Inspection on 18/04/07 for Notrees

This inspection was carried out on 18th April 2007.

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

Notrees 07/02/06

Notrees 02/08/05

Notrees 11/01/05

Notrees 19/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Notrees 10 High Street Kintbury Newbury Berks RG17 9TW Lead Inspector Jill Chapman Unannounced Inspection 18th April 2007 10:05 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 Notrees DS0000031304.V331020.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. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Notrees Address 10 High Street Kintbury Newbury Berks RG17 9TW 01488 658332 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) West Berkshire Council Mrs Susan Mary Goalby Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2006 Brief Description of the Service: Notrees provides long term 24-hour residential accommodation and care for up to 16 and short term care for up to two elderly people. West Berkshire Community Services are the authority responsible for the overall management of the home. The home is situated in the village of Kintbury and has excellent community links. The home is a single storey building situated back from the road with a large parking area to front of the building and well maintained grounds surrounding the property. The home has a large conservatory at the front and a large sitting/ dining room. There is a large kitchen and a smaller kitchen area used to make coffee etc. Service Users rooms are located off two corridors which are accessed via the lounge /dining area. The home benefits from having a small private lounge, which can also be used for relatives/carers to stay overnight. Most Service Users rooms have individual en -suite facilities. The current weekly fees for the home are between £64.65 and £630.00. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 10.05 am and was in the service for 6 hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspector looked at the building and gardens and spoke with the manager and some of the staff on duty. The inspector also talked to service users, some individually their rooms and some in a group during the lunchtime meal. Records relating to care, staff and health and safety were sampled. A visiting relative gave her views on the care and the welcome to visitors. What the service does well: The home looks thoroughly at whether it can meet the needs of new service users. The assessment includes seeing if there any special religious, cultural or other different needs. Service users are given information about the home and are offered trial visits to help them decide whether to live there. Service Users care and health needs are well met. Risks are identified and action taken to prevent these. Service user medication is looked after and given safely. Staff treat service users with respect and dignity. Service users have the opportunity to join in in-house activities and entertainment and it is planned to develop these further. Service users are helped to follow the religion of their choice. The home is good at making visitors welcome. There is an excellent choice at mealtimes and service users benefit from a healthy diet. Service users and their relatives know that their concerns will be dealt with well. Staff are trained to know how to protect vulnerable service users and how to deal with complaints. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 6 Service users benefit from warm, well cared for and spacious accomodation that gives them choice and opportunity for privacy. The home provides suitable equipment for service users with mobility problems. The home is kept very clean and there are no unpleasant smells, staff are trained to know how to keep service users free from infection. Service users are supported by enough staff who are trained to meet their needs. Recruitment checks makes sure they are suitable to work with vulnerable service users. Staff at all levels know how to do their job properly. The home is well managed by a trained and capable manager. The views of service users and others help improve the service. Service users know that their money is looked after safely. Health and safety checks help keep service users safe. 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. Notrees DS0000031304.V331020.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 Notrees DS0000031304.V331020.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): 1, 2, 3, & 5. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home looks thoroughly at whether it can meet the needs of potential service users. The assessment includes seeing if there any special religious, cultural or other diverse needs. Service users are given information about the home and are offered trial visits to help them decide whether to live there. EVIDENCE: The home has an up to date Statement of Purpose and service User Guide which gives prospective service users, relatives and professionals information about the service. Service users confirmed that they had received this information prior to coming to live at the home. From surveys received it was found that service users are given a contract of terms and conditions so that they know what services the home offers and what their obligations are. A sample contract was seen and covers the required areas. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 9 Service users benefit from a full assessment prior to the home deciding to whether they can meet their needs. This includes assessment by the care management team and the home manager also visits potential service users and carries out an assessment. In discussion with the manager it was found that the homes assessment sometimes raises issues about whether the home can meet specific needs but it was seen that on these occasions trial periods can be extended. The home is not registered to take service users with a primary diagnosis of dementia, however the manager said that recently a number of potential service users have symptoms associated with this illness. It was clear that the home looks at how they can manage these needs in the environment and if they are compatible with the needs of the other service users. It was seen that the admissions assessment includes identifying any religious, cultural or other diversity issues. From speaking to service users and from records sampled it was seen that they can visit the home before deciding to live there. Some service users who had been in hospital and could not visit themselves said relatives were able to tell them about it. One service user said that the home had exceeded her expectations and she was lucky to live there. Standard 6 does not apply to this home. Notrees DS0000031304.V331020.