Inspection on 13/09/06 for Tall Trees Nursing Home

This inspection was carried out on 13th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tall Trees Nursing Home 16/07/08

Tall Trees Nursing Home 27/09/07

Tall Trees Nursing Home 06/12/05

Tall Trees Nursing Home 22/04/05

Tall Trees Nursing Home 05/11/04

Tall Trees Nursing Home 14/05/04

Tall Trees Nursing Home 12/01/04

Tall Trees Nursing Home 12/06/03

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

CARE HOMES FOR OLDER PEOPLE Tall Trees Nursing Home Oaks Place Mile End Road Colchester Essex CO4 5XR Lead Inspector Lysette Butler Final Unannounced Inspection 08:15 13th September 2006 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 Tall Trees Nursing Home DS0000015342.V311988.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. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tall Trees Nursing Home Address Oaks Place Mile End Road Colchester Essex CO4 5XR 01206 844425 01206 855230 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) Lanemile Limited Mrs Penelope Irene Heap Care Home 48 Category(ies) of Dementia (24), Dementia - over 65 years of age registration, with number (24), Old age, not falling within any other of places category (3), Physical disability (24), Physical disability over 65 years of age (24), Terminally ill (3), Terminally ill over 65 years of age (3) Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. 9. Persons of either sex, aged 60 years and over, who require nursing care by reason of a physical disability (not to exceed 24 persons) Persons of either sex, aged 50 years and over, who require nursing care by reason of a physical disability (not to exceed 4 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of a physical disability (not to exceed 24 persons) Persons of either sex, aged 60 years and over, who require nursing care by reason of dementia (not to exceed 24 persons) Persons of either sex, aged 65 years and over, who require nursing care by reason of dementia (not to exceed 24 persons) Persons of either sex, aged 55 years and over, who require general palliative care (not to exceed 3 persons) Persons of either sex, aged 65 years and over, who require general palliative care (not to exceed 3 persons) Persons of either sex, aged 65 years and over, only falling within the category of old age (not to exceed 3 persons) The total number of service users accommodated must not exceed 48 persons 6th December 2005 Date of last inspection Brief Description of the Service: Tall Trees is a purpose built home on two floors, registered to provide care for forty-eight service users. Twenty-four who are mentally frail, twenty-one who are physically frail and three who are in of need palliative care. It is in the grounds of a private hospital, in Colchester. Lanemile Ltd, part of the Care UK group, is the proprietor of Tall Trees. The home is divided into two separate units: Rowan on the ground floor and Aspen on the first floor. Rowan is the mentally frail unit and Aspen is the physically frail unit. A multidisciplinary team that includes registered nurses, care assistants and other professionals allied to medicine, deliver care that enables the service users to live safely. Forty beds are offered in single rooms with the remaining eight being offered in double rooms. The home has neat, well laid out grounds to the rear of the building, to which all service users have access. Current Fee scale: £600 to £713 Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection started on 1st April 2006. The inspection process included: a site visit on 13th September 2006, which lasted 7 hours; review of evidence supplied by the proprietor, residents, visitors to the service or the staff; resident, visitor, healthcare professionals and staff surveys; discussions with the registered manager, senior carers, care staff, ancillary staff, residents and relatives. During the site visit the premises were inspected, including inspection of the grounds. Samples of records and residents care plans were also reviewed. The home was clean and well maintained. The overall care and well being of the residents was the focus of the inspection. Staff and residents were welcoming and happy to speak to the inspector at the site visit. This inspection covered all twenty-two key standards and five of the remaining standards. The staff approached the inspection in a positive and cooperative manner that was focused on achieving best practice to meet the needs of the residents. What the service does well: What has improved since the last inspection? A new permanent manager has been appointed and registered by the Commission for Social Care Inspection. The redecoration and replacement of carpets on Aspen unit has enhanced the environment of the home for residents and their visitors. The employment of a second activities coordinator will increase the range and frequency of activities offered to all residents. The changes in staff hours later in the day helps during the busiest period of the day and ensures better continuity of care. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 6 Care plans on Rowan unit have improved and are regularly reviewed to ensure continuity of care and that changes are made in a timely fashion. 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 Nursing Home DS0000015342.V311988.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 Tall Trees Nursing Home DS0000015342.V311988.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 & 6 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Admission assessment is based on resident need and the welfare of the current residents, ensuring that all residents receive care appropriate to their needs. EVIDENCE: The statement of purpose & service users guide was in process of being updated at the time of the site visit, to incorporate the change of manager details and the changes to the care planning organisation. (See health & personal care section) Contracts for the home have not changed however the amount of social service contracted beds has decreased with a subsequent increase in privately funded beds. All private residents have the standard Care UK contract. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 9 The manager or senior registered nurse on each floor, using Care UK documentation, carries out assessments of all prospective residents. Care files reviewed during this site visit, contained details of the residents’ initial assessment, which is used as the basis of the care offered when they are admitted to the home. Assessments were in the process of being transferred to the computerised care plan system, (See health & personal care section), and future assessments would be entered directly onto the system when the assessor returns to the home. Staff are all offered appropriate training to enable them to offer the care needed to the current residents. The manager checked with the commission who she could accept into the home on taking up her post and is very clear about which residents she can accept within the conditions of the home’s registration. Residents admitted to the physically frail unit of the home are all offered trial visits if they wish, but rarely take up the offer. However the placement is reviewed with all concerned parties four to six weeks after admission. Prospective residents who are mentally frail are not offered trial visits as it is deemed too disorientating, but again a review of the placement is made between all concerned parties six to eight weeks after admission. The Care UK documentation issued to prospective residents and their families contain details of the arrangements for trial visits if they wish to make them. Intermediate care is not offered at this home. Tall Trees Nursing Home DS0000015342.V311988.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Care plans were generally fair, but as reviews are not carried out frequently enough, they were therefore not always as up to date as they should be. Medication procedures were safe and appropriate for the level of care the residents were receiving. EVIDENCE: Care UK is in the process of computerising all care planning and personal files throughout its care homes. The system called Saturn was in its final stage of implementation at the time of the site visit, when both a paper system and the computerised one were running in tandem, however for the purposes of this inspection and to maintain proportionality paper files only were reviewed at the site visit. A total of six care plans were reviewed, three from each unit. The care plans on Rowan unit were detailed, reviewed regularly and complete, had improved significantly since the last inspection. However following an initial improvement immediately after the last inspection, care plans on Aspen had not maintained the improvements. A number were being reviewed but not on Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 11 a regular basis and there was very little evidence of current/appropriate updating of the care needed. The range of risk assessment documents used on both units was good, but changes were not always made to the care plans in relation to the updated assessments. It is envisaged that there will be an improvement in plans following full implementation of the Saturn system, as has happened in other Care UK homes. There is always a registered nurse on duty, on each unit of the home. Consequently district nurses do not need to visit the home, however staff were clear that they consult community nurse specialists as needed for individual residents. There was evidence within the care plans that there had been recent referrals to the continence service, the tissue viability service and the community psychiatric nurse service. Other professionals allied to medicine, such as dentists, opticians and chiropodists attend the individual residents in the home. All professionals attend the residents in their own rooms. Documentation reviewed during the site visit demonstrated regular GP visits to the home, and all residents were seen by their GP when needed. Medication procedures throughout the home were generally good and there was no over-stocking observed. Each unit had their own medication room, but the medication policies & procedures were the same Care UK ones throughout. All medication administration record dividers contained a dated picture of the resident, which had been taken within the last eight months and updated as changes to the residents’ appearance occurred. The dividers also contained specialist administration procedures for the individual resident. If ‘covert’ administration is required for individual residents a form signed by the registered nurse, the GP and the residents’ family is also contained within the medication administration record file. Tablet cutters and crushers observed during the site visit were clean and appropriate for the usage in this home. Oxygen is stored in the medication room on Aspen unit. Fridge and room temperatures were not being recorded regularly in either medication room. Some individual medication audits had been carried out, but were not regular, as required by Care UK procedures. All medication administration records were reviewed during the site visit and there was evidence on both units that not all medications were signed for when administered, (this was more evident on Rowan than on Aspen,) and changes had been made on several charts reviewed with no way of telling who, when, or why the changes had been made. (Again this was worse on Rowan than on Aspen.) There was also evidence that a number of charts had been rewritten or partially rewritten, but the reason for the changes was not clear and left the nurse having to look through a number of different charts to administer all medications to individual Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 12 residents. There was also evidence of changes made to the describing details of some medications, with no reason to change highlighted. All policies and procedures in this home take into account the privacy and dignity all of the residents. During the site visit the inspector observed staff communicating well and treating the residents with respect. A new hairdresser was being shown round the home on the day of the site visit as they had not had access to a hairdresser in the previous few weeks, following of the resignation of the previous one. The new hairdresser owned their own saloon and will be able to supply stylists on a regular basis, but also in-between if residents request it. Documentation regarding residents’ wishes if they become terminally ill or die within the home were good throughout. Tall Trees Nursing Home DS0000015342.V311988.