Inspection on 22/03/07 for Tree Tops Residential Care Home

This inspection was carried out on 22nd March 2007.

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

Tree Tops Residential Care Home 16/05/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Tree Tops Residential Care Home Overton Timber Hill Lyme Regis Dorset DT7 3HQ Lead Inspector Gloria Ashwell Key Unannounced Inspection 22nd March 2007 11:00 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 DS0000066167.V333904.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. DS0000066167.V333904.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tree Tops Residential Care Home Address Overton Timber Hill Lyme Regis Dorset DT7 3HQ 01297 443821 01297 444868 richardiyavoo@btconnect.com 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) Mrs Belinda Davila Iyavoo Mr Richard Kirk Iyavoo Mrs Belinda Davila Iyavoo Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places DS0000066167.V333904.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th May 2006 Brief Description of the Service: Tree Tops is a large house set in its own grounds on Timber Hill on the outskirts of Lyme Regis with some views of the sea. There are well maintained attractive gardens at the front and rear of the home. Tree Tops operates in accordance with Christian values and welcomes residents and staff of all faiths, or of none. The home provides personal care for a maximum of 17 elderly people and also offers day and respite care. Residents’ bedrooms are on the ground and first floor. Registered providers Mr & Mrs Iyavoo live with their family on the second floor. Stair lifts operate between all floors. Communal facilities include a lounge and separate dining room, there is an additional small lounge area on the second floor of the home. Laundering of clothing and household linen is carried out at the home and arrangements can be made for chiropodists, opticians and other health and social care professionals to visit individual residents. There is a car park at the front of the home with street parking nearby. The home is close to a bus route, with a bus stop within walking distance. Fees are charged weekly; at present fees range between £350 and £420 per person. Information regarding the subjects Value for Money and Fair Terms in contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link: http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1-A65A7AFD347B/0/oft780.pdf DS0000066167.V333904.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a statutory inspection required in accordance with the Care Standards Act 2000. The inspection was unannounced; the inspector arrived at 11.00 on 22 March 2007, toured the premises and spoke to residents and staff and arranged the next visit which took place at 10.00 on 28 March 2007 when documentation relating to care provision and the premises was discussed and examined. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same resident were examined, and the resident spoken with. During this inspection compliance with all key standards of the National Minimum Standards was assessed. Since the previous key inspection random inspections have taken place on 5 September 2006, 2 November 2006, 12 December 2006 and 25 January 2007. At each of this visits it was found that a gradual improvement in general standards was maintained and has culminated with the service now meeting most of the National Minimum Standards. What the service does well: Comments made by residents during the inspection included a number referring to the kindness of the staff, with particular recognition of Mrs Iyavoo. The visiting relative of a resident said “In the last few months this home has greatly improved; everyone is so helpful and it is very peaceful.” Residents are assisted to maintain as much independence as possible and are encouraged to maintain contact with the local community. The premises are comfortable, with a communal lounge, a large dining room and attractive grounds. Residents say that staff are kind and helpful to them and that they are treated with respect, their privacy is protected and staff understand their needs. Residents say they feel well cared for. DS0000066167.V333904.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000066167.V333904.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 DS0000066167.V333904.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care so Standard 6 does not apply). Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prior to admission, the needs of each proposed resident are comprehensively assessed and in consequence, when the new resident arrives in the home staff have the information necessary to guide their work and ensure they properly care for the person. EVIDENCE: The records of two recently admitted residents included details of a comprehensive and clear pre-admission assessment which had been carried out in advance of admission and contained sufficient information to guide staff in their practice. DS0000066167.V333904.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Care plans provide staff with sufficient information upon which to base their care practice. Residents health care needs are properly met. Residents are treated with respect and their privacy and dignity is protected at all times. EVIDENCE: Care plans for 4 residents were examined and found to be of very good standard, based on relevant and up to date assessments, clear and comprehensive and thereby providing staff with sufficient information upon which to base their care practice. DS0000066167.V333904.R01.S.doc Version 5.2 Page 10 Periodic audit of accidents is recorded and the home has implemented a falls management policy and procedure to minimise risks of recurrence. Since the last key inspection the home has introduced the use of a monitored dosage system. Records of medicines prescribed by doctors indicate the regular correct administration of medicines and the associated promotion of residents wellbeing. Residents wishing to do so can manage their own medicines in accordance with risk assessment; at present one resident self administers prescribed medicines. Residents believe they are properly cared for; comments received during the inspection included “they are so kind” and “they will do anything for me”. DS0000066167.V333904.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The quality of daily life in the home is good; social and leisure activities are provided and suited to the preference and ability of currently accommodated residents. