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Inspection report

Date of Inspection: 24 May 2011
Date of Publication: 12 July 2011

Overview

Inspection carried out on 24 May 2011

During an inspection in response to concerns

The people that use the service at Tusker house have dementia and therefore not everyone was able to tell us about their experiences. To help us to understand the experiences people have we used our SOFI (Short Observational Framework for Inspection) tool. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences. Some people using the service were able to tell us about their experiences and we also spoke with visitors to the service and other health professionals.

People who regularly visit the service told us that generally they saw people being treated with respect and one person told us that their relative had continued to be able to make their own decisions, for example if they chose not to shave that day this was respected.

Visitors generally commented positively about the approach of the staff and one person said �99% of the staff put that extra bit in and are really friendly� and another said �the activities worker circulates all the time in the lounge giving people a boost�. However, one person commented �Some staff are great, but I have seen others just dumping people down in chairs with no respect�. Some people told us that they had seen people sitting in the lounge for long periods of time without any staff talking to them.

Some people told us they were not happy with how often people that use the service were helped to the toilet. One person said �I am not always sure that people get toileted very often. X is continent but doesn�t know how to ask staff to take them to the toilet. Several times I have come in and X has been soaked up their back. Once I had to ask staff to take them to the toilet to and when they brought them back they went to sit them on the same chair. I had to stop them and clean it myself first� Another person said �I have seen others being taken away [to get changed] and chairs not cleaned and then another person goes and sits in it.� They also said they had needed to point out to staff that someone had been incontinent. However, this was not everyone�s experience and one person told us that they were completely satisfied that their relative was helped to the toilet when needed and as far as they were aware they were helped to have a bath regularly as they always appeared clean. They said �the level of care shown to X has transformed my family�s life� and that there was an �emphasis on normality of life�.

One person told us that they were concerned about the number of falls people using the service had. They said their relative had twice fallen and been injured since being in the home. They felt that they had not been given a satisfactory explanation about how the falls had happened or what would be done to stop it happening again. Another person told us that their relative had fallen in the home, but they were satisfied that the service had told them what action they were going to take to help keep the person safe.

People told us that they had some choices about the care they were provided with. They said they could choose whether they wanted to join in with the social activities in the home and had a choice of drinks throughout the day. However, most people told us that they did not have a choice of meals and one person said ��we have a choice whether to eat it or not��.

People using the service said they thought the home was kept �reasonably clean�. They told us they were happy with their rooms and the facilities available. Visitors to the home, including health professionals, told us that they had noticed an unpleasant odour in the entrance hall.

People told us that they were aware of staff shortages in the home, but said that sometimes staff from the office would come and help people to eat their meals at lunchtime. Visitors told us that they did not feel there were enough staff as they had no time to spend with people to sit and talk with them. One person told us that they had noticed the use of agency staff had increased recently.

One person told us that they thought it was good that the staff had a good grasp of English and so there were no language barriers between them and the people that use the service.