Inspection on 23/11/05 for Tall Trees

This inspection was carried out on 23rd November 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tall Trees 13/03/07

Tall Trees 24/05/05

Tall Trees 23/11/04

Tall Trees 02/06/04

Tall Trees 05/11/02

Similar services:

Southfields

Thorndene

Insight - Eastchurch

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 148 De La Warr Road Bexhill-on-Sea East Sussex TN40 2JP Lead Inspector James Houston Unannounced Inspection 23rd November 2005 08:30 Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 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 Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 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 Adults 18-65. 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. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tall Trees Address 148 De La Warr Road Bexhill-on-Sea East Sussex TN40 2JP 01424 211990 01424 819104 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) Care Management Group Limited Mrs Rebecca Theresa Woolett Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of residents must not exceed six (6) The people accommodated will be between the ages of eighteen and sixty five years on admission 24th May 2005 Date of last inspection Brief Description of the Service: Tall Trees is a detached property in a residential area of Bexhill. It is located on the main road to St. Leonards-on-Sea and Hastings, within easy walking distance to shops and local amenities. A secluded rear garden is accessed via steps from a patio seating area. The home provides residential and social care for six adults with learning disabilities. It is one of around 80 homes owned by the Care Management Group, providing services for people with learning disabilities, who may also present challenging needs. Service users private accommodation is on two floors. Each bedroom is provided with en suite facilities. There is no passenger lift and Tall Trees would not be suited to service users with restricted mobility. The home has a car, provided by the owners, for taking service users on trips and outings. There is a parking area at the front of the building, sufficient for a small number of vehicles. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over 6.1 hours during the morning and afternoon of 23rd of November 2005 when six residents were being accommodated. Four of the residents were spoken to, as well as two members of staff and deputy manager who had come in on her day off. A tour was made of the whole premises and a range of policies and procedures and records including three care plans were read. A relative was spoken with after the inspection. There were six people resident in the home on the day of the inspection. What the service does well: 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. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 6 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 Outcomes Statutory Requirements Identified During the Inspection Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 7 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 the following standard(s): 1 and 4. Prospective residents and their representatives are given full information and every assistance to assist them in making the decision about whether or not to move into the home. EVIDENCE: The home has a statement of purpose and information leaflet that contain all the required items. A copy of the latest inspection report was on display in the entrance hall should any visitor wish to see it. The home has full occupancy and the last admission was about a year ago. Staff said that prospective residents would be invited to visit the home prior to admission, and that admission would initially be on a trial basis. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 6,9 and 10. Some care plans need more regular review. Staff relate well to residents. EVIDENCE: All residents have a key worker. The home has a system for holding six monthly reviews to which relatives are invited. Where these have not been held at this frequency recently, arrangements are being made for this to happen. Risk assessments are made and updated regularly. Staff give advice to residents about their safety and well being. The home has a suitable procedure about the action for staff to take in the event of a resident going missing and staff said that they are aware of this. All staff are informed of the home’s policy on confidentiality at the time of their induction. Discussion with staff showed that they are aware when confidential information should be shared with their manager, with parents or others. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 11,12,15 and 17. Residents lead a fulfilling life. Visitors are made welcome. Meals and mealtimes are a source of variety and enjoyment for residents. EVIDENCE: Residents have opportunities to receive appropriate advice and counselling when this is required. Opportunities for personal development are an integral part of the service of the home. Staff said that residents spiritual needs are met and some residents attend a local place of worship from time to time. Some residents attend day centres for part of their week and during the inspection two residents went out with a member of staff for lunch and to do shopping for the house. A relative said that the social opportunities for residents are many and varied and they go out a lot. Residents are not in paid or voluntary work placements. Educational opportunities for residents are regularly reviewed with them. Staff said that they see greeting residents’ visitors and offering them hospitality as important. Residents said that their visitors are made welcome, and a relative confirmed this. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 10 Residents may choose to assist with the preparation of meals and clearing away afterwards. Residents said that they like the meals served. Records inspected showed that the home has a four weekly menu with an individual record kept of food served. Residents may invite friends in for meals by prior arrangement. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 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 the following standard(s): 19,20 and 21. Residents’ healthcare needs are well met. Medicine administration systems are good but administration records need attention. Systems to care for dying residents and death are in place. EVIDENCE: Records inspected and discussion with staff showed that the home makes thorough arrangements to meet the health care needs of residents. Staff said that they have had training in the administration of medicines and records inspected confirmed this. Medicines are securely held. No controlled drugs are held at present and no residents self medicate. A pharmacist inspects the home’s systems regularly. The record of administration of medicines was inspected. Some gaps were found. This should be addressed. The home has a suitable policy on the care of dying residents. Staff said that they are aware of this. Care plans inspected were found to contain information on the action to be taken by staff to ensure that wishes of residents and their families as to the actions to be taken after the death of a resident are carried out. