Care Home: Tithebarn

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What the care home does well Tithebarn presented with a warm, friendly and homely atmosphere. The manager and staff on duty were attentive to the residents` needs and residents spoken with were complimentary regarding the care and support they receive. The activities organiser had arranged a quiz in the morning and there was musical entertainment in one of the lounges in the afternoon. This was very well attended and the residents confirmed how much they enjoyed it. Examples of comments received from residents are as follows: "Very good home", "The singing is just lovely", "I have been out today with one of the girls, they always take me out each week", "I love the food", "I am more than happy with everything here" and "I could not ask for more." A staff member said that they enjoyed working in the home and that the management team were very supportive. They also said they had received training in areas such as, moving and handling, infection control, food hygiene and first aid. This helps to ensure they work safely and provide good care for the residents. Care staff are given extra responsibilities as part of their development and all staffs` competencies, training needs and care practices are reviewed through supervision meetings. A staff member said, "The management are very good and you can go to them with anything." What the care home could do better: Staff who administer medicines are checked to make sure they can undertake this practice safely. We would recommend a record be kept of the details of this compliance to evidence their skills and knowledge. The policies and procedures for residents` self administration of medicines should be reviewed with the staff, so that they know how to record this practice safely. Staff should receive training regarding Deprivation of Liberty safeguards. This will help to ensure they understand how to deliver care in the least restrictive way or if necessary follow a standard process to protect residents if they are at risk. People`s mental capacity should also be assessed at the point of moving into the home. This helps to ensure that people`s ability to make this judgment is recorded. It also assists with daily care decisions once residing. We would recommend that the manager and staff review this and ensure that such assessments are built into the admission and ongoing assessments. Random inspection report Care homes for older people Name: Address: Tithebarn Moor Lane Crosby Liverpool Merseyside L23 2SH three star excellent service 04/06/2007 The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Claire Lee Date: 0 5 0 5 2 0 1 0 Information about the care home Name of care home: Address: Tithebarn Moor Lane Crosby Liverpool Merseyside L23 2SH 01519243683 01519321917 Telephone number: Fax number: Email address: Provider web address: www.rmbi.org.uk Name of registered provider(s): Name of registered manager (if applicable) Ms Linda Christine Johnson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Royal Masonic Benevolent Institution care home 42 Number of places (if applicable): Under 65 Over 65 42 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category of service only: Care Home with Nursing - Code N To Service Users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 42 Date of last inspection Brief description of the care home Tithebarn Care Home provides care and support for forty two older people who require personal or nursing care. The Royal Masonic Benevolent Society, a registered charity, Care Homes for Older People Page 2 of 10 Brief description of the care home owns Tithebarn. Only people with links to The Masonic Society are eligible to live in the home. These details are available on request in the form of a resident information pack. The manager is Ms Linda Johnson. The home is located near Crosby. The home has its own minibus and company car for residents use. There are four lounges and two dining facilities. One lounge is exclusively for residents who smoke. Residents have access to all areas of the home by stairs or passenger lift and there is a good standard of equipment to assist those who are less independent. A call bell system is fitted in all areas with an alarm facility for the residents. Tithebarn has extensive grounds to the front and rear of the The gardens are well maintained and are accessible for residents. The weekly fee rate for accommdoation is 492.00-528.00 pounds for personal care and 765.00 pounds for nursing care. Care Homes for Older People Page 3 of 10 What we found: The random inspection for Tithebarn was conducted with the homes manager on 5th May 2010 and it lasted approximately four and half hours. The purpose of the inspection was to undertake a review of the service. Tithebarn was rated by us as excellent at the last inspection on 4th June 2007 and there were no requirements made. People accommodated at the home like to be called residents and this term is used in this report as a mark of respect to them. We undertook a site visit as part of the inspection which focused on two outcome areas. These were Health and Personal Care and Complaints and Protection. During the visit three of the residents care files were case tracked (their care files were examined to help ensure staff were providing the care and support they needed). Time was spent meeting with residents and staff to gain their opinions of the overall service. An annual quality assurance assessment (AQAA) was sent to us by the service. The AQAA is a self assessment and a dataset that is filled in once a year by all providers and it is one of the main ways that we get information from providers about how they are meeting outcomes for people using the service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. We have included some of the information from the AQAA in this report and also a number of comments received from the residents and staff at the time of our visit. Outcome Area - Health and Personal Care The AQAA reported that the home, provides a homely environment with high standards of care based on individual need. The AQAA also confirmed that policies and procedures are in place in respect of care planning, respecting the residents values of privacy, dignity, choice and fulfillment and independence. To evidence how this is achieved, we looked at three residents care files. The residents had been admitted