Inspection on 07/06/05 for Lime Tree House

This inspection was carried out on 7th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lime Tree House 09/01/09

Lime Tree House 16/07/08

Lime Tree House 14/02/08

Lime Tree House 04/09/07

Lime Tree House 12/10/06

Lime Tree House 17/05/06

Lime Tree House 14/12/05

Lime Tree House 19/10/04

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

CARE HOMES FOR OLDER PEOPLE Lime Tree House Chantry Green Main Street Upper Poppleton, York YO26 6DL Lead Inspector Irene Ward Unannounced 7 June 2005 09:15 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. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lime Tree House Address Chantry Green Upper Poppleton York YO26 6DL 01904 795280 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) Roseville Care Homes Ltd Awating Manager Application Care Home only 26 Category(ies) of OP Old age (26) registration, with number of places Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 19/10/04 Brief Description of the Service: Lime Tree House provides personnel care and accomodation for up to 26 older people and is owned and managed by Roseville Care Homes Ltd. The home is a large detached property set in private gardens in the village of Upper Poppleton on the outskirts of York off the A59 York to Harrogate Road. There is parking to the front and side of the home. The village offers amenties within walking distance. The home caters for up to 26 older people, with various needs relating to old age. Service users accomodation is over two floors and and has a passenger lift and stairs to access each floor. Communal areas such as the lounge and dinning room are all on the ground floor. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection carried out on the 7th June 2005, which started at 9.15hrs and finished at 16.45hrs. A tour of the home was carried out which included the service users’ private accommodation, a selection of records were looked at and time was spent observing activity in the home, talking and listening to service users, relatives and staff. The focus of the inspection was a number of key standards, inspecting the care records of four service users in detail to establish if they corresponded with service users experiences in the home. There were also discussions with agency staff, Mrs Linda Bayley the newly appointed manager and Mrs Dinka Knezevic the registered person on behalf of the company. What the service does well: What has improved since the last inspection? Written plans relating to service users needs via care assessments have improved. This gives clear guidance to all staff in the home when providing care and ensures a consistent approach when meeting the needs of service users. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 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 House J53-J04 S61499 Lime Tree House V229438 070605 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 Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 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 and 6 Prospective service users can be confident before moving into the home that their needs can be met. EVIDENCE: The home’s Statement of Purpose requires updating since the home’s takeover in September 2004, and must include all the elements referred to in Schedule 1. A pre-admission assessment is carried out prior to a service users admission into the home. A care plan from placing or funding authorities where applicable is obtained. The information on files was comprehensive and details give good indication of the care needs of prospective users. The manager stated that the home does not provide intermediate care. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 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 and 10 The health care needs of service users are well met. EVIDENCE: Four service users’ case files were inspected, including the most recent admission into the home. All files contained comprehensive plans of care. Risk assessments covering areas of daily living were available and up to date. The health care needs of service users were recorded on their individual care plans. A new monitored dosage system has recently been introduced. The storage of medication was secure, however senior staff were secondary dispensing from the dosage system into plastic pots. The manager was advised for this practice to cease immediately as this was unsafe practice. Advice was also given for the manager to contact the dispensing chemist and ask for further training. One issue regarding the care package for one service user raised concerns. This issue did not directly involve the home, but the provision of agency staff through the district nurses for critical care. There was no care plan in place at the home, for the agency staff to follow. There were only daily records completed by agency staff. A care plan for the home’s staff was in place. A Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 Page 10 care plan is vital when a multi-disciplinary team is providing a package of care. This ensures that the service user’s needs are met at all times by all parties concerned. This has been reported to the care management team responsible and needs to be addressed. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 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) 13 and 15 Flexible visiting arrangements allow the service users to maintain good and regular contact with family and friends. The meals provided are nutritious and offer a varied diet for service users. EVIDENCE: Service users confirmed that they could have as many visitors as they liked and at any time they chose. The arrangement for visiting are made clear in the statement of purpose and the service users guide for the home. All service users spoken to commented favourably on the quality and variety of the meals provided. Menus provided indicate that there is a variety of choices at each mealtime except lunchtime. The manager stated that the home intends to look at developing this further and to provide choices at lunchtime. Menus are based on a three weekly rota. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 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 standard(s) 16 and 18 Service users are confident that their complaints and concerns are dealt with and are acted upon. EVIDENCE: The home has received one complaint that had been dealt with appropriately. Service users commented that if they had a complaint they would speak directly with staff on duty. It would then be acted upon. Service users were also confident that either the manager or Mrs Knezevic would put things right. The manager had requested from Social Service the local Adult Protection Policy, and had received the incorrect documentation. It was agreed that the manager would contact the relevant department and obtained the correct documentation. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 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 standard(s) 19,22,25 and 26 The standard of the environment is good and provides service users with comfortable surroundings. EVIDENCE: The home is a large building with a large entrance hall where some service users enjoy sitting. There are corridors running off to the communal areas such as the lounge and dinning room and a number of service users bedrooms. Service users accommodation is over two floors, which are easily accessed by a passenger lift. The home is decorated to a good standard. However the home is to be re-decorated which commences next week. The home was clean and free from odours in all areas except one. There was an offensive odour near to the main entrance of the home. This was discussed with the manager and registered person. It would seem that there is an ongoing problem with a service user’s bedroom. It was agreed that this issue needs to be resolved. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 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 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) 29 Service users are protected by the home’s recruitment procedure. EVIDENCE: Three staff files were inspected. One person who had recently commenced working at the home had all the relevant checks undertaken prior to commencing work at the home. All staff files inspected held application forms, two written references, and records of interviews. CRB checks have been carried out and staff have been checked against the POVA first list. Staff are given contracts of employment and job descriptions, however these were not held on staff files and not available for inspection. The manager agreed to up date the staff files, to include contracts of employment, job descriptions and all relevant documentation as outline in the regulations. All service users commented about how caring the staff were. One service user said, “Staff are very good, if you had to be in a home you could not be in a better one”. One relative said that the staff are sensitive to the needs of service users. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 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 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) 33 and 38 Service users’ health safety and welfare are promoted and protected. EVIDENCE: The home has a new manager Linda Bayley who has only worked at the home for several weeks. In discussions held with service users, staff, relatives and through observations the home has a committed staff team and meets the needs of service users living there. A number of health and safety record were inspected all of which were up to date and accurately maintained. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 Page 16 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 1 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x 3 x x 3 1 STAFFING Standard No Score 27 x 28 x 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 3 x x x x 3 Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 Page 17 YES Are there any outstanding requirements from the last inspection? 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. 3. 4. Standard OP 1 OP9 OP26 OP29 Regulation 4(1) 13(2) 23(2) (d) 19 (1) Schedule 2 Requirement The statement of purpose must be reviewed to include areas covered in Schedule 1. Secondary dispensing must cease and the monitored dosage system used correctly. The odour in the main entrance/ hallway must be addressed. Staff files must be updated and include all the documentation required by regulation. Timescale for action 30/9/05 From the date of the inspection. 30/9/05 30/9/05 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. 2. Refer to Standard OP15 OP18 Good Practice Recommendations Choices should be available at each mealtime including lunchtime. The correct local Social Service Adult Protection Policy should be obtained. Lime Tree House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection Unit 4, Triune Court Monks Cross YORK YO32 9GZ 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 House J53-J04 S61499 Lime Tree House V229438 070605 Stage 4.doc Version 1.30 Page 19 - 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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