Tytler Gardens Care Home Service 10/13 Tytler Gardens Abbeyhill Edinburgh EH8 8HS Inspected by: (Care Commission Officer) Type of inspection: Alfred Francis Announced Inspection completed on: 23 January 2008 1/7
Service Number Service name CS2003011074 Tytler Gardens Service address 10/13 Tytler Gardens Abbeyhill Edinburgh EH8 8HS Provider Number Provider Name SP2003002599 Community Integrated Care Inspected By Inspection Type Alfred Francis Care Commission Officer Announced Inspection Completed Period since last inspection 23 January 2008 5 months Local Office Address Stuart House Eskmills Musselburgh East Lothian EH21 7PB 0845 600 8335 2/7
Introduction Community Integrated Care (CIC) is a not for profit company formed in 1988. They work in partnership with Health and Local Authorities to provide services to a variety of client groups. Tytler Gardens is a group home registered to provide care to six adults with learning disabilities. The Home is located on the ground floor of a block of flats in a residential area and is appropriately adapted to suit the needs of the residents. The Home, which was opened in 1998, comprises of two self contained flats, with a connecting door, both of which have their own secluded garden area. The Home is located close to local amenities and public transport. The stated aim of the Home is "to offer a homely, happy and relaxed atmosphere". The Home was fully occupied at the time of the Inspection, and was last Inspected by the Care Commission in August 2007. Basis of Report Before the Inspection the service submitted a completed Annual Return as requested by the Care Commission. This service was inspected after a Regulation Support Assessment (RSA) was carried out to determine the intensity of inspection necessary. The RSA is an assessment undertaken by the Care Commission Officer (CCO) which considers: complaints activity, changes in the provision of the service, nature of notifications made to the Care Commission by the service (such as absence of a manager) and action taken upon requirements. The CCO will also have considered how the service responded to situations and issues as part of the RSA. This assessment resulted in this service receiving a low RSA score and so a low intensity inspection was required as a result. The inspection was then based upon the relevant Inspection Focus Areas and follow up on any recommendations and requirements from previous inspections, complaints or other regulatory activity. This was an announced Inspection carried out by Care Commission Officer, (the Officer), Alfie Francis on 23 January 2008. During the Inspection the Officer had detailed discussion with the Manager. The Officer also looked at a range of policies, procedures and records including the following: All the residents' Medication Administration Records (MAR) Visitors Policy Palliative Care Policy Restraint Policy Staff training records. The inspection focus areas for Care Homes for Adults, including those with learning disabilities, for 2007/08 are palliative care, protecting vulnerable people, including Child Protection (for visiting children) restraint and staff development and training. These are 3/7
discussed in the report in relation to the National Care Standards for Care Homes for Adults with Learning Disabilities. The Officer also took into account the Regulation of Care (Scotland) Act 2001 and associated Regulations. Fire Safety Issues The Fire (Scotland) Act 2005 introduced new regulatory arrangements in respect of fire safety, on 1 October 2006. In terms of those arrangements, responsibility for enforcing the statutory provisions in relation to fire safety now lies with the Fire and Rescue service for the area in which a care service is located. Accordingly, the Care Commission will no longer report on matters of fire safety as part of its regulatory function, but, where significant fire safety issues become apparent, will alert the relevant Fire and Rescue service to their existence in order that it may act as it considers appropriate. Further advice on your responsibilities is available at www.infoscotland.com/firelaw. Action taken on requirements in last Inspection Report There were no Requirements arising from the last Inspection. Comments on Self-Evaluation The Manager, who has been in post since September 2007, was aware of the purpose of the Self Evaluation, but had been unable to access the on-line form to complete it as requested by the Care Commission. View of Service Users There were three residents present for a short while before leaving to go out on various planned activities. However, due to the residents limited abilities the Officer was unable to elicit their views of the service. However, the Officer observed that the residents appeared to be well cared for, relaxed and comfortable in their environment. View of Carers There were no carers present at the time of this Inspection. 4/7
Regulations / Principles National Care Standards National Care Standard Number 5: Care Homes for People with Learning Disabilities - Management and Staffing Arrangements Strengths This report does not include comments on all of the elements of this standard, only those relating to previous requirements, recommendations, the IFA s and associated regulations. There was a wide range of policies and procedures in place to give guidance to staff, including restraint. The Manager had obtained copies of the Mental Welfare Commission's guidance on the principles and practice of restraint. The Manager stated that the topic of restraint is included as part of staff's Induction and that the organisation provide annual "refresher" training for all staff thereafter. The service undertook risk assessments in relation to restraint which were recorded and retained in the residents' personal plans. The Manager stated that risk assessments were reviewed every six months or sooner if required. The organisation had an Adult Protection / Abuse Policy which the Manager informed the Officer was under review. The Manager and a Senior Support Worker had attended adult protection training within the last two months and the Manager advised the Officer that it was anticipated that all staff would attend this training. The service had a local visitors policy that included a statement stating that no unaccompanied children were allowed to visit the service. Although staff had little or no direct contact or care responsibilities for children the service had obtained a copy of the Local Authority Child Protection Committee Child Protection Guidelines and staff were aware of and knew how to access this document. The service had a copy of "Making good care better", the national practice statements for general palliative care in adult care homes in Scotland. The Manager stated that the service considered the Home to be "a home for life" and a local Palliative Care Policy had been produced to assist staff to continue to provide care for any resident should their needs change. The Manager advised the Officer that palliative care had been the subject of discussion at a Team Meeting. The Officer was advised by the Manager that CIC had a programme in place to ensure that all care staff had access to SVQ training to enable them to register with the Scottish Social Services Council, and that approximately 70% of staff had obtained SVQ II or SVQ III. The organisation produced an annual training programme which incorporated a range of mandatory statutory topics and appropriately related non-statutory topics. At the last Inspection the service had agreed to ensure that the residents' MAR sheets were amended by the GP and supplying pharmacist to accurately reflect the treatment regime. The Officer reviewed the residents' MAR sheets and found that they accurately reflected the medicines and dosages prescribed. 5/7
Areas for Development The Manager stated that the Home had links with Primary and other Health Care Workers and agreed to liaise with them to devise a protocol for staff to access advice and assistance should a resident develop a life limiting illnesses. Whilst acknowledging that staff had good communication skills, the Manager recognised that there may be the need for further training particularly around the sensitive issues of death and dying. The service did not have a pain assessment tool, but care staff had noted how residents communicated to staff when they were in pain and recorded this in the individual's personal plan. The service may wish to consider sourcing appropriate pain assessment tools specifically for use if staff have to provide palliative care. Progress with these matters will be monitored at the next Inspection. 6/7
Enforcement There has been no enforcement action against this service since the last inspection. Other Information None. Requirements There were no Requirements arising from this Inspection. Recommendations There were no Recommendations arising from this Inspection. Alfred Francis Care Commission Officer 7/7