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Residents were enabled to make choices in their day-to-day lives so that they can control aspects that are important to them. EVIDENCE: There are a wide range of activities offered at this home and a list of all forthcoming activities is displayed on both floors and in the entrance hall. There was one activities coordinator in post at the time of this inspection, however a new activities coordinator was due to commence work at the home the week following the site visit. Between the two coordinators sixty-six hours activities will be offered each week and the home supplied to the commission a prospective list of what extra activities would be enabled to be offered with the commencement of the new member of staff. This home operates an open visiting policy and during the site visit visitors were observed coming and going from the home. Everybody signed the visitors book and staff were welcoming to all the visitors they met. Visitors are enabled to visit their friends and relatives in private or in communal rooms Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 14 throughout the home. There are a couple of rooms that can be used for family parties if booked in advance. At the time of the site visit no one had asked for restricted visiting. During this inspection process none of the residents were using services of an advocate. There is very little community input to the home however via the local church communion is undertaken in the home regularly and the local PAT dog scheme participants bring their dogs into the home. At the time as this inspection none of the current residents were looking after their own finances. The administrator is appointee for two of the residents. All residents are on the electoral register. Documentation regarding residents within the home is stored in line with Data Protection Act guidelines. Personal possessions are listed when the resident is admitted to the home; however the home reported that it is difficult to keep this up to date as relatives and friends often bring possessions in without letting the staff know. The kitchens were clean and tidy at the time of the site visit. Environmental Health Officer visits were up-to-date. The chef has been with the home for some years and cooks all cakes, tarts, etc in the home. It was observed that water jugs and glasses were being regularly changed and were available throughout the home. When speaking to the residents and visitors they commented that during the very hot weather earlier in the year staff were very quick to make sure that everybody had a drink at regular intervals. On speaking to the chef she is not happy with the quality of the service being offered by the new food delivery service. However she feels that the things are beginning to improve and that the right orders would be sorted out soon after this site visit. Vegetables, meat and fish are still sourced locally as the quality was better than that being delivered. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. The residents in this home are protected by the policies & procedures the service operates, being followed at all times by the staff. EVIDENCE: At the time of the site visit there were no complaints pending. The Commission for Social Care Inspection checks all Care UK policies and procedures, centrally. But there had only been one complaint since the last inspection, that was forwarded to the commission and this had been resolved satisfactorily. The manager of this home is clear about her responsibilities regarding Care UK complaints procedures and how the Commission for Social Care Inspection wishes them to be handled. There were no Protection of Vulnerable Adults issues at the time of the site visit and had been none since the last inspection. A large number of staff were due to have a POVA training update session the week following the site visit and then all staff would be up-to-date with their training. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. This home is well sited and the grounds are well kept; however the ongoing decoration on Rowan will further improve the environment for the residents. EVIDENCE: There has been no change the fabric of the building since the last inspection. Aspen unit has been redecorated and there are new carpets fitted, on the day of the site visit the unit looked bright and airy throughout. However consideration needs to be given to replacing the dining chairs in Aspen unit as a number were unstable or had ripped covers on the seats. Rowan unit is in the process of being decorated and there is an ongoing plan of decoration that is currently being completed. There is a new maintenance person at the home, who is following Care UK policies and procedures. Six hot water temperatures were checked during the site visit and all were within acceptable limits. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 17 Infection control procedures are good throughout the home. On arrival at the site visit there was one area on Rowan unit that was malodorous, however this had been rectified by lunchtime. Otherwise the home was fresh smelling, bright and airy throughout the day of the site visit. The laundry was clean and tidy and it was evident that there are good routines being followed. The laundry person on duty worked one day a week in the laundry and on other duties for the rest of the week. The laundry person told the inspector that they enjoy having two roles as it kept their job interesting. Even though the laundry was reviewed at the busiest part of the day the room was tidy and organised. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Staffing numbers were improved and training is generally comprehensive to ensure appropriate care is offered for the individual needs of the residents. EVIDENCE: Staff numbers and skill mix are within agreed limits and are adequate for the current resident dependency levels at the home. Student nurses occasionally work at home as part of their training. Agency staff are used at the home and there is a short induction pack which is undertaken with them on the first day at the home. On the day of the site visit a care assistant was going through the induction pack with the registered nurse on Rowan. There was a staff meeting in the afternoon of the site visit, which was well attended and was minuted. A number of issues were raised and staff were given the opportunity to discuss the work of the commission. The home currently has 45 of its care assistants trained to NVQ level 2 or above and two further care assistants are about to complete their course, which will raise the number trained to over 50 . Ongoing NVQ training is offered to all care staff. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 19 Four personnel files were reviewed at the site visit all were tidy, easy to read and complete. Some aspects of the files are already on the Saturn system, (see health and personal care section), however for the purposes of this inspection and to maintain proportionality paper files only were reviewed at the site visit. Staff training records demonstrated a commitment to both statutory and various other types of training as required or needed by the individual staff members. Statutory training was up-to-date and there were a number of further sessions booked throughout the year. Induction packs for both permanent and agency staff were reviewed and were comprehensive. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 - Quality in this outcome area is good; this judgement has been made from evidence gathered both during and before the visit to this service. Management and administration procedures in the home protect the health and welfare of the residents. EVIDENCE: Since the last inspection a new manager has been employed and registered by the Commission for Social Care Inspection. The new manager has been registered in the past with the commission and is well qualified for the post. She is a registered nurse with a mental health background. Residents and relatives spoken to said that the new manager was approachable and the atmosphere in the home had improved, overall. Some staff spoken to however are not happy with some of the changes being made, the manager is aware of this and is dealing with it appropriately. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 21 Quality assurance issues were not looked at during this inspection, however the home has been asked to supply details of all future audits and resident/relative surveys that Care UK undertake. Six resident accounts were checked during the site visit, all were correct and documentation showed a clear, detailed audit trail. The administrator was appointee for two residents and none of the residents were looking after their own finances. All residents receive their full weekly allowances to use how they choose. The manager regularly checks the accounts with the administrator and only the administrator and manager have access to the accounts. The new manager has commenced regular supervision for all staff members. Records are kept separately from personnel files, but there is a list of when each session is undertaken. All staff should have had an appropriate number of sessions by the end of the financial year. There is a large range of health and safety checks undertaken in the home covering all aspects of resident safety. All certificates were checked during this inspection were up to date and complied with the standards. The regular fire alarm test was undertaken during the site visit and all doors automatically shut instantly as the system is set up. Care UK maintenance records were checked, they were detailed and methodically completed. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 22 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 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 3 X X X 3 3 X 3 Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 23 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 1. OP7 Regulation 15(2b-c) Requirement The registered manager must ensure that all care plans are regularly reviewed and changes are made appropriately. (The standard states that this would normally be once a month.) Timescale for action 31/10/06 Timescale of 28/02/06 not met. (Aspen only) 2. 3. OP9 OP9 13(2) 13(2) 4. OP19 23(2b) The registered manager must ensure that all medications administered are signed for. The registered manager must ensure that all medications are regularly reviewed by the GP and changed as required. The registered manager must ensure that the ongoing decoration of the home continues. 31/10/06 31/10/06 31/12/06 Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 24 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. 2. Refer to Standard OP9 OP19 Good Practice Recommendations The registered manager should ensure that medication room and fridge temperatures are taken and recorded daily, so that all medications are kept at optimum temperatures. The registered manager should consider replacing the dining chairs on Aspen. Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Tall Trees Nursing Home DS0000015342.V311988.R01.S.doc Version 5.2 Page 26 - 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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