Inspection on 14/06/05 for Fir Trees

This inspection was carried out on 14th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Fir Trees 17/10/07

Fir Trees 29/08/06

Fir Trees 28/11/05

Fir Trees 12/01/05

Fir Trees 29/06/04

Fir Trees 18/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Fir Trees Gorse Hall Road Dukinfield Tameside SK16 5HN Lead Inspector Janet Ranson Announced 14 & 15 June 2005 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 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. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Fir Trees Address Gorse Hall Road, Dukinfield, SK16 5HN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 338 2977 Tameside Care Limited Anne Robertson Boyd Dobson CRH - Care Home 45 Category(ies) of DE(E) Dementia - over 65 (45) registration, with number OP Old Age (45) of places PD(E) Physical Disability - over 65 (45) Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 45 service users to include: up to 45 service users in the category of DE(E) (Dementia over 65 years of age); up to 45 service users in the category of PD(E) (Physical Disability over 65 years of age); up to 45 service users in the category of OP (Old Age not falling within any other category). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 12th January 2005 Brief Description of the Service: Fir Trees is a large, purpose built home orginally commissioned and managed by the local authority. Tameside Care Limited (a not for profit company), is now the registered provider. The home has been extended and developed over the years to provide care for up to 45 elderly people, some of whom may have dementia or a physical disabilty. A day care unit is also located within the building but is not subject to regulation. Single room accommodation is provided over two floors. Forty one bedrooms also benefit from en-suite facilities. Lounge and dining areas are located on both floors and each dining area has its own domestic kitchen. There are aids and adaptations to meet the assessed needs of the service users in addition to a passenger lift. A landscaped garden is situated in the centre of the building and is fully accessible from the home. Fir Trees is located within a residential area of Dukinfield, close to the market town of Ashton-under-Lyne with all the associated local facilities. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out over one and a half days, a total of 11.25 hours. Fir Trees provides personal care for up to 45 people over 65 years of age. It is owned by Tameside Care Limited, a not for profit organisation. The manager is registered with the Commission for Social Care Inspection and was present throughout the inspection. In addition to teams of carers, the organisation employs domestic, catering and maintenance personnel. The home has recently undergone a total refurbishment with improvements made to the residents’ accommodation and the communal areas. The work has been carried out to a very high standard. Individual case files and care plans of four residents were examined as part of the inspection process. They concerned people who had lived at the home for a long time, were newly admitted and whose needs were changing. Wherever possible, the residents were invited to talk to the inspector regarding their experiences and expectations of the home. Four members of the care staff were interviewed and a resident’s relation assisted the inspector with his comments. Observations of staff practice were also made during the second day. Seven comment cards from relatives were returned to the inspector. Written comments on two of the cards concerned night staffing levels and the facility provided for those residents who smoke. A positive comment noted, “The staff are extremely friendly and welcoming and seem to treat the residents and visitors with the utmost respect.” What the service does well: Fir Trees provides a good standard of care from a well-trained and committed staff team. The environment is well presented and the standard of accommodation meets fully with the residents’ expectations. Recording systems and documentation protect the residents from potential abuse. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: 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. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 8 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 standard(s) 1 & 3 The residents have access to information about the home to assist them to make an informed choice. Systems are in place to ensure the residents’ needs can be fully identified and met by the home. EVIDENCE: A statement of purpose and service user guide were available at the time of the inspection. The manager reported that all prospective residents are offered a copy of the service user guide in order that they can obtain the information to make an informed choice. Copies are also available in the area close to the main entrance. Care needs assessments were contained within the four care files examined as part of the inspection. The home also has a process of assessing potential residents’ needs carried out by a senior member of staff. By completing such an assessment, the home can ascertain individual needs and ensure they can be met. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7, 8, 9 & 10 The residents’ personal care, health and welfare needs are fully documented and reviewed. The residents’ identified health needs are fully met by the various healthcare professionals and by the provision of equipment. The residents are enabled to self medicate wherever possible. The residents are treated with respect and their privacy is maintained at all times. EVIDENCE: Four care plans were examined as part of the inspection process. They clearly set out the residents’ individual care needs. The care plans document the action to be taken by the carers to ensure all aspects of health, personal and social care are met and reviewed. A visitor who spoke with the inspector was aware of the care planning process and felt able to ask for a review of his mother’s care plan. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 10 Where identified, the residents’ health is monitored and addressed by the appropriate health care professionals. The district nurses are involved on a regular basis as are the chiropodist, audiologist and optician. Requirements made at the last inspection concerning the provision of sitting scales have been fully met. This now enables those residents who are nonweight bearing to be weighed at regular intervals. The records of individual weight were detailed on each of the care plans examined. Specialist equipment to prevent pressure sores was in evidence. An external trainer provides regular sessions of armchair aerobics to maintain or improve the residents’ mobility. Four medication administration records were examined and found to be completed in the approved manner. All senior staff responsible for the administration of medication have received the appropriate training. Records are retained to show changes to medications. There is a policy and procedure in place to enable the residents to self medicate where this is considered to be appropriate and subject to an assessment of risk. The inspector observed the staff respecting the residents’ privacy by knocking and waiting before entering the room. At interview the staff clearly demonstrated their understanding of privacy and dignity. A resident was taking a rest on his bed during the afternoon of the inspection. The resident explained this was because he had had a poor night’s sleep. This person stated his accommodation met with his needs. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14 & 15 The choices offered to the residents meet with their requirements and needs and enable them to exercise day-to-day control over their lives. The residents can participate in a programme of daily activities. Visitors are made to feel welcome and remain in contact with their relatives care. The contents of the menu appeared nutritious and well balanced, with a choice provided at each mealtime. The timing of the meals is not flexible and may not meet the residents’ needs. EVIDENCE: The individual care plans documented the resident’s previous lifestyle and social history. At interview the carers clearly demonstrated their knowledge of the residents’ previous experiences and fully understood the importance of this in providing the care package. