Inspection on 25/09/06 for The Lemon Tree

This inspection was carried out on 25th 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

The Lemon Tree 04/01/06

The Lemon Tree 12/09/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Lemon Tree 133 Hornby Road Blackpool Lancashire FY1 4JG Lead Inspector Mr Wesley Cornwell Unannounced Inspection 25th September 2006 09:30 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 The Lemon Tree DS0000062940.V304566.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. The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lemon Tree Address 133 Hornby Road Blackpool Lancashire FY1 4JG 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) 01253 621643 Mrs Nivedita Devi Kurtis Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The home is registered for a maximum of 12 service users over the age of 65. 4th January 2006 2. Date of last inspection Brief Description of the Service: The Lemon Tree is registered for 12 male and female residents over the age of 65 years. The home is situated close to Blackpool town centre and comprises of the following accommodation: One lounge and one dining room/sitting area both of which are designated as non-smoking areas. Resident bedrooms are situated on the ground and first floor. Three bedrooms have en-suite facilities. The home has a chairlift that facilitates access between the ground and first floor. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice whether to move into the home. The range of fees at the home are £285.04 to £329.91 covering all aspects of care, food and accommodation. The owner provided this information on the 11th September 2006. The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was undertaken as part of the homes Key Inspection. The site visit commenced at 9.30am and took place over 4 hours. The Inspector spoke to one staff member, five residents and the owner of the home. Comment cards were completed by thirteen residents and their relatives providing their views about the home. Staff, care, maintenance and financial records were also examined. A full tour of the premises was undertaken with the owner of the home. What the service does well: What has improved since the last inspection? The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 6 There have been improvements made to the environment since the last inspection with the redecoration and re-furbishment of bedrooms and communal area’s. Residents spoken to were very happy with the improvements being made. The home has purchased a mini-bus to take residents on outings. One resident said they had been on several outings during the summer and was looking forward to the trip arranged to look around the illuminations next week. Staff and resident meetings have been introduced to seek the views of residents and staff members about the quality of service being provided by the home and keep them informed about forthcoming events and any changes that may be happening within the home. Residents spoken to said they found these very informative. 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 Lemon Tree DS0000062940.V304566.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 The Lemon Tree DS0000062940.V304566.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: The care plan records of one resident recently admitted to the home had full assessment information including the religious/cultural and relationship needs of residents. Staff members confirmed they had access to this information and could describe in detail the care needs of the resident. Staff responsible for the preparation of meals said they were they had information about residents who had special dietary needs and these are always accommodated. This home does not provide intermediate care. The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 9 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs were met. Residents feel respected by the staff team and their right to privacy is upheld. EVIDENCE: Individual records are kept for each resident with a plan of care setting out the action that is needed to be taken by care staff to ensure all aspects of health, personal and social care needs of the residents were met. Significant events had been recorded and daily entries made setting out the care given. The care plans were structured and were being reviewed at least once a month and updated to reflect any changing needs in the health and personal care of the resident and these were being actioned. The records of two residents were looked at and these described their healthcare needs. Discussion with the staff member on duty confirmed they The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 10 were fully aware of the healthcare needs of residents and these are monitored and their care plans kept up to date. Entries made on care plans showed good communication between the home and healthcare professionals. The records of one resident confirmed a healthcare problem had been identified and appropriate action had been taken by the home. The relative of one service user said, “ My mother was recently admitted into hospital and when she was ready for discharge it was thought she might not be able to return to the home because of the level of care she would need. The owner of the home said they could provide the care required. My mother was very well looked after on her return to the home and I don’t think she would have recovered as well as she did if she had gone elsewhere”. Residents spoken to said they liked living at the home and were well treated by staff members. One resident said, “ I am very satisfied with my care. The owners and staff are very kind”. The relative of one resident said, “ I am very satisfied with all aspects of care. In my opinion this is a very good care home”. Observation of practice and examination of care plan records confirmed staff were meeting the diverse needs of service users with specific disabilities and specialised equipment was readily available to assist them with their duties. Medication practices observed were safe and good records had been maintained. Residents spoken to said the staff team respected their privacy and they could spend time on their own if that was their wish. The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 11 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes procedures enable residents to exercise choice and control over their lives. Visiting arrangements at the home are informal and family and friends of residents are encouraged to maintain contact. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. EVIDENCE: Residents spoken to said routines within the home were flexible and they were able to make their own decisions about how to live their lives. One resident said, “ I have lived here for several years having moved from another care home. I have always been happy and very satisfied with the care provided. The staff are very caring and friendly. They are very respectful and allow me to make my own decisions. I come and go as I please and like to get out most days”. Residents spoken to said they were happy with arrangements in place for receiving their visitors. The relatives of seven residents said they were always The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 12 made welcome by the staff when they visited the home and found the staff friendly and approachable. Residents spoken to confirmed they enjoyed the food provided by the home. One resident said, “ I really enjoy the food and get plenty to eat. The food provided is very good and I always look forward to my meals. Meal times were served in a relaxed and unhurried manner. Staff members were observed being very attentive to residents needs. Most residents at the home handle their own financial affairs or these are handled by their relatives/representatives. Records being kept by the home in respect of residents unable to manage their own finances were being well maintained. Care plan records confirm the home are promoting equality by treating residents as individuals and ensuring people with diverse needs are having these met. Discussion with one resident confirmed the support being provided by the home enabled them to pursue hobbies and interests and maintain an independent lifestyle. The resident said, “ I like to retain my independence and the owners and staff respect this. I have my own daily routine and like to go out most days. The staff are very accommodating”. Residents spoken to said the staff at the home were polite, kind, caring and supportive and had the skills and competence required to meet their needs. Residents spoken to were very happy with the arrangements in place for social activities. These were varied and arranged individually and in groups. Several residents spoken to said they enjoyed the weekly outings organised on the mini bus. One resident said, “ I really look forward to the outings. We have trips into the countryside and also go shopping. I am looking forward to the trip arranged to look around the illuminations next week”. The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 13 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Procedures for dealing with and reporting abuse were satisfactory ensuring people are adequately protected. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission to the home. Residents spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. The relatives of seven residents also said they were aware of the complaints procedure but hadn’t had any cause to make a complaint about the home. At the time of this site visit no complaints had been recorded by the home or referred to the Commission for Social Care Inspection to investigate. The home has a procedure in place for dealing with allegations of abuse. The owner and staff spoken to had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. One incident that recently occurred at the home between a resident and staff member had been dealt with appropriately with all relevant procedures followed. The staff member on duty informed the Inspector abusive practices and how to recognise these had been covered during their National Care training. The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 14 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, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a planned maintenance and renewal programme for the redecoration and refurbishment of the home to ensure residents live in a comfortable, homely, clean and safe environment. EVIDENCE: The home has been well maintained and decorated for the comfort of residents. Since the last inspection one bedroom had been redecorated and had a new carpet fitted. Communal areas had also recently been redecorated. A new central heating boiler has been fitted and the home also had a new chairlift for those residents accommodated on the first floor. Residents were observed using the chairlift independently during the visit. The owner said the refurbishment of the home was ongoing and there were further plans for The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 15 refurbishment throughout the home. Residents spoken to were very happy with the improvements being made to the home. A tour of the building confirmed resident bedrooms had been personalised with their own belongings. All residents spoken to were happy with their rooms and said they had the choice of spending time on their own or in the lounge area’s. Hot water temperatures throughout the home were checked and found to deliver water at a safe temperature in line with health and safety guidelines. The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The deployment of staff throughout the day is sufficient to meet the needs of residents. The homes recruitment procedures are robust and these provide safeguards for the protection of residents. Staff are trained and competent to do their jobs. EVIDENCE: Staffing levels were sufficient for the number of residents living at the home. Residents said they were happy with the care they receive from the home and were well treated by the staff. One resident said, “ I really can’t fault the care I receive. I am very happy living at the home and wouldn’t want to live anywhere else”. The relative’s of seven residents said in their opinion there was always sufficient staff members on duty. One relative said, “ The staff are very good. They are always around when you need them and nothing seems to be too much trouble for them. I am very satisfied with the care being provided and have no complaints”. Staff spoken to said they were clear about their role and work well as a team to ensure the individual and collective needs of residents are met. Records show 37 of staff members have achieved National Care Qualifications. Discussion with staff and examination of records confirmed training had been provided for staff members to ensure they had a clear The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 17 understanding of the specific care needs of residents accommodated at the home. Examination of staff records showed the home was obtaining relevant documentation for staff members employed by the home ensuring the protection of residents. The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 18 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of residents. The homes financial records are well maintained ensuring residents financial interests are safeguarded. The home has policies and procedures in place to ensure the health and safety of residents and staff are promoted and protected. EVIDENCE: The owner of the home is a Registered General Nurse and has achieved a relevant management qualification. Records seen confirmed the owner has access to training to ensure her knowledge and skills are updated. Residents spoken to were very positive in their comments about the owner who was described as being friendly, approachable, very helpful and The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 19 professional. Quality assurance systems are in place to gather the views of residents and keep them informed about events being organised by the home. Inspection of records for residents finances were well maintained and up to date ensuring residents interests are safeguarded. Staff spoken to had a clear understanding of their role and what is expected of them during their shift. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation to provide a safe environment for residents and staff. The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X 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 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 21 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. 1. Refer to Standard OP28 Good Practice Recommendations 50 of the care staff team should achieve NVQ qualifications The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 The Lemon Tree DS0000062940.V304566.R01.S.doc Version 5.2 Page 23 - 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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