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 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 the following standard(s): 22 The home has a suitable complaints system. EVIDENCE: The staff are trained to respond to the wishes and suggestions of residents. A record is kept in the home of any complaints made and actions taken to address them. Two matters entered were found to have been well dealt with and fully recorded. The Commission for Social Care Inspection has received no complaints concerning the running of the home. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 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 the following standard(s): 24,26,28 and 30. The overall standard of the environment within this home is very good, providing residents with an attractive and homely place in which to live. Requirements made at the last inspection regarding the lopping of trees in the rear garden and the re-siting of the laundry require to be addressed. EVIDENCE: Residents said that they like the home. The home has its own maintenance staff that were on site during the inspection. Staff said that the relationship with these staff and their response is excellent. Since the last inspection exterior woodwork to the rear of the premise has been replaced, and new furniture provided in the lounge. The kitchen has been replaced and there is an ongoing programme of redecoration. The home has tried to have the very tall trees on the rear boundary fence lopped, and now has a date of January 2006 for this to be done. Residents’ rooms are well presented, and residents said that they are involved in any plans to redecorate them. Residents can bring in items of their own and an inventory is kept of these. Rooms are lockable but residents do not choose at present to use their keys. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 14 Communal areas are well presented. The home has a large garden that a resident said that they enjoy using. Staff said that they have suitable facilities in the home. The home is clean and tidy throughout. Residents are involved in cleaning where possible. The home’s laundry is sited in a small storage area leading off the kitchen and has not been re-sited despite a requirement to this effect made at the last inspection. The home has suitable infection control policies of which staff said they are aware. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 15 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,34 and 36. The staff group has clear roles and responsibilities. Recruitment processes are thorough. Supervision should be offered more regularly to staff. EVIDENCE: Staff employed in the home have considerable relevant experience. Staff said that they have job descriptions and copies of these were made available for inspection. Residents said that they like the staff. A relative confirmed that the home has a stable staff group who appear to enjoy working there. Interactions observed between staff and residents demonstrated that staff know the residents they support and are able to meet individual needs. A staff recruitment file sampled showed that all the required paperwork had been obtained. Staff confirmed that they are given contracts and have copies of the General Social Care Council Code of Conduct. The home’s staff confirmed that they receive regular supervision but records showed that this was not quite at the recommended level of at least six times per year. Senior staff are planning to remedy this. Staff who supervise have been given appropriate training. Annual staff appraisals have been introduced, but not all staff have had them as yet. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41and 42. An application in respect of a registered manager is required. The home’s atmosphere is good. Quality assurance processes are thorough. Records are well kept. Appropriate attention is paid to ensuring the health and safety of residents is good. EVIDENCE: The home’s acting manager has an appropriate job description. She undertakes appropriate training updates and is seeking to obtain the Registered Managers Award. An application from a registered manager is required. The home has regular staff and residents meetings, and the minutes of these were made available to the inspector. The home has an open and positive atmosphere and gives a safe, supportive and homely environment for residents. Staff, residents and a relative said that they relate well to the acting manager. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 17 The home has suitable quality assurance processes. Records inspected showed that residents, relatives and care managers have completed questionnaires about how the home is achieving goals for service users. The home has a current annual development plan. Record keeping in the home is generally good, except where raised elsewhere in this report. Records are securely held. Residents are able to access their records if they so wish. Arrangements for staff to train in safe working practices are thorough, with only training in moving and handling needing attention. Records inspected showed that gas and electricity installations and portable electrical appliances have been inspected. The home carries out thorough and very regular checks on the environment in the home. Several fire doors were found to be wedged open. Consideration should be given to the installation of devices, where permitted, which allow fire doors held open to close in the event of the fire alarm sounding. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 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 2 X X 3 X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 3 X 3 X 2 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X X 3 X 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tall Trees Score X 3 2 3 Standard No 37 38 39 40 41 42 43 Score 2 3 3 X X 2 X DS0000021236.V261998.R01.S.doc Version 5.0 Page 19 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA20 YA24 Regulation 17(1)(a)& Sch3 3(i) 23(2)(b) Requirement Keep fully the record of medicines administered. The premises are satisfactorily maintained i.e. homes garden boundary trees, which are excessively overgrown. (Previous timescale of 01/11/05 not met). That laundry facilities are sited so that soiled articles and clothing are not carried through areas where food is stored, prepared, cooked or eaten and do not intrude on residents. (Previous timescale of 01/11/05 not met). That the home employs a registered manager who is suitably experienced and qualified.(Previous timescale of 01/11/05 not met). Do not wedge open fire doors Timescale for action 23/11/05 31/01/06 3 YA30 16(2)(j) 30/05/06 4 YA37 9(2)(b)(i) 31/03/06 5 YA42 23(4)(a) 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 20 No. 1 2 3. Refer to Standard YA7 YA36 YA42 Good Practice Recommendations Review care plans at least six monthly. Give staff regular recorded supervision at least six times per year and annual appraisals. Provide moving and handling training for staff. Tall Trees DS0000021236.V261998.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 DS0000021236.V261998.R01.S.doc Version 5.0 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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