Inspection on 23/01/09 for Tree Tops

This inspection was carried out on 23rd January 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tree Tops 05/11/07

Tree Tops 03/08/06

Tree Tops 22/12/05

Tree Tops 11/07/05

Tree Tops 24/01/05

Tree Tops 09/09/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Tree Tops 3 Campden Road South Croydon Surrey CR2 7EQ The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Barry Khabbazi Date: 2 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 27 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Tree Tops 3 Campden Road South Croydon Surrey CR2 7EQ 02086801219 02086671232 sarah@totemcare.co.uk www.totemcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Tamarind Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : learning disability Additional conditions: care home 10 Number of places (if applicable): Under 65 Over 65 10 0 The registered person may provide the following category of service only: Care Home Only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 10 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 27 A bit about the care home Tree Tops is a large family house situated in South Croydon, not far from a bus route and about ten minutes walk from South Croydon rail station. There is parking space to the front of the house (enough to accommodate the homes minibus) while visitors can park in the street directly outside. The house provides accommodation for up to ten adults with learning disabilities. All bedrooms are single occupancy, and are spread over three floors (including the ground). A passenger lift serves all floors. Toilet facilities are available on all floors, with bathing facilities on the ground and first floors. There is a pleasant lounge, a separate dining room, and a well laid out kitchen. There is a large well-maintained garden to the rear of the home. More detailed information about the services provided at Tree tops can be found in the homes Statement of Purpose and Service User Guide - copies of these documents can be obtained directly from the home. Fees charged range from #700.00. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 27 How we did our inspection: This is what the inspector did when they were at the care home The overall quality rating of the service is 2 star. This means the people who use this service generally experience Good outcomes. This inspection was unannounced. As the people who use this service go out early in the day the inspection started early to allow the people who use this service to be met and so involved in the inspection. The manager was interviewed and records, policies, care plans, and the building were examined. The managers latest selfassessment AQAA was also used to support findings in this inspection. The people who use this service appeared relaxed and were preparing for the day ahead. There was a calm and relaxed atmosphere in the home and the staff were seen to treat the people with kindness and respect and to be supportive and responsive to peoples needs. All previous requirements were assessed as met at this inspection, and only one new requirement was needed Please see the requirement section for details. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well The new owners have taken an active interest in raising quality at the home, and have demonstrated a commitment to meeting all outstanding requirements raising standards and promoting good practice. The home has exceeded the 50 of staff who are required to have a NVQ2 Qualification. This provides a wellqualified staff group who have a better understanding of the needs of those who use the service. There is a specific medical information sheet so that medical information can be taken to hospital effectively and quickly in the event of an incident. This saves photocopying details during an emergency. In addition to the complaints procedure the home has a suggestions box. This encourages raising and recording issues that may not be recorded normally because they are not seen to be serious enough to be a complaint. This also supports better communication and involvement for those using this service. A new sensory room has been created. This provides additional communal space and activities for the people that use this service. Care Homes for Adults (18-65 years) Page 8 of 27 What has got better from the last inspection The dining room has been redecorated since the last inspection. Care plans are now available for all the people who use this service and now contain all the elements required. This was needed to ensure that all needs are known to all staff. Care plans are now reviewed on a six monthly basis. This ensures that peoples changing needs are recorded and known. Person centred plans are now also available, and are in a format that is accessible to the individual. These also include preferences for how care is carried out. All staff who administer medication now have approved and accredited medication administration training to ensure safe administration of medication. To improve the quality and enjoyment of life the home has provided a wider range of social and leisure activities. The home now provides a six week induction, and a six months foundation training programme to ensure that staff are adequately inducted. Each staff member now has formal documented supervision at least six times per year Care Homes for Adults (18-65 years) Page 9 of 27 To ensure that undesirable staff are not employed, all staff files now contain all the documentation required The home now has a structured quality assurance system that makes the people who use this service central to the process. Risk assessments have now been produced for all restrictions of liberty or pre planned restraints This ensures that any limitations are essential and a result of this process was that some limitations have been removed. For example people who use this service now have access to the kitchen What the care home could do better Supervision should be more spaced out to ensure that there are not long gaps where staff do not receive supervision. The annual development plan should show which proposed changes were requested by the people who use this service. This will then show how the people are central to the quality assurance system. Bedroom doors should only be held open by fire responsive door closing devices, and not be held open by bins as this reduces protection from fire. Care Homes for Adults (18-65 years) Page 10 of 27 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Barry Khabbazi 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 11 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 12 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who want to live at this home can be confident that their needs and aspirations will be assessed and recorded so that they can be met by the home. Evidence: Standard 2: People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service Care Homes for Adults (18-65 years) Page 13 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The needs and changing needs of people who use this service are assessed and recorded so that staff know and can therefore meet these needs However the information is recorded over a number of documents and could be difficult for new staff to find. People who use this service are supported to make decisions about their lives to maximise their independence and choices People who use this service are consulted on and participate in all areas of life at the home Evidence: Standard 6 7, and 9 People who use this service experience good quality outcomes in these areas This judgement has been made using available evidence including a visit to this service Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use this service receive sufficient access to activities to maintain a stimulating life. People who use this service are regularly participating in the local community with the aim of maximum integration and challenging discrimination. People who use this service are supported in maintaining appropriate relationships so that their social lives are maximised within chosen boundaries. The daily routines and house rules do generally promote the rights of people who use this service to ensure equality and that all rights are enjoyed by all. Dietary needs are catered for and a balanced diet is provided to ensure health and enjoyment of food. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: Standard 12 13 14 15 16 and 17 People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Standard, 18, 19, 20. People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: Personal care is usually carried out in a way that people prefer, so that dignity and choice are maintained. Physical health needs are met by this home. This ensures that physical health is well maintained and therefore the quality of life experienced is also maximised. Medication is well managed and all staff have had approved and accredited medication administration training. This promotes health and safer medication administration. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home manages complaints well, so that people feel their concerns are listened to and the complaints procedure is now more accessible . The homes protection policies and procedures promote protecting people from abuse. Evidence: Standard 22, and 23. People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The environment and furniture generally met the needs of the people who use this service, and the environment promotes their well being. The home is particularly hygienic and clean, homely and comfortable. This environment therefore facilitates the health and emotional wellbeing of the people who live there. Evidence: Standard, 24, and 30. People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Standard, 32, 34, 35, and 36. People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: People who use this service are supported by appropriately qualified staff which raises the quality of staff and their practices The home has exceeded the 50 of staff who are required to have an NVQ2 qualification This provides a well qualified staff group The homes recruitment procedures protect the people who use this service through vigorous staff vetting Staff receive induction training to national training sector specifications This ensures a better inducted staff team Staff receive sufficient supervision to ensure they are well supervised. However the sessions could be better spaced out to ensure long periods without supervision do not occur. Care Homes for Adults (18-65 years) Page 20 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Standard, 37, 39, and 42. People who use this service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Evidence: The home is managed by an experienced and well-qualified manager who ensures a quality service. There is a quality assurance system which involves the people who use this service and provides a way for them to measure improvements in quality for themselves. The home promotes the health and safety of the people who use this service so that practices and the environment do not generally place their health and safety at risk. Care Homes for Adults (18-65 years) Page 21 of 27 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 1 6 151 Care plans must be available 01/01/2008 for all service users and contain all the elements required under Standard 6. Priority requirement. 2 6 152b Care plans must be reviewed 01/04/2008 on a 6 monthly basis {monthly for those over 65} and be updated with any changes identified. Priority requirement. 3 9 13(7) For any pre-planned 01/01/2008 restrictions of liberty or preplanned restraints {and specifically cot sides}, risk assessments must be produced. These must also contain all the information required under Standard 9.4, and in particular, details of how training and other options have been explored. Priority requirement. 4 12 12(1 - 3)16(2 The home must provide a 01/08/2008 Page 22 of 27 Care Homes for Adults (18-65 years) m,n) wider range of social and leisure activities that meet the needs and preferences of the service users.{Unmet from previous inspection} 5 13 12(3) 16(2m) The proprietor and those 01/08/2008 responsible for the homes management must ensure that service users are enabled to participate in activities outside of the home. Allocation of staff (drivers) needs to be organised in better fashion to enable service users to participate in community outings.{Unmet from previous inspection} 6 17 92 i The registered manager must be qualified to NVQ Level 4 in Management and Care. 01/08/2008 7 20 132 All staff who administer medication, must have approved and accredited medication administration training. Priority requirement. 01/01/2008 8 34 13 (4 c)18(1) The registered provider must 01/01/2008 Sch. 2 & 4(6) ensure that all documentation required in Schedule 2 of the National Minimum Standards and Page 23 of 27 Care Homes for Adults (18-65 years) regulations is obtained for all staff members and retained in the home. {Unmet from previous inspection} Priority requirement. 9 35 18(1)(c) 195b The home must provide a six 01/04/2008 weeks induction, and a 6 months foundation training programme, that must both fully meet National Training Organisation specifications and standards. 10 36 18(1a)(2) The registered manager must ensure that each member of staff has formal documented supervision at least six times per year. Unmet from previous inspection. Time-scale extended. Priority requirement. 01/01/2008 11 39 24,1,2,3 The home must pull together 01/08/2008 its Quality Assurance tools into a system that makes the service users central to the process. The home must also ensure that there is annual development plan that is open to the service users, to allow measurement of achievement in improving quality, and include the service users in this process. Care Homes for Adults (18-65 years) Page 24 of 27 12 42 12(1a) The portable appliance testing results must be sent into the Commission Priority requirement. 01/01/2008 Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 42 12 01/06/2009 Bedroom doors should only be held open by fire responsive door closing devices and not be held open by bins as this reduces protection from fire fire saftey Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 36 Supervision should be more spaced out to ensure that there are not long gaps where staff do not receive supervision. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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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