Inspection on 19/04/07 for Lime Trees

This inspection was carried out on 19th April 2007.

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 01/03/06

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 Key Unannounced Inspection 19th April 2007 10:00 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.V336978.R01.S.doc Version 5.2 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.V336978.R01.S.doc Version 5.2 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.V336978.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home accommodates six people with learning disabilities who may also have physical disabilities 1st March 2006 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. The home has its own mini bus with tail lift to transport those people who require the use of a wheelchair. The Inspector was advised that the fees for this service were currently approximately £1000 per week. Additional fees are charged for chiropody services and music therapy. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 19th April 2007, over a period of six hours. All of the Key National Minimum Standards (NMS) for Older People and the intended outcomes were assessed in relation to this service during the inspection. The inspection process included reviewing documents required under the Care Home Regulations. A number of records were looked at relating to the residents, staff recruitment, training, staff rosters and policies and procedures. Time was spent talking to the Registered Manager, Deputy Manager and staff. During the inspection the inspector also met with the chiropodist and the regular weekly musical activity entertainer. Due to the complex needs of the people living at Lime Trees, discussion with regard to care delivery was difficult, however observation of body language, expression and interaction between the residents and the staff, demonstrated that the residents were comfortable and relaxed at Lime Trees. This report has been written using accumulated evidence gathered prior to and during the inspection, including a pre inspection questionnaire completed by the home; required notifications received by the Commission from the home of notifiable events affecting people who live in the home; and comment cards distributed by the Commission. Comment cards were completed and returned by two relatives and the views expressed are included within the contents of the report. What the service does well: Lime Trees is a care home renovated and designed with reference to relevant guidance. It provides a safe and well maintained environment and is furnished and decorated to a very high standard. The home meets residents’ individual and collective needs in a comfortable and homely way. Lime Trees is an effective, efficient and professionally run service, successfully providing high quality care and support for older people who have a learning disability, complex needs and/or sensory impairment. Interaction between staff and residents was calm, positive and respectful. The residents were relaxed and observed to enjoy good relationships with the staff and said they liked living at Lime Trees. Mr James Moor, the registered manager is very committed to the service and is strongly and competently supported by his deputy manager, Linda. Together they have a clear vision for improving the residents’ quality of life and continue to operate at a high level of professional practice. They lead a loyal staff team who deliver a good Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 6 standard of care and have a good understanding of the residents needs. The staff are supported in their work and opportunities to develop their care practice through training was provided. Effective quality assurance and monitoring systems are in place to continually review and improve care practice and the outcomes for the residents. People living at this home are happy, comfortable and relaxed and have developed good and trusting relationships with those who look after them. 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. The summary of this inspection report can be made available in other formats on request. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 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.V336978.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service operates an informative and responsible pre admission process giving care and attention to ensure the home is suitable to meet the all the assessed needs of those people admitted. The home does not provide intermediate care and therefore standard 6 and corresponding expected outcome is not applicable for this service. EVIDENCE: Previous inspections commended the service for its thorough, comprehensive pre-admission process, which met the intended outcomes for prospective residents. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 9 The people living at Lime Trees have lived there since it opened, four years ago, and were admitted under the re-provision programme from NHS longterm care, as part of ‘Better Lives’ programme. They each were involved during the pre-admission process and the transition period, which was well planned and supported through appropriate assessment identifying physical, social, psychological and emotional needs by the home’s manager and the multidisciplinary team. The service has not admitted any new residents since the last inspection. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 . People who use this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service can be certain that they will be treated with respect and that all aspects of their physical and personal needs will be met. The arrangements for care planning in this home are excellent. Healthcare needs are met promptly and the assessment and monitoring of potential healthcare needs are a fundamental part of the residents care. EVIDENCE: The care plans examined were developed in partnership with the resident, according to the individuals assessed needs, strengths and ability, following the principles of person centred planning. Excellent detail provided staff with a good understanding of how the resident is to be supported in achieving outcomes. The care plan is used as a working tool to provide care staff with detailed information about each person ensuring appropriate, consistent and Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 11 continued support, and can be used in an emergency by people who are not familiar with its content or the resident. Interaction between the residents and staff was observed to be very respectful and supportive throughout the inspection and the residents clearly enjoyed the company of the staff. Staff were observed to consult with the residents and assisted appropriately to enable the residents to make choices and decisions. The level and style of communication between the carers and residents was reflective of good practice. Nutritional screening and weight monitoring was recorded regularly and residents nutritional needs were assessed annually by the dietician. Attention was given to healthy eating and a