Inspection on 09/02/06 for Lime Tree Court

This inspection was carried out on 9th February 2006.

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

Lime Tree Court 07/06/07

Lime Tree Court 15/11/05

Lime Tree Court 16/03/05

Lime Tree Court 15/06/04

Lime Tree Court 12/03/04

Similar services:

The Maypole Nursing Centre

The Briars

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Lime Tree Court Church Street Twyford Bucks MK18 4EX Lead Inspector Nichola Cahill Unannounced Inspection 9th 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 Lime Tree Court DS0000022988.V281987.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. Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lime Tree Court Address Church Street Twyford Bucks MK18 4EX 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) 01296 730556 01869 278100 georgierixon@hotmail.com Mrs Georgina Rixon Mrs Georgina Rixon Care Home 23 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 23 residents, no more than twelve of whom may have dementia. Date of last inspection 15th November 2005 Brief Description of the Service: Lime Tree Court care home is situated in the peaceful and pleasant village of Twyford, in Buckinghamshire. The home is located at the end of a quiet country lane and is close to the church. The home is registered for the care of 23 older persons, some of which have a dementia type illness. The building and gardens are enclosed providing security for service users but allowing them to mobilise freely within the grounds. The garden areas are well maintained and contain patio areas for service users to sit and enjoy the outdoors. Local amenities include the church, a village shop and a public house, all of which are visited by service users in the company of staff. Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the annual unannounced inspection visit carried out by Nicky Cahill (lead inspector) and Gill Gentles (inspector) on 9th February 2006. The inspection commenced at 12.25pm and was carried out over a two and half hour period. The inspection consisted of an assessment of compliance against requirements made at the previous visit, viewing documentation regarding the health and well being of service users and carrying out a brief tour of the home. Service users were offered the opportunity to discuss their views of the home. All core standards have been assessed during the two annual inspection visits, with the exception of 6 and 35, neither of which are applicable to this service. A feedback of the findings from the inspection visit were delivered to the homes manager / proprietor. What the service does well: What has improved since the last inspection? Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 6 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. Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 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 the following standard(s): Core standard 3 was assessed at the inspection visit in November 2005 and was being met at this time. Standard 6 is not applicable to this service. EVIDENCE: Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 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 the following standard(s): 7, 9 All service users have a care plan. Information is limited, however, would enable care staff to deliver appropriate care. EVIDENCE: All service users have a care plan file, three of which were viewed during the inspection visit. Care plans include the following information: • Admission information • Personal care plan – Information within this document was limited. For example, under the title ‘skincare’ the comment made was ‘good’, under the title of ‘nutrition’ the comment made was ‘eats well’. This document does not lend itself, due to the size of each comment box, to giving more specific detail to the care needed. • Pre-admission information. • Service users goals. Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 10 Pen Pictures for individual service users, some of which gave a lovely picture of who the service user was, where they had come from and what was important in their lives. • Manual handling assessments – these did not include a date of assessment on all occasions. • One service user had moved to Lime Tree Court from another care establishment. It was not documented as to why this move had been actioned. Care plans contained good information, which would enable service users to be cared for by the current staff team. However, it is recommended that more detailed care plans are put into place to ensure that there is an appropriate description of what assistance is needed, by whom and how will the care staff ensure that such needs will be met. The manager must be mindful that all details regarding admissions to the home should be passed to care staff if this will have an impact on the care delivered and any inherent risks to the service user or staff. The home has a comprehensive medications policy in place, which has been signed off by the local GP. A GP surgery is held in the home weekly and service users medication regularly reviewed. If new medication is prescribed the GP will make an entry onto the homes MAR sheet. No service users are self-medicating at present due to their limited abilities. The homes MAR sheets contain all relevant information, with the exception of any allergies known. It was discussed with the manager that this could have impact on the treatment received by medical staff should a service user be admitted to accident and emergency. Some MAR sheets had gaps where medication had either been refused or not given for any other reason. New coding had not been utilised. The MAR sheet did not stipulate the name that the service user wished to be known as. It is recommended that the manager amend MAR sheets to include any known allergies, the name the service users wishes to be known by (in addition to their official title) and that the new coding in place is used on all occasions where medication is not administered. All medication is safely stored in the homes office, medication is checked into and out of the home. The local pharmacist carries out a medication audit regularly. • Lime Tree Court DS0000022988.V281987.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): 13, 14 Service users are able to maintain contact with family and friends who are welcome in the home at any time. Service users are assisted in exercising choice and control over their own lives. EVIDENCE: It was confirmed through discussions with service users and care plan documentation that the home encourage service user to maintain contact with their family and friends and to have links with the local community. The ethos of the home is welcoming and visitors are able to visit at any reasonable time. Lime Tree Court DS0000022988.V281987.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): Core standards 16, 17 and 18 were assessed during the inspection visit in November 2005 and were being met at this time. EVIDENCE: Lime Tree Court DS0000022988.V281987.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): Core standards 19 and 26 were assessed during the inspection in November 2005 and were being met at this time. EVIDENCE: Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 14 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 The staffing numbers are adequate and allow the needs of the service users to be met appropriately. EVIDENCE: The staffing rotas were viewed during the inspection visit and confirm that the appropriate numbers of staff are on duty to ensure that the assessed needs of the service users are met. Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 15 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 The home is well managed and supported by an experienced team of care staff. The home has a very positive ethos and is run in the best interests of the service users. EVIDENCE: The home is owned and managed by Georgina Rixon. Mrs Rixon is an experienced care professional who has gained an NVQ level 4 in management and care. She is well supported by a deputy manager and an experienced team of care workers, many of whom have been employed in the home for a number of years. Service users and their relatives and representatives speak highly of the care delivered. There is an obvious positive relationship with external health and social care professionals who will ensure that the correct guidance is given to the home to enable them to meet the ongoing needs of the service user group. Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 16 Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 17 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X N/A X X X Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 18 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. Standard Regulation Requirement Timescale for action 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 OP12 Good Practice Recommendations It is recommended that the homes new practice of obtaining pen pictures of residents is developed to include them all. It is recommended that more detailed care plans are put into place to ensure that there is an appropriate description of what assistance is needed, by whom and how will the care staff ensure that such needs will be met. It is recommended that the manager amend MAR sheets to include any known allergies, the name the service users wishes to be known by (in addition to their official title) and that the new coding in place is used on all occasions where medication is not administered. 2 OP7 3 OP9 Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Lime Tree Court DS0000022988.V281987.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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