in relation to other homes the price is right) I`ll book my place now". What has improved since the last inspection? Care plans are now in place for those people who are at risk of developing pressure sores and for those people who have diabetes. The day-to-day activities for people living in the home have improved. People can now access a range of activities on a regular basis. Staff now makes sure that those people at risk of falling are identified and a falls assessment is completed at the point of admission and updated. What the care home could do better: The organisation should find ways to reduce the number of agency staff at Tealbeck House, comments such as "I don`t know who is who" "they keep changing" came from people living in the home. This would enable people living in the home to have more constancy. More training is required to make sure staff understand and are more comfortable in putting information in peoples care plan. This would ensure people are safe at all times. CARE HOMES FOR OLDER PEOPLE Tealbeck House Tealbeck Approach, Crow Lane Otley Leeds West Yorkshire LS21 1RJ Lead Inspector Hebrew Rawlins Key Unannounced Inspection 14th November 2007 08:35 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Tealbeck House DS0000001514.V354988.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tealbeck House Address Tealbeck Approach, Crow Lane Otley Leeds West Yorkshire LS21 1RJ 01943 850821 01943 461 018 barbara.thomson@anchor.org.uk sharon.blackwell@anchor.org.uk Anchor Trust 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 Barbara Thomson Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Tealbeck House provides personal care, without nursing, for 50 people in a purpose built two-storey building, on the outskirts of Otley town centre. The home is centrally situated within a sheltered housing complex, and although this complex is not part of Anchor Trust, some of the tenants occasionally visit the home to make use of facilities such as the bar. Accommodation for people is in single rooms, which have a fridge, kettle, toaster and all are well stocked with tea, coffee, milk, snacks, bread, butter pats, marmalades, jams, and cereals. Some rooms have en-suite facilities. There is a lift giving access to the second floor. Communal accommodation includes an attractive dining room, 1 large and 1 small lounge, and a conservatory. The home is within walking distance of Otley town centre, and public transport to Leeds, Skipton, Harrogate and Ilkley is within easy reach of the home. The weekly fees range from £525.00 to £595.00. This was given on the day of the inspection. Additional charges are made for hairdressing, private chiropody and newspapers Copies of previous inspection reports are available in the home. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. Information about the inspection process can be found on our website www.csci.org.uk This visit was unannounced and carried out by one inspector who was at the home from 8.35 until 16.30 on 14th November 2007. The inspector was accompanied on the day by an “expert by experience” from the organisation Choices and Rights. An “expert by experience” is a person who, because of their shared experience of using services, is able to help us get a better picture of what it is actually like for people using services. The “expert” who came during the visit looked around the home, had lunch and spoke to some of the people living there. The feedback she gave us has been incorporated into this report. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who use the service and in accordance with requirements. Before the inspection accumulated evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the inspection visit. During the visit a number of documents were looked at and areas of the home used by the people living there were visited. A good proportion of time was spent talking with the people who live at the home as well as with the manager and staff. The manager had completed an Annual Quality Assurance Assessment (AQAA) before the visit to provide additional information about the home. Survey forms were sent out to the people who use the service, relatives, carers, general practitioners (GPs) and other healthcare professionals. Several were returned and information provided in this way will be reflected in the report. Feedback at the end of this inspection was given to the manager. Thanks are extended to everyone who contributed to the inspection and for the hospitality during the visit. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Care plans are now in place for those people who are at risk of developing pressure sores and for those people who have diabetes. The day-to-day activities for people living in the home have improved. People can now access a range of activities on a regular basis. Staff now makes sure that those people at risk of falling are identified and a falls assessment is completed at the point of admission and updated. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 and 6. People who use the service experience good quality outcomes in this area. The information provided about the service is good and gives people that are considering using the service the opportunity to decide whether or not the home can meet their needs. The assessment procedure is thorough and people can be sure that the home will not offer to provide a service unless the staff are able to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose provides good information about the service, which helps people decide whether or not the home can meet their needs. The people living in the home and their relatives have been consulted and contributed to the assessment. Two visitors spoken to said they had spoken to Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 10 other relatives and had received good feedback about the home. They also said they visited the home before making a choice. Records sampled showed assessment details with sufficient information about the person’s needs and strengths in all aspects of their care to form the basis of a care plan. The expert by experience said “Four people I spoke to chose specifically to come to Tealbeck House, either because they had visited someone else there before or because of strong recommendations”. All the people in the home have a contract with the organisation that outlines all the terms and conditions. The home does not provide intermediate care, so standard six does not apply. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. People who use the service experience good quality outcomes in this area. Staff are aware of the specific needs of people living in the home. Their privacy and dignity is respected. People’s health care needs are met, and medication practices are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six care plans were looked at. The manager has introduced a new service user plan for people living in the home. The recording of information to assist staff care for the people living in the home was fairly good. However staff should have more in depth training on assessment and people’s changing needs must always be documented and followed through. When a care need had been identified there was not clear instruction to staff on how to manage the change. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 12 People’s care plans are reviewed regularly. There was evidence of signatures by people agreeing to their plans of care and end of life documentation is within the care plans to ensure fulfilment of individual wishes. From discussion with staff it was clear that they knew the precise needs of the people living in the home and provided care based on individual needs and preferences. The home has a comprehensive medication policy that covers all aspects of recording and administering medication. Medication is stored in a safe environment. During conversations with relatives they said they had no concerns about the health care needs of relatives, and that the home responded to any changes in their relatives condition. Records sampled showed that people living in the home have chiropody and optical treatment. The expert by experience said “I found the level of care pretty high and on a par of excellence in specific standards”. From discussions with people during the inspection and from their returned survey cards it is clear that they feel that their dignity and privacy is respected. People living in the home looked well cared for. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use the service experience good quality outcomes in this area. The home has a relaxed and informal atmosphere that promotes flexibility and visitors are made to feel welcome. People are encouraged to take part in social and leisure activities. A good and varied diet is provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an activity plan showing varied and regular activity. There is something on offer each day. Activities include arts and crafts, board games, quizzes and sing-a-long. The local library provides a 2 weekly delivery and change over of library books in large print as well as talking books. People are encouraged to maintain their links with the local community by attending churches or a forum at the local civic centre. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 14 The expert by experience said Tealbeck House has a very welcoming feel about it as soon as you reach reception. Relatives said they are always made welcome and informed of anything that affects their relative. The home has facilities for people to meet with their friends or relatives in private. During the visit people living in the home were occupying themselves by reading newspapers, watching TV, quizzes or chatting with other people in the home and staff. Menus are varied and nutritionally balanced. Menus are developed after consultation with people in the home at meetings or on an individual basis. The cook goes round talking to people living in the home checking if they are happy with the meals. Meals are served in the dining rooms or people may have their meals in their own room. The dining rooms tables are arranged in small group settings that encourages conversation and makes meal times a social occasion. People are offered a choice of meals at every mealtime. All people spoken to said they enjoyed the food. The lunchtime meal seen on the day was attractively presented. The mealtime was relaxed and anyone who needed assistance at meal times was given this discreetly and with courtesy. Drinks were on offer at regular intervals Staff regularly assisted those who were not able to help themselves. A bar is opened at lunchtimes and the evenings. A glass of wine can be ordered with lunch. People from the sheltered housing accommodation adjacent to the House can also come in and enjoy a drink. Food is presented in restaurant style, using tureens for vegetables, and served by carers who provide a high standard of waiting-on. The food is cooked well. People living in the home who are able to look after their own money are encouraged to do so. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. People and their representatives can be confident that their concerns will be listened to and dealt with. The home has the necessary systems in place to make sure that people are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is displayed in the home. The manager said complaints and feedback is actively welcomed, as a mechanism to improve service provision. The home records all complaints they receive. No complaints have been made either to the home or the Commission For Social Care Inspection. The home has a comprehensive policy and procedure on the action staff should take if abuse is suspected or reported. In discussion with staff they all appeared confident in the action to be taken. Protection of vulnerable adult training for staff has taken place and new staff receive training within their induction period. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 16 Advice is available from a care specialist team, a use of restraint policy is in place and confidential information is kept securely. Relatives spoken with said information on how to make a complaint was included in the introductory welcome pack and people spoken with said they know how to make a complaint. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23,24,25 and 26. People who use the service experience good quality outcomes in this area. People live in a homely environment that is clean, comfortable, and generally well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is welcoming and provides a homely atmosphere. Fresh flowers are provided weekly in the reception area and also on the dining tables. Some baths have been replaced with Jacuzzi spa type baths and bathrooms are decorated to a high standard. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 18 All bedrooms seen were tastefully decorated and have en-suites facilities. Each room has a fridge; kettle and toaster for people living there or their families to make drinks or snacks as and when required. People’s laundry is washed separately and returned within 24 hours. All the people living in the home and relatives spoken with said the home was always clean and free from offensive odours. Gloves, aprons and alcohol gel is provided and used by all staff and infection control procedures and policy are in place. The home has a 10-year maintenance programme in place to ensure continuous improvement. The expert by experience said, “Cosmetically the home is decorated relatively modern”. “However, I was very pleased to hear that when redecoration takes place, that specific colours relative to trigger points in the ageing process of dementia, will be used, along with changing or removing colours of curtains that trigger bouts of dementia, or even epilepsy”. The kitchen was clean and the Department of Environment rate Tealbeck House as 4 stars. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People who use the service experience good quality outcomes in this area. The recruitment practices guarantees that people are suitable to work with older people. This makes it a safe place to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The comments made by people living in the home were very positive about the staff and they complimented their care and kindness in meeting their personal needs. The expert by experience said “Although “Agency staff” were used frequently, this did not detract from the pleasurable atmosphere created by top class management and cascading down influencing everyone”. When the people living in the home were asked about the number of agency staff used by the home, comments back were “I don’t know who is who” “they keep changing” came from people living in the home. The organisation should try to find a way of addressing this problem. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 20 The manager confirmed that CRB/POVA Criminal Record Bureau/Protection of Vulnerable Adult checks were undertaken before each person started work. There is an ongoing programme of NVQ (National Vocational Qualification) training over 60 of care staff have achieved an NVQ. There was evidence in the training records that staff receive training on person centred care and equality and diversity. The home continues to let us know about things that have happened and to date they have shown that they have managed issues well. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,36,37 and 38. People who use the service experience good quality outcomes in this area. The home is well organised and the manager provides effective leadership. The health and safety of people is promoted and protected. This makes it a safe and good place to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The returned Annual Quality Assurance Assessment showed that servicing of equipment takes place as required and a selection of service certificates were seen, along with the records of fire alarm tests which show a different actuation point is tested each time. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 22 The fire alarms were being tested during our visit and prompted a few jokes, as the equipment reminded everyone of the “Gaslighterman” and the “Knockerupper”. Staff appeared to be always on hand to give assistance. They described the management team as always willing to help and supportive. Accident records were kept in individual files and there is an accident monitoring system in place. Training records show that all staff have received training in health and safety. Staff were observed using correct methods of moving and handling. There is an established system in place for supervision of the staff and the person carrying out supervision has been trained to do so. The format used indicated that personal development; training and goal setting are amongst the topics covered. Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x 3 x 3 3 3 Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 (2) Requirement To make sure that people who manage their own medication are safe to do so, the home must develop a formal system of assessing capacity to self medicate (Raised at the last inspection, previous deadline 01/03/07) Timescale for action 08/01/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations More training is required to make sure staff understand and are more comfortable in putting information in people’s care plan. The organisation should find a way to reduce the number of agency staff used at Tealbeck House so that people who they know can support people living in the home. 2. OP29 Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Tealbeck House DS0000001514.V354988.R01.S.doc Version 5.2 Page 26 - 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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