balanced diet promoting well-being, particularly for those with actual or potential health risks. Each care plan held an ‘OK’ Health Check, a comprehensive checklist to enable the key worker to carry out a detailed health check and prompts an awareness to identify, record and report additional information, occurrences and observations in the individuals’ physical and mental health; and identify any slow deterioration that may otherwise go unnoticed. The gathered information is recorded and used in partnership with the GP in annual health checks and medication reviews and is considered in care planning reviews. Care files provided evidence of guidance and prompt intervention from healthcare professionals such as the Continence Advisor, District Nurse, Community Psychiatric Nurse and Community Physiotherapist/Occupational Therapist to meet specific identified needs. Records were in place of ophthalmic and chiropody appointments. It was evident from records that one resident with deteriorating mobility was promptly followed up with a physiotherapist assessment and appropriate walking aids were supplied. A moving and handling assessment was undertaken to identify the level and type of support required of staff. Another care plan identified problems with a toe to which the chiropodist attended to the following day. Those residents with chronic diseases such as asthma and hypertension were regularly followed up at the appropriate clinics held at the GP surgery. Risk assessments and management strategies were included within the care planning process. Each risk assessment had an activity benefit analysis to assess whether taking a responsible risk with support would actually benefit the quality of the individuals lifestyle, experience, competence or dignity. The homes Administration of Medicines policy contained the relevant information for staff to follow for the receipt, recording, storage, handling administration and disposal of medication. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 12 Staff had received training ensuring appropriate knowledge and skills for safe practice and responsibility in medication administration. Current residents did not retain, administer or control their own medication. Resident’s prescribed medication was dispensed by the local pharmacy into Monitored Dose Systems (MDS) and appropriately stored in a locked cabinet in their bedroom. Medication is administered to residents in the privacy of their room, a practice that promotes dignity. The home is not registered to provide nursing care and endeavours to offer continued care for those residents whose needs can be appropriately met with the support of Community Healthcare professionals. Care plans identified the arrangements required following death and this was considered with the relatives. Staff had recently received training in managing bereavement and supporting residents in their grief. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People who use this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service experience an ordinary and meaningful lifestyle suited to their assessed needs and abilities, both in the home and in the community. They receive good quality food suited to their taste and dietary requirements. EVIDENCE: Lime Trees caters for people who have a varying level of dependency and need in relation to the older person with a learning disability. The current residents formerly lived for all or most of their lives in long term NHS institutionalised establishments. Lime Trees provides a relaxed and flexible lifestyle for its residents according to their wishes, choices and abilities. Comments from relatives expressed satisfaction with the overall care received by their relatives using the service. One stated that the home does ‘everything’ well. Another stated that the home ‘gives my brother the chance to live his life to the full extent that he can. The care he receives is excellent. The home is Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 14 like one big family and he receives the right care and staff have the knowledge of how to treat him.’ Opportunities are given to access the nearby community and residents are supported to participate in activities, which are age appropriate and according to their preference, contributing to a fulfilling lifestyle. One resident likes going out for car rides, others enjoy going to Felixstowe for a fish and chip lunch and watching the boats coming across from Norway and Holland. Boat trips are taken annually on the Norfolk Broads and picnics are enjoyed during the warmer months. The home has its own mini bus with tail lift to transport those people who require the use of a wheelchair. Weekly activities include shopping, pub lunches, morning coffee and afternoon tea outings, church activities and musical entertainment. The regular attending musician plays guitar and was observed during the inspection to interact positively with the residents and encouraged their participation in singing and playing the tambourine. One resident enjoys music and singing and the home has supplied him with karaoke videos to sing along to. Residents were relaxed and there were several examples observed that demonstrated residents enjoy a positive and supportive relationship with carers. Carers spoke with residents in a caring and friendly tone using appropriate language and communication methods. Daily routines were flexible and there was a strong ethos in the home of promoting service users’ independence and choices. The home recognises family and friendships as an extremely important factor for residents well being. Since living at Lime Trees, some with dedicated support from staff, have re established and now maintain new contact with family; and happy reunions have brought great joy to all concerned. One resident met their sister for the first time in seventy years. Another now speaks regularly on loudspeaker phone with their sister in New Zealand. Being a small home, meals were prepared and cooked by the care staff and the residents are given the opportunity to participate, with support, in the planning, shopping and food preparation if they wish to. A great emphasis is given to an individualised healthy eating approach promoting well-being. Menus reviewed by a dietician were commended for their balanced nutritional value. Nutritional needs and particular dietary requirements are assessed for each resident annually by the dietician; and as Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 15 and when required. Changes made following assessments are incorporated into the menus for each individual according to choice and preferences. The residents have profound communication difficulties and the staff identify each individuals likes and dislikes by their behaviour, facial expressions and by the foods they eat. To further promote choice picture menus were introduced to encourage active participation but this was not received well by the residents. The pleasant gardens have patio furniture, which is used during the good weather. Residents were observed having their lunch outside, and sitting in the sunshine during the afternoon of the inspection. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can be assured that satisfactory arrangements are in place to promote their protection from abuse and that any concerns they may have will be listened to and acted upon. EVIDENCE: The complaint and adult protection policies and procedures remain the same as seen at previous inspections. Suitable complaints policies and procedures were in place. 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. Surveys from relatives expressed satisfaction with the service and were confident that if they had any concerns they would be dealt with promptly. An Adult Protection policy and procedure, including Whistle Blowing, was in place, which ran in conjunction with Social Service policy and Department of Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 17 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. The homes robust recruitment and selection practice and thorough induction process provided the appropriate safeguards to support and protect residents. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 People who use this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service live in a home that was renovated and designed with reference to relevant guidance. It provides a safe and well maintained environment, furnished and decorated to a very high standard, and meets residents’ individual and collective needs in a comfortable and homely way. EVIDENCE: Lime Trees is a spacious bungalow, with ramped exits and wide doorways, suitable for wheelchair users. Grab rails, hoists and walking aids are provided to assist those residents with limited mobility. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 19 A tour of the home was undertaken. The premises are in good keeping with the local community, clean, comfortable and homely. Each individual bedroom has en suite facilities, which comprise of a washbasin, an assisted bath with a hoist and a toilet. The bedrooms are personalised, decorated and furnished to a high quality and met individual needs. The lounge and dining room are spacious and comfortable. A large well-maintained garden provides a pleasant communal extension to the home. Fruit trees, lawn, vegetable plot and well stocked flowerbeds; patio area and garden furniture provides stimulation and interest for the residents during the warmer months. The laundry meets National Minimum Standards and Infection Control guidance. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A competent and enthusiastic workforce works positively with the people who use this service, providing quality of life. The homes robust recruitment and selection practice and thorough induction process provides the appropriate safeguards to support and protect the residents EVIDENCE: The home has a stable and dedicated staff team. Staff spoken with during the inspection presented as confident and knowledgeable about service users. They demonstrated a clear understanding of their roles and responsibilities, based on accurate job descriptions and specifications. Staff held additional responsibilities for household tasks such as cleaning, laundry, cooking and the kitchen and this was taken into consideration when calculating the staffing levels required in relation to the assessed needs of the residents. Staffing hours were calculated using the Department of Health tool for care hours required in homes for people with a learning disability and were considered adequate during the inspection. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 21 The staff files examined contained all the required documentation to ensure the suitability of the person being employed for the purpose of the job. Three of the ten staff employed have successfully achieved National Vocational Qualification in Care and three staff are currently working towards it. This qualification ensures that staff have the skills, knowledge and competence needed to carry out their role. . The training matrix maintained by the home clearly identified the short course training received by staff each year and indicates when updates for each individual were required. All staff had received training in mandatory areas. Additional training in bereavement and dementia awareness has also been received. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38. People who use this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is efficiently and professionally managed and run in the best interests of the people who use the service. 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. The manager is strongly supported by the deputy manager who has completed 6 modules of the Registered Managers award in the last four months. Future planning includes Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 23 the deputy to eventually take over the day to day management of the service once she has applied and successfully completed the registration process and registration is agreed with the Commission. Residents were observed management and staff. to be comfortable and relaxed around the Lime Trees is recognised as meeting the standards for effective investing in people and achieved The Investor in People Award in March 2005. The home has an effective Quality Assurance and Quality Monitoring system in place to measure its success in achieving the aims and objectives of the home and care outcomes for the residents. This provides them with an open and analytical approach to continue to further develop care practice in the best interests of the residents. Staff meetings were used for consultation, training and the involvement of staff in the development of the service. The deputy manager meets fortnightly with night staff to ensure inclusion within the staff team. Records indicated that staff received regular supervision that clearly contained all the elements necessary to support staff in developing and sustaining their working practice. Records, policies and procedures required by regulation for the safeguarding of residents and staff safe working practice were in place, reviewed dated and signed. 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 Records relating to maintenance of equipment, utility services, safety systems and risk assessments were in order. These included electrical and gas safety certificates and fire safety and system checks and servicing of equipment. Staff had received mandatory training in health and safety, food and hygiene, advanced moving and handling and First Aid. Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 24 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 4 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 3 3 3 Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 25 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. Refer to Standard Good Practice Recommendations Lime Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Trees DS0000035818.V336978.R01.S.doc Version 5.2 Page 27 - 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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