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 12 At a previous inspection residents complained of a lack of stimulation. At that time, the activities were dependent on the skills and availability of the staff on duty. Activities are now provided each afternoon and the options are clearly displayed on a board in the main lounge. A visiting relative complained about the length of time he had to wait to gain entry to the home after 8:00pm. This was due in part to the night staff assisting residents to bed and not being able to respond immediately to the doorbell. The inspector was advised that the front door, which is open throughout the day, is locked during the evening. The interviewed staff clearly demonstrated respect and their understanding of the need for privacy and dignity. They could be observed to knock and wait for a response before entering residents’ rooms. Based on direct observation, the residents benefit from informal contact with the staff who showed great empathy in their dealings with those residents who may be distressed. The main meal of the day at Fir Trees is served at midday, breakfast is flexible as and when the residents get up. The evening meal is provided at 4:00pm with supper at 7:00pm. One resident commented that she had a cooked breakfast at 9:00am and would prefer her main meal at 1:00pm. The timing of the meals was discussed with the manager. The choice of menu for the day was not displayed. The resident’s who spoke with the inspector were unable to remember what they had chosen for their next meal. The daily menu could be written on a wipe clean board and would provide a reminder for the residents. The residents who spoke with the inspector stated that, in general, the standard of meals was good, they were also aware that they could have alternatives to the main choice. Small domestic kitchens are located on both floors. They enable the staff to make the residents drinks and snacks throughout the day. The menu was submitted as part of the pre-inspection process. The content appeared nutritious and well balanced. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16 & 18 The residents and staff were confident their complaints would be treated with respect and acted upon. The policies, procedures and staff training protect the residents from abuse. EVIDENCE: The home has a complaints policy and system available to the residents and their representatives. In discussion, the residents stated they would speak to their family or manager if they had a complaint or concern. They felt sure that this would be addressed but had not had occasion to make a complaint. A visitor stated that he had made a complaint to the organisation and also confirmed his dissatisfaction with the outcome in a comment card to the inspector. He stated that the smoking area had recently been relocated to the first floor and maintained that the area was isolated. His main concern was that his relative was able to move from the area independently but rarely did this and the staffing level was such that the three residents who use the smoking area could not be observed. The staff demonstrated their understanding and expectations in the event of a complaint made to them. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 14 The staff have recently undergone training in the protection of vulnerable adults. This has now been incorporated into the induction training. Systems and policies are also in place concerning this issue. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19 & 26 Fir Trees provides a warm, clean and well-maintained environment with a high standard of furnishings and fittings. The security of the residents cannot be guaranteed. EVIDENCE: The residents and their representatives who spoke with the inspector voiced their satisfaction with their accommodation. The home has recently undergone a total refurbishment. The quality of the work the furniture and fittings is to a high standard. The main entrance into the home is accessible to the general public. A visitor commented that they were surprised visitors could enter the building unobserved and once in the building were free to access all areas of the home. The installation of an entry phone would improve the security. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 16 The grounds are fully accessible to the residents. Garden furniture is provided for use in the better weather. Yew Tree is maintained in a clean and hygienic state; there were no offensive smells noted. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 The residents receive care from well-trained staff who respond to the residents and visitors in a respectful manner. The organisation’s recruitment policy and procedure provides protection to the residents from potential abuse. EVIDENCE: From observation, the staff were attentive and responded to the residents and their visitors in a respectful manner. Additional information contained in a resident’s comment card noted: “I personally think there should be more staff on, especially on night shifts.” The registered manager stated the staffing met with the current residents’ dependency levels. It was acknowledged that the size of the building should also be taken into account when assessing the levels. Recruitment is carried out according to the organisation’s policies. The staff who spoke with the inspector confirmed they had provided referees and had CRB clearance. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 18 The organisation continues to support carers to complete the National Vocational Qualification at level 2. According to the pre-inspection questionnaire, the number of carers with a level 2 or above currently stands at 60 . Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 & 38 The use of questionnaires and continued reviewing of care plans enables the residents and their relatives to be involved in the delivery of care. Systems are in place to protect the residents’ financial interests and to ensure their health and safety at all times. EVIDENCE: The organisation ascertains the residents’ views by questionnaire. All care plans are reviewed at regular intervals and a relative confirmed his understanding of the reviewing process. A representative of the organisation also carries out regular spot checks on records, health and safety issues in addition to seeking the residents’ views of the service. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 20 When questioned, two staff informed the inspector that they felt fulfilled and supported in their work. The residents are enabled to maintain their own financial affairs. The home handles small amounts of money on behalf of the residents. Records are retained to account for expenditure. The staff confirmed they had received all the mandatory training concerning the health and safety of the residents. The organisation also has a system to ensure the training is current. The maintenance of all appliances and equipment is carried out under contract. The health, safety and welfare is further ensured by the systems in place to report accident and incidents. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x x x x x 3 Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 22 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. 2. Standard 15 19 Regulation 16(2)(1) 13(4)(a) Requirement The registered person must ensure that the timings of the meals are reviewed. The registered person must provide security to the main entrance. Timescale for action 01/12/05 01/09/05 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 15 Good Practice Recommendations The registered person should display the daily menu in the dining areas. Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton under Lyne OL7 0QD 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 Fir Trees F54 F04 s5591 Fir Trees A v226193 140605 Stage 4.doc Version 1.30 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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