Latest Inspection
This is the latest available inspection report for this service, carried out on 7th January 2010. it is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Good.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Tinkers Hatch Limited.
Annual service review
Name of Service: Tinkers Hatch Limited The quality rating for this care home is: The rating was made on: two star good service 1 7 1 2 2 0 0 8 A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.
Has this annual service review changed our opinion of the service?
No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: June Davies Date of this annual service review: 1 9 1 1 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service
Address of service: New Pond Hill Cross In Hand East Sussex TN21 0LX 01435863119 01435864062 services@tinkershatch.co.uk Tinkershatch.co.uk Mr Nigel Ashton, Mrs Sarah Brown Telephone number: Fax number: Email address: Provider web address:
Name of registered provider(s): Conditions of registration: Category(ies) : learning disability physical disability Conditions of registration: Number of places (if applicable): Under 65 Over 65 32 4 0 0 The maximum number of service users who can be accommodated is: 32 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability - LD Physical disability - PD Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Tinkers Hatch is situated approximately one mile from Heathfield town centre, where a limited bus service can be accessed. On site accommodation is provided in the main house, which accommodates 24 service users, the cottage which accommodates five, the flat which is for two service users and a unit for one service user. The home is registered to accommodate up to 32 adults with a learning disability four of whom may also have a physical disability and eight of whom may be aged over 65 years of
Annual Service Review Page 2 of 8 No 1 7 1 2 2 0 0 8 age. The basic weekly fee can be obtained by application to the registered manager. Fees cover hotel and staffing costs in house day care and entertainment and contributions towards the cost of an annual holiday. Optional additional services include Counselling, 1-1 massage, sports therapy, Horse riding, College courses, literacy and gym work the costs for which vary and are not included in the fees. Additional care hours can be arranged and costs obtained from application to the registered manager. Copies of the Inspection report is available upon request from the office at the home. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review:
What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how ell outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we have about how the service has managed complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. What other people have told us about the service. What has this told us about the service? The home returned the annual quality assurance assessment (AQAA) when we asked for it. The AQAA provided us with clear and comprehensive information. It provided us with details of what the home does well, what they could do better and plans for improvement within the next twelve months. The homes Statement of Purpose and Service User Guide have been produced in different formats, to help clients understand these documents. Within the next twelve months Tinkers Hatch is hoping to make a short film with permission of present residents, about life in the home, this will give prospective clients more insight into how the home operates, and help them to choose if the home is where they would like to live. All prospective clients are assessed prior to moving into Tinkers Hatch. Further information will be gained from external health, social care professionals and families to ensure that the staff have the knowledge and skills and the environment is suitable to meet that clients assessed needs. Prospective clients will also be offered short overnight stays or an extended period of respite care, use of day services and may wish to attend social activities within the home, so they are able to make an informed choice about the home. All clients in the home are involved with their key worker in developing their individual person centred care plan which will include the clients likes and dislikes and how they wish to be treated. Care plans are also based on the clients pre-admission assessment and other information gained prior to moving into Tinkers Hatch. Risk assessments are also drawn up for each client and are individual to that clients needs and personal, physical and social care. The care plan and risk assessments are reviewed on a weekly Annual Service Review Page 4 of 8 basis and changes made where assessed needs or risk have changed. All care plans and risk assessments are produced in a language or format that clients are able to understand and relate to. Clients in the home have access to a variety of external health specialists, they are able to be present at and take part in their General Practitioner reviews at a level that is appropriate to them. In the last twelve months clients have created their own Health Action Plans which they call Health Passports. These Health Passports incorporate all required knowledge for health checks, hospital stays and visits and have been checked out and used successfully by hospital staff. The home is in the process of working towards further development of communication needs in that they are working closely with East Sussex County Council, Communication Matters Team on Communication Standards, they will be further developing Person Centred Approaches and Total Communication and are hoping to sponsor and trial post for a member of staff to work as a Communication Champion with the Speech and Language Team. The home has also sought opportunities for clients to have increased control of the support they receive and their own participation in activities and daily living. In the next twelve months the registered manager is hoping to work with Key Moves an assessments package so that the clients can increase their skills of independence and have more control for self medication, personal shopping and handling their own finances. At the last Key Inspection in December 2008, the inspection found that many clients were able to access local college courses, activities of their choice in the community, and through the Client Forum they were able to have a say about activities which are offered in-house. The AQAA states that clients are encouraged to participate in learning programmes, a wider variety of communal activities, and more say and choice in regard to in-house activities. The home works with Frameworks 4 Change - My Life My Way Project with helps to create, support and develop individualised life styles. The registered manager is also hoping to improve individual access to the internet and multimedia by purchasing the appropriate hardware and software for the existing computer system in the home. Since the last inspection clients weekend activities choices are also included on their care plan. The registered manager and staff ensure that clients maintain contact with families and friends and are able to develop personal relationships if they wish to.The home has also introduced and advocacy service for clients. Staff have the skills and knowledge to ensure that clients are treated with respect at all times and that their rights to dignity and privacy are upheld. All clients are provided with three meals a day, with snacks and beverages available between meals. The menu offers clients a choice of well balanced and nutritious meals, as well as catering for specialised diets as and when required. Clients in Tinkers Hatch are able to say how they wish to receive personal support, and are given choice around daily routines. Where necessary the home ensures individual clients obtain the aids and equipment