Inspection on 19/07/05 for Tall Trees

This inspection was carried out on 19th July 2005.

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

Tall Trees 01/12/05

Tall Trees 20/12/04

Tall Trees 02/07/02

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Tall Trees Guildford Road Chertsey Surrey KT16 0PL Lead Inspector Sandra Holland Unannounced 19 July 2005 13:45 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Tall Trees Address Tall Trees Guildford Road Chertsey Surrey KT16 0PL 01932 844044 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) Welmede Housing Association Ltd Byfleet House, 2 Guildford Road, Chertsey, Surrey, KT16 9BJ Mrs Jennifer McArthur Care Home (CRH) 3 Category(ies) of Learning disability (LD), 3 registration, with number Learning disability over 65 years of age (LD(E)), of places 1 Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 The age/age range of the persons to be accommodated will be 30-65 Years 2 One service user can be accomodated who is over 65 years of age. Date of last inspection 10 February 2005 Brief Description of the Service: Tall Trees is a residential home for up to 3 adults who have learning disabilities. The service is managed by Welmede Housing Association and the staff are employed by the North Surrey Primary Care Trust (NSPCT). The service is a detached property and the facilities and accommodation are set on two floors. There is no mechanical means to access the upper floor and none is required for the existing service users. All service users have a single bedroom and access to a separate lounge, dining room and kitchen. There is a garden area to the rear and front of the house. The location of the home is near to a busy motorway and roundabout and is such, that transport is required for all activities and appointments. The service users living at the home require full support and supervision from staff for all their daily living activities, both inside and outside of the home. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the first to be carried out in the Commission for Social Care Inspection (CSCI) year April 2005 to March 2006. The inspection was carried out over three and three quarter hours by Mrs. Sandra Holland, Lead Inspector for the service. Mrs. Jennifer McArthur, Registered Manager was present representing the service. A number of records and documents were examined, including medication administration records (MAR’s), some health and safety records and service user finance records. All three service users and two members of staff were spoken with. The inspector wishes to thank the service users and staff for their time, hospitality and assistance. What the service does well: What has improved since the last inspection? What they could do better: The stock of medication held in the home did not match the record held. This is unacceptable and systems must be put in place to ensure this does not continue. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 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. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Letters of amendments have been issued to service users. 5. EVIDENCE: The manager advised that each service user is provided with a Licence Agreement which details the terms and conditions of residence at the home. These listed the home by its previous name and did not accurately specify each service user’s financial contribution. Letters have now been sent to service users specifying these details. These letters form amendments to the contract between each service user and the home. As the service users are unable to sign to show they have received and understood these amendments, because of their complex needs, it is recommended that service user’s representatives are asked to sign on their behalf. A recommendation has been made – please see page 20. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed at this inspection. EVIDENCE: Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Service users are supported to maintain family links. EVIDENCE: 15 and 16. The senior support worker advised that a service user is being supported to develop further contact with his family, as this has been infrequent in the past. Another service user has regular visits to stay with his family. Staff advised that the daily routine in the home is flexible and is arranged to suit the preferences of the service users. It was clear that staff support service users in making choices and involve them in household activities and conversations. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 20. Service users receive support in the way they prefer and require. EVIDENCE: It was clear from observing the service users and staff that support is provided sensitively and discreetly and in a way that promotes each service users privacy and independence. Medication is provided to the home by a local pharmacy and is recorded on Medication Administration Record (MAR) sheets. Medication training which was organised by the local pharmacy company, has been undertaken by all members of staff. Although the receipt of medication into the home is recorded, the stock of medication held did not tally with the MAR sheet. It is unacceptable that medication cannot be fully accounted for and it is required that the systems for medication administration are reviewed. A requirement has been made – please see page 20. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23. Staff are aware of their responsibilities in the protection of service users. Procedures are in place to safeguard service user’s finances. EVIDENCE: From discussions with staff it was clear that they are aware of their responsibilities in the protection of the service users living at the home. The manager advised that she and her deputy are appointed persons and signatories to service users financial accounts. Access to service users accounts is restricted to the appointed persons and two signatures are required and recorded for all transactions. This is to safeguard the service users and the staff. A detailed record book is maintained for each service user, in which all financial transactions are recorded. A check of monies held for safekeeping is made three times a day at the handover of staff shifts. This was checked and found to be accurate. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30. The overall décor and furnishings in this home provide a well-cared for and homely environment for residents. EVIDENCE: The home was cheerful, bright and is appropriately furnished and equipped in a domestic, family style, to meet the needs of residents. It was clean, tidy and freshly aired throughout. The cellar of the home had recently been affected by a flood, caused by a burst water main in the road outside. The manager advised that all appropriate action had been taken to safeguard items stored there and that equipment had been provided to dry the area out. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33 and 36. Service users are supported by a stable and effective staff team under the leadership of the manager. EVIDENCE: The manager advised that the home is run by a small team of experienced support staff, who carry out all roles within the home, including shopping, cooking, laundry and domestic tasks. Service users are supported to assist with tasks as they are able and if they wish to. Staff advised that team meetings are held on a monthly basis. Minutes (notes) of the discussions at the meeting are taken and copies of these were seen. It was clear that the meetings cover a variety of subjects. The manager stated that as not all staff attend the monthly meetings, she has requested that staff attend at least eight each year. This is to ensure they are involved and consulted. Staff members are requested by the manager to sign the minutes of the meeting to show they have read them. The manager advised that supervision is usually held with staff six times a year and was last carried out in April 2005. The manager stated that supervision of staff is carried out more frequently if necessary, to address specific issues. This had been required for a member of staff who has now left the home. Records or notes of the supervision meetings were not available for inspection due to the recent flood affecting the document storage area. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 15 Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38 and (42 partially). The service users in this home benefit from a well-run home and are supported by an enthusiastic staff team and an effective manager. EVIDENCE: The manager advised that she has managed the home for a number of years and is undertaking training for National Vocational Qualification (NVQ) Level 4. It was evident that she has created an open and inclusive atmosphere. Staff and service users were seen to be at ease, whilst interacting in a professional manner. Staff members have been developed to run the home in the manager’s absence, as the deputy manager and senior support worker were able to assist the inspector and provide much of the information required. The senior support worker advised that she takes the lead in health and safety issues at the service. A number of records in relation to health and safety (but not all), were seen and these were found to be satisfactory. The records Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 17 relating to fire safety were seen and found to be up to date, with appropriate equipment in place which is regularly serviced. The records of hot water temperatures were also seen and recorded that the hot water supply was within a safe range. The service was inspected by a Fire Officer earlier this year. The only recommendation made was that a fire risk assessment be carried out for the premises and this is in place. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x 2 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x 3 3 x Standard No 31 32 33 34 35 36 Score 2 x 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tall Trees Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 19 NO 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. Standard 20 Regulation 13 (2) Timescale for action The registered person shall make 19th July arrangements for the recording, 2005 handling, safekeeping, safe administration and disposal of medicines received into the care home. Specifically, the quantity of stock held must accurately match the records held. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 5 Good Practice Recommendations It is good practice to ensure that service users contracts or terms and conditions of residence are signed by service users. If this is not possible due to the needs of the service user, their next of kin or representative should be asked to sign on their behalf. Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Tall Trees H09 H58 S13812 Tall Trees V237518 190705 Stage 4.doc Version 1.40 Page 21 - 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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