Inspection on 28/02/06 for Appletree Care Home

This inspection was carried out on 28th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

Other inspections for this house

Appletree Care Home 31/07/06

Appletree Care Home 01/12/05

Appletree Care Home 05/11/04

Appletree Care Home 19/07/04

Similar services:

Ann Charlton Lodge

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Appletree Care Home Frederick Street Meadowfield Durham DH7 8RT Lead Inspector Gavin Purdon Unannounced Inspection 28th February 2006 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Appletree Care Home Address Frederick Street Meadowfield Durham DH7 8RT Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 3783152 0191 3789080 Maria Mallaband Care Homes Limited Shannette Isobell Render Care Home 48 Category(ies) of Dementia (17), Old age, not falling within any registration, with number other category (38), Physical disability (15) of places Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Physical Disability: Up to 15 persons with a physical disability (over the age of 55 years) may be accommodated, commensurate with the home`s statement of purpose. Dementia: Up to 17 persons with demnetia (over the age of 60 years) may be accommodated, commensurate with the home`s statement of purpose. 1st December 2005 2. Date of last inspection Brief Description of the Service: Appletree Residential Care Home cares for up to 48 older people. It is one of a number of care homes owned and managed by Maria Malaband Limited. The home is situated just off the A690 Durham to Crook road in the village of Meadowfield and is about 3 miles from Durham City centre. There is a drive of about 50 metres into the home from the public road. Adequate parking space is available outside the home. There is a regular bus service into Durham. The home is a modern two storey building with two passenger lifts for the use of residents. There is an enclosed garden space for the use of residents. All rooms have en suite toilet facilities. Residents are encouraged to bring with them small personal items to make their room as nice as possible. Residents can have their own external telephone line installed should they wish. Six lounges are available for the use of residents (four of which have televisions). A hairdresser visits the home weekly and a separate room is set aside for this. As part of the building there is a separate facility (the Acorn suite) specifically intended for people with dementia. Access to this area is controlled by a keypad on the doors. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home employs an activities coordinator. Unfortunately the coordinator was not available on the day of the inspection. There was evidence of service users being engaged in activities within the home including individual and group activities. One gentleman spoke about getting his newspaper, another lady was busy knitting, and there was evidence of artwork, shopping trips and outside entertainment. The home also facilitates horse riding for those that enjoy this activity. The impression gained is that the home will try anything if they think service users will gain some benefit from it. The manager explained that activities were planned for during the day but evenings tended to be more spontaneous. All 8-service users who completed comment cards indicated that they felt that the home provided suitable activities. From talking to service users and staff and by observing events throughout the day it appears that service users are helped to maintain independence and make choices in their lives. As stated in the previous section, the manager has asked that visitors do not visit the home until after 11am to help maintain service user privacy and dignity. Relatives confirmed that they were able to visit in private. The manager said that once it has been agreed that a service user is to live at the home, the relatives are given a copy of the visitors’ policy. Daily records also show that visitors come to the home and service users make visits to their relatives outside of the home. Some service users are able to manage their own financial affairs. Each service user has a care plan that states who is responsible for managing their finances. Service users or their relatives can be referred to independent advocacy service through their care manager. It is evident from looking around the home and by what some service users have said, that service users are encouraged to personalise their own rooms. Time was spent talking to the cook and looking at the newly fitted kitchen. The cook said that the kitchen had recently had a satisfactory visit from the Environmental Health Officer. The cook has completed the Focus on Food programme, which is a training programme that is supported by a local health nutritionist. The cook spoke about all the special diets they catered for in the home and it was evident that the cook is aware of service user individual likes and dislikes. Menus show a good range of and variety of meals offered and it is pleasing to see that real alternatives are offered each day for example Shepherds Pie or Salmon, tuna and cauliflower bake. A snack menu is also available. Meals are taken in individual dining rooms unless service users request otherwise. Meal times are staggered to allow for the kitchen staff to serve meals on individual units. Staff were observed helping those that needed help and a range of adaptations were seen that enabled service users to eat Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 6 independently. All service users indicated that they liked the food. The dining areas are adequate but uninspiring, however, there is evidence that redecoration and refurbishment is taking place within the home.There is evidence that shows that the home responds to complaints. The home aims to protect service users from abuse. What the service does well: What has improved since the last inspection? What they could do better: The home must improve its recording of fire drills and practice to more clearly show that day staff and night staff are receiving the amount required by the home’s fire safety risk assessment. The home is extending and some refurbishment in the existing home is on temporary hold, to coincide with completion of the extension. All carpeting Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 7 seen in the existing home is clean and undamaged but consideration should be given to replacing those carpets faded by frequent cleaning and heavy use, at a convenient time linked to the completion of the extension. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not assessed on this occasion. EVIDENCE: Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8&9 Residents benefit from having their health care needs carefully planned for, provided for, and recorded. Residents who wish to administer their own medication may do so, subject to a risk assessment confirming this as a safe practice. This strikes the correct balance between the safety and independence of residents. EVIDENCE: The health care needs and health care records of 5 individual residents were discussed with the registered manager, and those records seen. These records are well detailed and used to ensure that the needs of residents are known and provided for on an individual basis. The self-medication risk assessments of 2 individual residents were discussed with the registered manager, and those records seen. The use of these records shows that the home is committed to treating residents as individuals and to supporting residents’ choice as far as they can safely do so. The home makes every effort to gather and use information for the benefit of its individual residents. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Residents enjoy good food in pleasant surroundings. EVIDENCE: The registered manager, 3 of the home’s residents, 1 of the home’s cooks, and 1 of the care staff all thought of food as one of the home’s strong points. “ The food looks nice and tastes nice ” “ The dining room’s very pleasant ” “ I like the food. I eat everything here. It’s all good stuff. Egg and bacon butties for breakfast. I like that.” “ You can have a choice.” The manager, a cook, and a carer, all commented on the need to ensure resident satisfaction, but also good nutrition, and good records of food intake for residents where appetite and eating habits need careful monitoring. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Residents benefit from the home having an active interest in knowing what people think about the care it provides, and also from the home’s interest in working openly and collaboratively with others for the good of its residents. EVIDENCE: The manager pointed out that the home has no history of serious complaint, and does actively seek views from other people about how they think the home is doing. Residents and staff said they felt comfortable about raising any concerns with staff or management. “If you are worried you have someone to talk to here.” “ If you are not happy you can see any of the staff about that, or speak to the boss.” “You can talk to the manager here. The manager’s supportive, willing to help, and approachable.” In the course of the inspection there was an opportunity to see how positively the manager and the home worked with a relative and with a visiting health care worker. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Residents benefit from living in a home that is purpose built to provide general ease of use and access. Residents also benefit from professional assessment of individual equipment requirements to support their comfort and independence. EVIDENCE: During the inspection the registered manager pointed out various useful features of the home, such as ramps, wide corridors, wide doors, and large bedrooms. The manager was also able to show how individual residents’ needs were provided for by involving an occupational therapist, and assessing individual needs for personal items such as large cups and plate guards to allow residents to eat as independently as possible. Residents spoken to, some of them wheelchair users, were happy with the accommodation and facilities in the home. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 14 Standard 19 was not assessed in full, but it was noted that the layout of the home seemed generally well suited to its purpose and well cared for. The home is extending and some refurbishment in the existing home is on temporary hold, to coincide with completion of the extension. All carpeting seen in the existing home is clean and undamaged but consideration should be given to replacing those faded by frequent cleaning and heavy use at a convenient time linked to the completion of the extension. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Residents have the benefit of being cared for by a substantial workforce, with a good level of expertise. Residents have the benefit of being cared for by a staff group whose qualifications exceed the national minimum standard. The home has robust staff recruitment policies and practices that protect its residents. Residents are safely cared for by staff with a good standard of basic and advanced training, provided on an organised basis, and in line with national minimum standards. EVIDENCE: The registered manager’s view was that staffing arrangements met the needs of the 39 residents being cared for in the home on the day of the inspection, up to 30 of whom were of medium to high dependency. The overall team on the day of inspection was made up of management, senior care, care staff, catering staff, laundry and maintenance staff, and an activities coordinator. Staff spoken with, including care, catering, and maintenance, thought the team worked well together for the benefit of residents. Approximately 75 of care staff hold the NVQ 2 Qualification in care, which exceeds the 50 expectation of the National Minimum Standard. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 16 The selection and recruitment records and general personnel file of a recent member of staff were looked at, and these were in line with the National Minimum Standards and Regulations. The registered manager outlined the additional programme of staff training for carers and senior carers, as well as the NVQ 2 and NVQ 3 training completed or in progress. Staff spoken to were interested in their training and thought it benefited them and the residents. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Residents and staff benefit from having a manager who is qualified, competent and experienced. Residents benefit from the home trying hard to ensure that their needs are understood and acted on, and that their wishes are known and taken seriously. Money held by the home, for residents, is well recorded and accounted for, and safely kept. Generally the health safety and welfare of people in Appletree Care Home is planned and provided for in a proper manner. EVIDENCE: The home’s registered manager has just completed the Registered Managers Award qualification, and is waiting for verification of the award. Staff and residents spoke very highly of the manager, who thought her very Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 18 approachable and a reliable source of advice and support. The manager’s contribution to the inspection was enthusiastic, positive, and professional. The home’s interest in gathering views and taking note of them helps ensure that its residents needs and wishes are understood. The home’s formal questionnaire arrangements, meetings, informal discussions, and supervisory checks all support good care, openness, and accountability. Positive comments made by management, residents, and staff showed a definite interest in making sure a good quality service is provided that people are happy with. The check made of the money being held for a resident by the home showed a full and accurate record was being kept, with details of purchases, receipts and signatures provided. The manager, and handyman, outlined arrangements for safety, servicing, repair, and maintenance in the home, and records relating to these activities were seen. Matters are dealt with on a formal planned basis, and as the need arises. Although fire drill and training records are kept, it was not clear from that record whether night staff and day staff had attended the number required by the home’s fire safety risk assessment. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 4 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X 3 X X X X STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP38 Regulation 23(4)e Requirement Although fire drills and training are provided, and records kept, it must be clear from that record whether night staff and day staff have attended the number required by the home’s fire risk assessment. Timescale for action 24/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations The home is extending and some refurbishment in the existing home is on temporary hold, to coincide with completion of the extension. All carpeting seen in the existing home is clean and undamaged but consideration should be given to replacing those faded by frequent cleaning and heavy use at a convenient time linked to the completion of the extension. Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Appletree Care Home DS0000061010.V287093.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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