they require to maximise their independence. The registered manager and staff have good working relationships with external health care professionals to ensure the individual needs of clients are met. Medication is well managed in the home. All staff who administer medication receive the appropriate training and are closely monitored. There are both internal and external audits for staff who administer medication. The home has also worked to improve medication handling when clients are away from the home to ensure clients are not placed at risk. Care plans contain clear guidelines in regard to PRN (as required) medication and this is regularly updated and countersigned by health care professionals Annual Service Review Page 5 of 8 The complaints policy and procedure is produced in a variety of formats as a result of clients forum meetings, so that a greater number of clients in the home have an understanding of how to make a complaint should they need to. Information given in the AQAA states that the home has had three complaints within the last twelve months, and that these have all been investigated and acted upon within the timescales set out. The home has a policy and procedure in place for safeguarding vulnerable adults, this was reviewed in June 2009. Since the last inspection in information given to Care Quality Commission there have been two safeguarding referrals made to the safeguarding team. One referral has been investigated and closed the second referral has partly been investigated and is awaiting outcomes. The home is hoping to locate training in regards the Mental Capacity Act and Deprivation of Liberty Training for its clients. The registered manager will ensure that Mental Capacity Act practises are followed by staff working in the home. All prospective staff are rigorously vetted prior to being employed by the home. Where clients request that the registered manager looks after their finances this is managed in a clear and transparent manner, with all individual accounts being maintained appropriately. Tinkers Hatch provides its clients with a warm, homely well maintained home for their clients. Clients are encouraged to choose decoration and furnishing both in their own bedrooms and in communal areas throughout the home. The registered manager ensure that suitable aids and equipment are made available for some clients so there independence can be maximised. There is an ongoing decoration and refurbishment plan for the home. In the last twelve months the home has re-sighted downstairs toileting facilities, sourced and acquired high quality furniture within budget constraints, purchased and erected a summerhouse and garden furniture for clients use and to improve clients outside facilities. In the next twelve months there are plans to re-site the office/workshops to increase accommodation areas, to redesign the cottage lounge and kitchen and to investigate the cost of expanding the day centre. Infection control procedures in the home are good, communal toilets and bathrooms are kept in a clean and hygienic condition. All staff adhere to infection control procedures. There are no offensive odours in the home. Staffing levels at the time of this report are appropriate to the assessed need of the clients and are adjusted to meet the clients social and personal care needs and wishes. On each shift there is a good skill mix of staff to meet the different needs of the clients. This was evidenced on the day of the unannounced key inspection in December 2008 where it was observed that clients can approach staff at any time, and that staff used the method of communication chosen by the client. There is an ongoing NVQ qualification programme for staff, to ensure that staff have the qualifications to meet the needs of the clients. The home has a rigorous recruitment structure that ensures all prospective staff are appropriately vetted prior to taking up employment in the home, this helps to protect clients from abuse. All new staff go through a period of induction and in the last twelve months the registered manager has developed the induction course in line with the Learning Disability induction awards and in conjunction with Age Care training to allow the induction course to be accredited to NVQ units via Edexcel. All staff have completed their mandatory training to ensure that clients are kept safe and not placed at risk. Mandatory training is updated to ensure that all staff have the relevant in date training certificates. Staff can also take up the opportunity to develop their hands on skills via a variety of job related training courses. In the next twelve months the home hopes to improve the vetting and barring scheme in the recruitment process, seek opportunities for clients to select staff for activities, and
Annual Service Review Page 6 of 8 attempt to ensure proposed professional registration of social care staff is well managed and reflects gained qualifications and grading. The registered manager has the qualifications, knowledge and skills to manage the home effectively and to respond to changes in client need, regulation and legislation He has been employed at Tinkers Hatch for over twenty years. The home has a clear management structure. The home has a good quality assurance system in place, where the views of clients are gained via client surveys, the clients forum which meets every six weeks. The views of clients are listened to and changes made in accordance with their wishes, for example - changes have been made to the main lounge and communal areas, provision of Wii games, changes to day care timetable to incorporate supporting hobbies and passions with a general theme to work towards. Clients have also become involved in the interviewing and recruitment process. The registered manager has changed the format and model of the annual review system to ensure it incorporates the person centred approach. The above are just a sample of the changes that have been made as a result of listening to the clients in the home. The home has regular fire, health and safety checks and risk assessments carried out on all rooms in Tinkers Hatch. One of the providers carries out regular monthly regulation 26 visits to the home. An annual business and development plan is produced. Health and safety of clients in the home and staff who work in the home is considered to be of high importance. All equipment used in the home has an up to date maintenance certificates, and regular checks are carried out of the fire call points, emergency lighting, and hot water delivery temperatures. The accident book is kept up to date, and where there is concern in regard to a number of accidents for one client the registered manager seeks assistance from the relevant health care or learning disability team. All staff are made aware of health and safety procedures during induction and training. Twelve resident surveys were returned to the Care Quality Commission. All gave positive comments about the home. In the question what the home does well the following comments were made - I like everything, The home helps me and makes me happy, They look after me very well and make sure I am happy, They organise lovely holidays, I enjoy life at Tinkers Hatch, I get on well with staff, Helps me a lot. There was evidence on surveys that clients had consulted their families about how they wished questions to be answered and their views of the home. The surveys also showed that they had been completed by both male and female clients from differing age groups. What are we going to do as a result of this annual service review? There will be no change to the Inspection plan and we will do a Key Inspection by the 19th November 2010. However, we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. Annual Service Review Page 7 of 8 Reader Information
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