Inspection on 01/03/06 for Lime Trees

This inspection was carried out on 1st March 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 Trees 18/04/08

Lime Trees 19/04/07

Lime Trees 18/11/05

Lime Trees 16/03/05

Lime Trees 03/09/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOMES FOR OLDER PEOPLE Lime Trees Harwich Road Sparrows Corner Little Oakley Essex CO12 5AD Lead Inspector Gaynor Elvin Final Unannounced Inspection 1st March 2006 13.30:p 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 Trees DS0000035818.V285562.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 Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lime Trees Address Harwich Road Sparrows Corner Little Oakley Essex CO12 5AD 01255 880281 01255 886374 jamesmoor4@aol.com 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) James Barry Moor James Barry Moor Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6), Physical disability (6), of places Physical disability over 65 years of age (6) Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home accommodates six people with learning disabilities who may also have physical disabilities 18th November 2005 Date of last inspection Brief Description of the Service: Lime Trees is located in the small village of Little Oakley on the outskirts of Harwich, which is a large town and international port. Lime Trees is a bungalow, renovated and extended to a very high standard meeting all the requirements of the National Minimum Standards in terms of room sizes, en suite bathrooms and communal space. Lime Trees is a registered care home for six people with learning disabilities and aged over 65 years. Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place one day in March 2006 over four hours. All of the key standards and the intended outcomes have been assessed in relation to this service during at least two inspections for the current inspection year (April to March). To view the assessment of standards and outcomes not included within this report, please refer to the previous published report dated 18th November 2005. The current residents residing at Lime Trees have high cognitive and communication needs and discussion with regard to care delivery was difficult. Observation of body language, expression and the rapport between the residents and the staff demonstrated that the residents were comfortable and contented at Lime Trees. Lime Trees is recognised as meeting the international standard for effective investing in people and achieved The Investor in People Award in March 2005. What the service does well: What has improved since the last inspection? What they could do better: This inspection concluded that all National Minimum Standards inspected met with minimum requirements. Nine Standards exceeded minimum requirements and were rated ‘4’. Based upon the standards inspected, the only improvements to standards rated ‘3’ would be for the service to work toward exceeding minimum requirements and increasing the ratings from a ‘3’ to a ‘4’. Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 6 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 Trees DS0000035818.V285562.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 Trees DS0000035818.V285562.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): National Minimum Standards 1-5 and intended outcomes have not been assessed on this occasion. The home does not admit residents for respite, emergency or intermediate care (NMS 6). EVIDENCE: The current residents have lived at Lime Trees since it opened, three years ago and were admitted under the re-provision programme from NHS long term care, as part of ‘Better Lives’ programme. The service has not admitted any new residents since the last inspection. Previous inspections commended the service for its thorough, comprehensive pre-admission process, which met the intended outcomes for prospective residents. Lime Trees DS0000035818.V285562.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): 9 & 10 Service users benefit from a well managed medication administration system. Staff engaged positively with the service users and demonstrated a good understanding of the service users they were supporting, respecting their privacy and dignity. EVIDENCE: Service user’s medication was stored within locked cupboards in their own private accommodation. The current service user’s did not retain, administer or control their medication and required support and assistance. The policy and procedure for the safe receipt, recording, storage, handling, administration and disposal of medicines had been reviewed and updated to guide staff. Staff had received training, ensuring appropriate knowledge and skills for safe practice and responsibility in medication administration. In addition, the Manager was seeking accredited medication training. Resident’s prescribed medication was dispensed by the local pharmacy into Monitored Dose Systems (MDS). Medication Administration Record sheets (MARs) examined were dated and signed appropriately. Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 10 Information relating to the side effects and adverse reactions of the prescribed medicines being taken by service users was readily available within individual care plans. Medication reviews were carried out by the GP. The staff were observed to be respectful in their approach to the residents and provided support with dignity and sensitivity. Lime Trees DS0000035818.V285562.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): 12, 14 & 15 Residents benefit from a relaxed and fulfilling lifestyle. Nutritious meals were served in a happy relaxed atmosphere with staff assisting sensitively where required. EVIDENCE: Lime Trees caters for a wide varying level of dependency and need in relation to the older person with a learning disability and a more relaxed lifestyle was respected for those individuals. Opportunities were given to access the nearby community and residents were supported to participate in activities which, are age appropriate and according to their preference, contributing to a fulfilling lifestyle. Staff spoken with felt the home was in tune with an ordinary lifestyle for the residents and offered opportunities for the service users to access the community and participate in chosen leisure activities individually or as a group. Daily routines were flexible and there was a strong ethos in the home of promoting service users’ independence and choices. Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 12 Meals were prepared and cooked by the care staff and the more independent service users were given the opportunity to assist, with support. A great emphasis is given to an individualised healthy eating approach promoting well being. Menus reviewed by a dietician were commended for balanced nutritional value; intake of fibre, protein, carbohydrates, calcium, fluid and salt was sufficient and well distributed and individualised advised changes following a nutritional assessment were incorporated according to choice and preferences. Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 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 the following standard(s): 16 & 18 Satisfactory arrangements were in place to promote the protection of service user’s from abuse and for responding to their concerns. EVIDENCE: Suitable complaints, policies and procedures were in place. Residents’ views were acted upon. The manager confirmed that no complaint investigations have been undertaken since the previous inspection. CSCI have received no complaints with regards to this service during the same period. An Adult Protection policy and procedure, including Whistle Blowing, was in place, which ran in conjunction with Local policy and Department of Health ‘No Secrets’ guidelines to guide staff of the steps to be taken in the event of an allegation or suspicion of abuse being reported. Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 14 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): 19, 20, 21, 22, 23, 24, 25 & 26 The resident’s benefit from a comfortable, safe and well maintained environment suited to their individual and collective needs, promoting independence and individuality. EVIDENCE: Lime Trees is a purpose built building, meeting National Minimum Standards with regard to private and communal space, bathroom and toilets. Individual accommodation was decorated and furnished to a high standard, personalised to each individual and offered en-suite facilities. The premises were in keeping with domestic style living arrangements and equipped to meet the residents’ assessed needs and lifestyles. Lime Trees created a comfortable, homely and safe environment and areas seen were cleaned to a high standard. Lime Trees DS0000035818.V285562.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): Standards 27 – 30 and intended outcomes were not assessed on this occasion. EVIDENCE: The key standards National Minimum Standards 27,28,29 & 30) were inspected at the previous visit (18th November 2005) and were found to comply with requirements. Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 16 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): 32, 37 & 38 The resident’s benefit from a well managed resident focused service. Appropriate arrangements are in place to safeguard residents’ financial interests. Overall the health, safety and welfare of the service users and staff are promoted and protected. EVIDENCE: This and previous inspections concluded that the service is well run and reflective of good professional practice. The manager sets a good example and a friendly and supportive environment exists. Residents’ financial interests are safeguarded through written records of all transactions and receipts. Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 17 There were no obvious health and safety concerns noted, health and safety policies and procedures relating to working and caring environment were in place. Risk assessments and risk reducing management plans had recently been reviewed, including fire risk assessments. Records indicated that fire drills had taken place regularly, fire alarms and equipment had been serviced this year and risk assessments and evacuation procedures were in place. Staff had received fire safety awareness training during induction and in house update, further training had been planned for in the annual training plan. Staff had received mandatory training in health and safety, food and hygiene, advanced moving and handling and First Aid. Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 18 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 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 4 X X 3 X X 3 Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 19 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. 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. Refer to Standard Good Practice Recommendations Lime Trees DS0000035818.V285562.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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. 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