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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users care and health needs are well met. Risks are identified and steps taken to reduce these. Service user medication is kept and given safely. Service users are treated with respect and dignity. EVIDENCE: From sampling service users records it was seen that there are detailed care plans in place, which are drawn up from the assessment of need. There are clear guidelines for staff as to how to meet these needs. Daily task sheets show how service users like to be helped and what their preferred routines are. Night care plans show service users preferred night routines. Care plans are reviewed monthly and formal reviews are carried out . Care plans include any religious or cultural needs. Risks to individual service users are identified and the steps taken to reduce risks are well documented. Bathing risk assessements needed further documentation and this was carried out during the inspection. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 11 Service users health needs are well documented and service users said that their health care needs are met. Charts are kept to monitor specific health needs such as weight, falls, and incontinence. Records show health appointments and their outcome. It was seen that the home has a safe system for the storage and administration of medication. Staff receive training from the local pharmacist who also checks the medication system regularily. Some staff also have additional training via a distance learning course. Service users said that their privacy and dignity is respected and observation of practice confirmed this. Staff induction and training covers these issues and they are highlighted in the Statement of Purpose and service Users guide.. Care records show that serevice users wishes are taken into account and the name they prefer to be called is recorded on their file. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 12 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users have the opportunity to join in in-house activities and entertainment and it is planned to develop these further. Service users are supported to follow the religion of their choice. The home is good at accomodating visitors. There is an excellent choice at mealtimes and service users benefit from a healthy diet. EVIDENCE: The home provides some activities for service users, they have an annual budget that has enabled the purchase of games and some visiting entertainments such as Singing for the Brain, Pat Dogs and Music with Instruments. It was seen that care staff spend 1-1 time with service users when they have time and that they work hard to provide activities within the current resources. Themed days are held for example May day, easter eggs and St Patricks day and an Irish Band for the benefit of Irish residents. The Friends of Notrees visit regularily and make tea and coffee. They provide a Strawberry Tea in the summer. The mobile library calls and a minister visits to hold communion every Wednesday. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 13 One staff has extra hours to carry out the role of Activity Co-0rdinator and other staff have a role in this. Currently activities are provided by staff as part of their care hours but the manager said that when vacant posts are recruited it is planned to provide some designated hours. Some service users felt there could be more activities on offer and some said they would like more outings. The manager said that current staffing levels are not enough to enable outings. During the course of the inspection it was clear that visitors are welcome in the home. One visitor said that they can come at any time and that there is a kitchenette off the lounge/dining room where they can make a cup of tea. There is a seperate small lounge where service users can have private visits. Service users said that they are able to bring some of their personal possessions and furniture into the home. Bedrooms seen were very homely and service users showed their own possessions brought in to the home. Inventories of items brought into the home were seen on file. The majority of service users have relatives who handle their financial affairs but some look after their own personal money. They have secure storage for this in their bedrooms. Service users were very complimentary about the food on offer. They like the variety and said it is always well cooked. There are no cultural or religious dietary needs at present but several diabetics are catered for. A large balckboard menu shows the choices on offer each day and there were several choices of the main lunchtime meal. Service users said they are asked what they would like for lunch each morning. Service users were particularly complimentary about the choice of a full English breakfast at the weekend and said that there is always a cooked choice at each breakfast time. Service users said that breakfast times are flexible, depending on their choice of morning routine. Some service users prefer to have their meals in their rooms. The inspector joined service users for a lunchtime meal and it was a sociable and happy occasion. Staff were seen to help those who need assistance to eat. There were plentifull food supplies and the cook carries out food and fridge/freezer temperature checks to make sure food is stored safely. Staff are trained in Food Hygiene. A recent Environmental Health Officers food safety inspection had highlighted that the kitchen worktops need replacement. Arrangements are being made to carry this work out. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 14 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users and their relatives know that their concerns will be dealt with effectively. Staff are trained to know how to protect vulnerable service users. EVIDENCE: The Commision has not received any information about complaints from service users or their relatives since the last inspection. There is a complaints procedure in place and it is good practice that staff receive training on this every year. There has only been one complaint this year and this was seen to have been dealt with appropriately. service users and their relatives were aware of who to talk to if they have a concern and have details of the complaints procedure in the Service Users Guide. Staff are trained in the Protection of Vulnerable Adults in their Social Care Induction and part of their National Vocational Qualification level 2. Senior staff have further training to make sure they are aware of how to refer any concern for investgation. Staff spoken with were aware of their roles and responsibilities in protecting vulnerable adults. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22 & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from warm, well cared for, flexible and spacious accomodation that gives them choice and opportunity for privacy. The home provides suitable equipment for service users with mobility problems. The home is kept very clean and there are no unpleasant odours, staff are trained to know how to keep service users free from infection. EVIDENCE: A tour of the building showed that the home is well cared for, comfortably furnished and well maintained. Although it is purpose built and there are open plan communal areas, it is decorated in a way that makes it homely and cosy. Service users said they are kept very warm by the underfloor and ceiling heating. There are large windows that give service users a view of the attractive and well kept gardens. Service users bedrooms are well decorated and nicely furnished. Some have en-suite toilets. The provision of a front conservatory, a visitors room and a quiet/sensory room give good choice to Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 16 service users. There are three staff offices that provide privacy for meetings and discussions with relatives or professionals. The home has a variety of equipment to help service users with mobility problems. These include assisted baths, walk in showers, hoists, special beds, rails and raised toilets. the garden has good accesibility and there are plenty of seats. The home is kept clean by domestic staff during the week and care staff at weekends. A number of service users and their relatives said that the cleanliness and fresh smell of the building impressed them on their first visit and was a strong factor in deciding to take up a place there. Service users said that the home is always very clean. Staff training records show that they are trained in Infection Control and how to manage infections such as MRSA. There is a well equiped laundry and there is a system to make sure that laundry is well managed. The laundry is shared by the tenants of the adjacent suuported living flats who have their own machines and specific times for access. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported by enough staff who are trained to meet their needs. Recruitment checks makes sure they are suitable to work with vulnerable service users. Staff at all levels knew how to do their job properly. EVIDENCE: Most of the staff team have worked in the home for a long time and there have been few changes. Two care vacancies have recently been filled and the new staff are due to start soon. A part time cook vacancy is currently covered by a regular agency cook. There is a senior staff and two care assistants on duty between 7.30 am and 9.00 pm. One senior staff and one care assistant from 9pm to 9.30pm and two night care assistants from 9.30pm to 7.30pm. There is a 15 minute overlap period for the senior staff to enable a handover between day and night shifts. The manager mostly works Monday to Friday. It was found by talking to service users and staff and from surveys received that staffing levels meet the current care needs of the service users. Some service users said that staff are very busy but make sure that service users needs are met. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 18 From comments received it was found that some additional hours would help staff develop activities further and the manager is looking into this. Service users and their families were complimentary about the care given. It was seen that staff are friendly and professional in their approach to service users and visitors. Staff at all levels were confident in their role and knew service users individual needs and preferences. Staff have access to a programme of National Vocational Qualification training and an Assessor visited one staff on the morning of the inspection. The home has 90 of staff trained to NVQ level 2 or above. Staff are recruited in line with West Berkshire’s recruitment policy. This includes carrying out checks and references to make sure they are suitable to work with vulnerable people. In discussion with staff and from sampling records it was seen that the procedure is carried out. New staff receive a Skills for Care induction and core training to make sure they are trained to meet the needs of the service users. Training records sampled and discussion with staff show that they receive updates when necessary. Training includes courses specific to the needs of elderly service users for example Dementia, Palliative Care and Parkinson’s disease. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed by a trained and competent manager. The views of service users and others help develop the service. Service users know that their money is looked after safely. Health and safety systems and staff training help keep service users safe. EVIDENCE: The manager has National Vocational Qualification training level 4 and the Registered Managers Award. She has managed the home for 9 years. It was seen from records that the manager regularily takes training courses to update her practice. There was positive feedback from service users and staff about how she manages the home. She is seen as friendly and supportive whilst being good at the management task. Staff felt that the senior team are friendly and supportive and that the staff team are like a big family. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 20 The home has a system to ask the views of service users and others to help develop the service. This involves a manager from another service asking for feedback via a questionnaire and telephone calls. The home has a system to look after service users monies if they need this. This was sampled and records and monies were found to be accurate. The Pre-Inspection checklist shows that essential equipment is regularily serviced. Health and safety records sampled were up to date and well organised. There are risk assessments in place for the building and other significant areas such as fire safety, oxygen, health of staff, manual handling and violence towards staff. Regular checks include, monthly health and safety audits, weekly health and safety checks and weekly checks to the fire safety system and hot water temperatures. Staff receive training in health and safety and first aid. Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 4 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 4 X X 3 X X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 4 Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Notrees DS0000031304.V331020.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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