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals provide good nutrition and are liked by residents. Most residents take meals in the large dining room on the ground floor; others receive them in their bedrooms. EVIDENCE: During recent months the provision of appropriate recreational and social activities has been subject to careful improvement and residents say they are now quite satisfied with the frequency and variety of activities. Visitors are welcome at any time and those the inspector spoke to said they are always made to feel welcome and placed at ease by the staff. DS0000066167.V333904.R01.S.doc Version 5.2 Page 12 Residents believe they are shown respect and are properly treated; comments received during the inspection included “When I ring my bell someone comes to see me immediately”. During the inspection the inspector observed the serving of lunch in the dining room; residents said they were satisfied with the quality, choice and quantity of food provided. DS0000066167.V333904.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The complaints procedure provides information on the procedure to follow to persons wishing to make complaint; all complaints are recorded and investigated. The home protects residents from harm and abuse. EVIDENCE: To ensure residents and their representatives have access to the complaints procedure it is included in the service user guide to the home and a copy is provided to each resident. Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. Comments made during the inspection included (from a resident) “I can always speak to the staff or the owners; they are all so nice”. The home keeps records of all complaints received and investigated. Since the last key inspection an Adult Protection allegation was received and investigated by the local Social Services department and followed by a random inspection by CSCI; the findings of the investigation partly substantiated the allegation. DS0000066167.V333904.R01.S.doc Version 5.2 Page 14 The home adheres to a policy/procedure for the prevention of abuse and all staff have received training in this subject to ensure that they remain vigilant to protect vulnerable residents from risks of abuse and know how to properly manage any allegation or suspicion of abuse. DS0000066167.V333904.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Tree Tops is a comfortable and homely. On the days of inspection the home was clean, pleasant and hygienic and there was evidence indicating that this is the usual standard of provision. EVIDENCE: Tree Tops is a traditionally built house with bathrooms equipped for the use of persons requiring assistance and comfortable communal rooms. The home does not have a passenger lift so is not ideally suited to meet the needs of people with severe mobility difficulties; stair lifts provide access to each floor and are suitable for the needs of the currently accommodated residents. DS0000066167.V333904.R01.S.doc Version 5.2 Page 16 On the days of inspection the home was clean, tidy and comfortable throughout; there were no unpleasant odours. DS0000066167.V333904.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The home employs enough staff to meet the needs of residents and to ensure their safety, comfort and maintenance of the good condition of the premises. Recruitment practices ensure the protection of residents from potentially unsuitable staff. Staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: The home is at all time in the charge of an experienced care worker and staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. All staff spoken with during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the management and training provision. The records of two recently employed staff members were examined and found to contain all essential information including written references, health details, DS0000066167.V333904.R01.S.doc Version 5.2 Page 18 evidence of identity and of induction training. Criminal Records Bureau (CRB) disclosures are obtained for all staff in advance of employment. The home has developed and implemented a comprehensive induction process for all staff, designed to ensure their familiarity with all aspects of the home and a clear understanding of their responsibilities. There is an enthusiastic approach to staff training; recent subjects have included moving and handling, medicine handling, understanding abuse and provision of oxygen therapy. The home meets the standard for at least 50 of care staff to hold a National Vocational Qualification in care. DS0000066167.V333904.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. Systems have been introduced to ensure staff understand their work and receive training enabling them to properly care for the accommodated residents. Residents and their representatives are generally satisfied with the home and feel staff care for them well and put them at their ease. It is intended to implement a quality assurance system to ensure that residents remain satisfied with all aspects of the home. The home does not manage the finances of residents. The premises and equipment are properly maintained in good condition to ensure provision of a comfortable and safe environment. DS0000066167.V333904.R01.S.doc Version 5.2 Page 20 EVIDENCE: Registered providers Mr & Mrs Iyavoo each possess the Registered Managers Award and both are trained in provision of First Aid. During the year ahead the it is intended to implement a quality assurance system to ensure that residents remain satisfied with all aspects of the home; an associated recommendation is made in this report. To ensure continuity of approach the home operates in accord with a variety of policy and procedure documents, including those for care provision and premises safety. The home does not manage the finances of residents who must therefore manage their own finances or arrange for a representative to do this on their behalf. Staff trained in emergency response are on duty in the home at all times. All staff are supervised and each has a personal profile containing records of appraisal ensuring that performance standards are monitored and training needs are identified, in the interests of providing good care to residents. Details of equipment servicing and maintenance are recorded; the inspector examined some records to verify this information including the following: - stair lifts: routine service 16 January 2007 - mobile hoist: routine service 29 November 2006. Risk assessment of the premises and working practices has been recorded to ensure that all known risks are managed and minimised; it is recommended that this process be extended to the grounds and gardens. DS0000066167.V333904.R01.S.doc Version 5.2 Page 21 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 N/A 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 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 3 X 3 X X 3 DS0000066167.V333904.R01.S.doc Version 5.2 Page 22 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 2 Refer to Standard OP33 OP38 Good Practice Recommendations It is recommended that a quality assurance system be implemented to ensure that residents remain satisfied with all aspects of the home. It is recommended that the risk assessment of the premises and working practices be extended to include consideration of potential risks presented in the grounds and gardens. 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