since the last key inspection and they showed us that that their care needs had been recorded in sufficient detail. This helps to ensure the staff can provide care and support according to individual need. The care documents also included risk assessments. These identified a risk associated with a care need or daily task and details of how the staff manage them and minimise the risk to the individual. For example, assessing mobility, diet and use of bed rails. Daily evaluation records had been completed by the staff to show the care and support given each day or any change to the care provision. There was good evidence of contact with outside health care professionals, either in the home or externally. District nurses and community matrons visit the residents to provide support and advice, as part of monitoring their health and well being. We were shown new care documents, which are being introduced. The residents and their families are being encouraged to take an active part in recording information. This was seen in respect of one file and there was good detail regarding the residents routine, wishes, choice, strengths and weaknesses. These help to make the new documents very person centred. We discussed with the manager how the care given by the staff was going to be recorded each day, as the documents seem to focus only on recording care if there is a change in respect of daily routine or the care provision. The manager and staff Care Homes for Older People Page 4 of 10 also expressed concerns regarding this and they are providing feedback to senior management about the implementation of the documents. These will be looked at in more detail at the next inspection when they have been introduced in full. The AQAA gave examples of the staff respect information in respect of equality and diversity so that peoples needs are respected by the staff. The care files showed evidence of this in respect of the choices residents make, as they go about their daily lives at the home. We saw plenty of equipment to support people who were frail and needed to spend time in bed. Special nursing beds help to ensure the comfort of the residents and staff were seen to attend to them regularly to monitor their care needs. We looked at the medicine policy and procedure and discussed with the manager how medicines are managed. We were told that all staff receive medicine training and we were shown computerised records of this. The staffs skills and knowledge to give out medicines safely had been checked, however there was no record to show us how this is carried out. We looked at number of medicine charts and there were good recording systems in place to show us that the residents had received their medicines correctly. This included their receipt into the building, storage and disposal. A staff member gave a good account of how medicines are ordered each month and also returned when needed. Reviews had also taken place to help ensure the medicines were being given safely to people. Residents can look after their medicines if they so wish. We looked at the management of two residents who had chosen to undertake this practice. One of the care plans lacked detail as to the support needed, however further information was added at the time of the site visit to rectify this. Risk assessments had been completed with the residents to help ensure the residents were able to administer their medicines safely. Advice was given in respect of how to record self administration on the medicine charts, as it was not clear whether staff were giving or observing a resident take their medication. Outcome Area - Complaints and Protection The AQAA reported, we have a clear complaints policy/procedure, which is given to clients (residents) prior to admission. We looked at these documents and also the complaint log. This showed complaints received, their subsequent investigation and outcome. These was sufficient information recorded to evidence this. The AQAA told us that the staff had received three complaints and one had been upheld. Two recent complaints had also been reported through to the appropriate safeguarding authorities, as they involved alleged theft of money. We were advised of these incidents as part of their respective investigations. A copy of the local authoritys safeguarding adults procedures was in place together with an abuse policy and whistle blowing statement. We saw evidence of staff attending safeguarding alerts training. This and the policies help to ensure the ongoing protection of people at the home. We saw information about the Deprivation of Liberty Safeguards, which have been introduced under the Mental Capacity Act 2005. These are to help protect people who Care Homes for Older People Page 5 of 10 cannot make their own decisions about their care home or treatment, because they do not have the capacity to do so. The manager has not been required to make any referrals using these safeguards. Staff have not received any training as yet about this or how to include and record it through the assessment process when residents are admitted. What the care home does well: What they could do better: 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 set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 9 Staff who administer medicines are checked to make sure they can undertake this practice safely. We would recommend a record be kept of the details of this compliance to evidence their skills and knowledge. The policies and procedures for residents self administration are reviewed with the staff, so that they know how to record this practice safely. 2 18 Staff should receive training regarding Deprivation of Liberty safeguards. This will help to ensure they understand how to deliver care in the least restrictive way or if necessary follow a standard process to protect residents if they are at risk. Peoples mental capacity should also be assessed at the point of moving into the home. This helps to ensure that peoples ability to make this judgment is recorded. It also assists with daily care decisions once residing. We would recommend that the manager and staff review this and ensure that such assessments are built into the admission Care Homes for Older People Page 8 of 10 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 and ongoing assessments. Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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