Care Home: Tunhill House

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Tunhill House 251 High Greave Sheffield S5 9GS two star good service The quality rating for this care home is: 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Rolt Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. They reflect the things that people have said are important to them: 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 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Tunhill House 251 High Greave Sheffield S5 9GS 01142466891 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Valeo Ltd Name of registered manager (if applicable) Mrs Kerry Jane Jones Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 care home 4 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability Code LD, maximum number of places 4 The maximum number of service users who can be accommodated is: 4 Date of last inspection A bit about the care home Tunhill House is an extended detached house within its own grounds. The home is on the outskirts of Sheffield on the road to Ecclesfield. There is ample car parking to the front and rear of the property. On the ground floor there is a lounge, dining room, kitchen, laundry, bathroom with lavatory and the main office. Bedrooms are accessed by a staircase. All four bedrooms are single occupancy and have en suite bathrooms with shower facilites and lavatories. 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. The attached paragraph is included on all reports. It does not apply to this home at present because it is a newly registered home. However, it is included to inform people of the consequences of noncompliance. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Tunhill House was registered earlier this year. This was its first key inspection and comprised information already received from or about the home and a site visit. The site visit was from 10:00 am to 3:00 pm. The registered manager completed an Annual Quality Assurance Assessment but did not return it by the due date and needed to be prompted for its completion and return. This document gave the manager the opportunity to tell us what the home did well and what they were working on to improve. Various aspects of the service were then checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the building was carried out and service provision was discussed with the registered manager. People living at the home were seen throughout the day and two were chatted to. The care provided was checked against records to determine if individual needs were being met. Questionnaires were sent to the four people living in the home and five members of staff. All were completed and returned. All information, opinions and comments were considered for inclusion in this report. The inspector wishes to thank people living at the home, the staff and the manager for their assistance and cooperation. What the care home does well The home was clean, comfortable and homely. People living in the home were satisfied with the care they received and one person commented that it was the best place that they had lived. Care plans provided up to date and detailed information to ensure that peoples needs were met. There were sufficient staff on duty to meet peoples needs. Staff training was promoted. What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Christine Rolt 33 Greycoat Street London SW1P 2QF 02079792000 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 . People only moved into the home after their needs had been assessed and they had been assured that the home could meet their needs. Evidence: The home had an up to date Statement of Purpose and Service User Guide. Copies of these were on peoples files. Files also contained full needs assessments. The information provided good detail of all aspects of each person’s assessed needs covering physical, emotional, health and social needs. Files also contained people’s preferences, known routines and likes and dislikes. Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 . Peoples’ assessed and changing needs were reflected in their care plans to ensure that their needs and wishes were met within a risk management framework. Evidence: Care plans were checked. They provided detailed information of each person’s physical, health, social and emotional needs and how these were to be met. Also included were detailed risk assessments, personal likes, dislikes and wishes and how these were to be incorporated into the care plan. The manager said that that peoples needs were constantly monitored. Records verified that care plans and risk assessments were reviewed regularly to ensure that needs were being met. Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 . People were able to participate in activities both inside and outside the home. Their rights were respected and choices were offered. Evidence: Each person had an individual timetable. Routines within the home were flexible and choices were offered to people within their defined programmes. There was also evidence throughout the home of people’s preferred leisure activities. Staff knew what each person liked to do and spoke about how these were incorporated into people’s daily routines. Peoples files contained information of activities in the community. Throughout the day of the site visit, people went out into the community. Staff support was provided where considered necessary and there were sufficient staff on duty to achieve this. One person spoke about a planned outing to the Blackpool Illuminations. Peoples comments and their interactions with staff indicated that their rights were respected. All bedrooms were fitted with locks to ensure peoples privacy. Contact with family and friends was encouraged where appropriate. Staff provided help and encouragement where needed for daily living skills such as cleaning, laundry, menu planning, shopping and cooking but independence was promoted. Some people were fairly independent with some aspects of daily living skills and the manager spoke about people cooking their own meals, cleaning and enjoying baking cakes. Evidence: People living in the home said that the meals were good. Care plans contained information of peoples food preferences, dislikes and any food allergies. The main meal of the day was served in the evening. Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 . People received the personal support they preferred and their physical, emotional and heath needs were met. Medication practises ensured that people were protected. Evidence: People received the help and support they needed and there was good information in their care plans of how their physical, emotional, health and social needs and wishes were to be met. Daily records were kept and were signed and dated by the relevant staff members. Peoples medication files contained all the relevant information of health needs, appointments with health professionals and outcomes. Medication was stored correctly. Medication quantities tallied with the Medication Administration Record charts. It was recommended that handwritten entries be countersigned to ensure that the correct information was recorded. Controlled medication was stored and recorded correctly. Medication that needed to be kept cool was stored in a medication refrigerator and daily temperatures were recorded. Staff dealing with medication had undertaken Boots accredited training. According to the manager, all medication was checked at each staff handover to ensure that there were no discrepancies. Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 . People were protected from abuse. The home’s complaint procedure ensured that people and their representatives had the means to complain. Evidence: The home had a complaints policy and procedure. However this was very detailed and wordy. The manager was advised to consider making it more user friendly by making it more concise and to the point. People living in the home had copies of the procedure in an easily understood format with Makaton symbols. All complaints were recorded in the complaints book and this was seen during the site visit. The manager said that all staff had received basic adult protection training and some staff had undertaken further training. The rest of the staff were due to attend this training. There had been one allegation of abuse. The manager had followed the correct procedures and the incident had been thoroughly investigated and was unsubstantiated. 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 was clean, comfortable and safe. Evidence: The home was clean, tidy and well maintained. Furnishings and furniture in both private and communal areas was modern, good quality and domestic in character. Bedrooms were on the first floor, accessed by a stair case. Two bedrooms were seen during the site visit. Both had been personalised. One person living in the home offered the information that they had chosen their bedroom colour. Bedrooms were large and had double beds. All had en-suite bathrooms with lavatories, wash basins, baths and shower facilities. The laundry room was clean and tidy and each person had their own baskets/drawers for their laundry. The kitchen was modern with ample cupboards and work surfaces and there was a separate dining room. The lounge was large enough to accommodate all people living in the home and provided a modern, comfortable environment with quality furnishings and fittings. 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 . Recruitment procedures were robust and staff were trained and competent to provide the relevant support to meet peoples individual and joint needs. Evidence: There were sufficient staff on duty at the time of this inspection to meet peoples needs. Therefore people could follow their individual programmes both in the home and in the community. According to the Annual Quality Assurance Assessment (AQAA), all staff undertook induction training and refresher courses throughout the year. National Vocational Qualifications were promoted. All training and nominations were organised by head office who kept records of each persons training needs. The managers of each home within the company were informed of the training courses and the members of staff nominated to attend. The manager of this home highlighted the names of staff from her home who had been nominated to attend the training and this information was seen during the site visit. Certificates were available on each persons recruitment file. Staff undertook a range of skills training to meet peoples individual needs and this included autism, challenging behaviour, epilepsy and diabetes. See next section re health and safety training. The files for three members of staff were checked. All contained the relevant checks, correspondence and information, which demonstrated that the recruitment procedure was robust. Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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’s quality assurance ensured people’s views were sought and the home was run in the best interests of people living in the home. The health, safety and welfare of people living or working in the home was generally promoted but some improvement could be made. Evidence: The home had a registered manager who had achieved the Registered Managers Award. The home had a Quality Assurance system that incorporated questionnaires, meetings, checks of the environment and audits of most systems within the home. Some of these audits were seen during the site visit. Money held on behalf of people living in the home was stored safely. Personal allowances were checked and cash tallied with the records. The organisations head office arranged mandatory health and safety training courses (i.e. moving and handling, first aid, infection control, fire awareness and basic food hygiene) and people were nominated to attend. The manager said that the head office kept records of each member of staffs training needs and also arranged refresher training. The manager said that she would only need to request training if she was concerned that a member of staff was not performing as well as they should and would benefit from extra training. Certificates for the maintenance and servicing of systems and equipment within the home were available and a sample of these was checked during the site visit and were up to date. However, during a check of the environment Evidence: it was noted that Portable Appliance Test (PAT) checks had not been carried out on some second hand electrical equipment that had been brought into the home. The owner of this equipment was informed that this equipment needed to be checked before being used in the home to prevent unnecessary risks to the health and safety of people living and working in the home. This was also discussed with the manager who was given advice on how this could be done. Are there any outstanding requirements from the last inspection? Yes  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 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 Description 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 Description Timescale for action 1 42 13 16/12/2008 Second hand and used electrical equipment must be checked before use to ensure that it is safe and does not pose any unnecessary risks to the health and safety of people living or working in the home. To protect people living or working in the home from unnecessary risks. 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 20 Handwritten entries on Medical Administration Records sheets should be countersigned to verify that the correct information is recorded. Consider producing a more concise text version of the complaints procedure so that it is easier to read and understand by anyone wishing to make a complaint. 2 22 Helpline: 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 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 © (2008) Commission for Social Care Inspection (CSCI). 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. 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