Inspection on 04/02/09 for Treelands Home Ltd

This inspection was carried out on 4th February 2009.

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

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

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Treelands Home Ltd Five Mile Hill Tedburn St Mary Exeter Devon EX6 6AQ     The quality rating for this care home is:   three star excellent 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: Jane Gurnell     Date: 0 4 0 2 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. that people have said are important to them: They reflect the things 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 Older People 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. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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 Older People Page 3 of 28 Information about the care home Name of care home: Address: Treelands Home Ltd Five Mile Hill Tedburn St Mary Exeter Devon EX6 6AQ 01392811664 01392811664 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Treelands Home Ltd care home 34 Number of places (if applicable): Under 65 Over 65 34 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is 34. The registered person may provide the following category of service only: Care home providing personal care- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home Treelands is a care home providing accommodation and personal care to a maximum of 34 people of either gender for reasons of frailty due to old age. The home has been owned by Mr Jordan since 1986 who in 2008 registered the home with the Commission as a Limited Company. The home is managed by Sharon Richards. The home, previously a residential dwelling prior to conversion to residential home, has been extended to provide a spacious home. The accommodation is provided over 2 floors and can be accessed by a small passenger lift, stair lift or stairs. The hall is spacious, light and welcoming and appears domestic in character. There are two large connected lounge rooms, a conservatory/sunroom, a small reading room and a dining room on Care Homes for Older People Page 4 of 28 Brief description of the care home the ground floor and a lounge room on the first floor. There are communal wellmaintained gardens, which surround the home. Private accommodation comprises of personalised rooms with either nearby bathing facilities or en-suite facilities. Many of the rooms have pleasant views over the countryside. The home is situated close to Pathfinder Village where a number of local amenities can be found. Tedburn St Mary is one mile to the west and Exeter is 5 miles to the east. A bus service runs close to the home. Information about the home can be obtained directly from the home or from its website www.treelandshomeltd.co.uk The previous inspection reports are displayed in reception for anybody to read and a Service Users Guide is kept in each room. The current fee levels range from 322 to 517 pounds per week dependent upon each persons care needs and the accommodation chosen. The contracts state that there will an annual rise in fees and people are also contacted by letter prior to the increase being made. Care Homes for Older People Page 5 of 28 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Treelands was previously inspection on 31st August 2007 when it was judged to provide excellent outcomes to the people who live there. This inspection was unannounced and undertaken on 4th February 2009. Prior to the inspection the Registered Manager had completed an Annual Quality Assurance Assessment, which is a document provided by the Commission and allows the home to report how it meets peoples needs, what has improved in the past 12 months and what future development plans there are. The Commission also sent surveys to 11 people living in the home, to be completed by them with the assistance of their family if wished, 10 member of staff and six health Care Homes for Older People Page 6 of 28 care professionals including the District Nursing Service and the GPs. All 11 resident surveys were returned and demonstrated a high level of satisfaction, two surveys were returned from staff and indicated they felt well supported in their work: none were returned from the health care professionals. A tour of the building was made, and documents relating to the care needs of three people were looked at, as were the recruitment and training files for three staff and records relating to the management of the home. What the care home does well: What has improved since the last inspection? What they could do better: 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 Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving to Treelands visit the home and are given information about the home in order to make an informed decision about whether the service is right for them. The personalised needs assessment means that peoples diverse needs are identified and planned for before they move to the home. The home is not registered to provide intermediate care. Evidence: The Registered Manager said that people interested in moving to the home are invited to visit for a whole day to meet the staff and other people living in the home, sample the food, participate in the activities and the atmosphere as well as view the room they will be moving into. Their relatives are encouraged to come along and spend the day as well. They are given information about the home and the services it offers during the visit. This Service User Guide is available in large print and information is Care Homes for Older People Page 10 of 28 Evidence: also displayed in the reception area and in each bedroom. The homes Guide is also available on the website www.treelandshomeltd.co.uk The home is commended for spending the day, or more than one day if necessary, with people prior to them making a decision, thus making the decision process much easier and less stressful for people and their families. The Registered Manager said that she or her deputy manager are able to make a full assessment of the persons needs during this visit: they ask staff who have provided care during the day and talk to the person themselves to decide whether Treelands is able to offer the care required. She said this has been very successful and it reduces the amount of misinformation they sometimes got if just taking information over the telephone. Care Homes for Older People Page 11 of 28 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Registered Manager promotes and maintains peoples health and ensures access to health care services to meet assessed needs. Care plans are detailed and thorough ensuring staff have up to date information about peoples needs. The homes medication practices promote peoples involvement and protects their welfare by reducing the risk of errors. People are treated with respect and their right to privacy is upheld. Evidence: The majority of people living in the home were spoken with and all said they were happy. People said they were very well cared, describing the home as wonderful and lovely. One person said she couldnt wish for better and another said its a real home from home. The care plans for three people were looked at in detail. In addition to the preadmission assessment, further assessments are undertaken on admission to identify if there are any changes since the person visited the home. Following on from this Care Homes for Older People Page 12 of 28 Evidence: assessment the home uses a two-part ongoing assessment and care planning system. The first part is a series of assessments identifying specific care needs such as skin condition and the risk of developing pressure sores; moving and handling and the aids and assistance required from staff; safety in general activities of daily living; mental well-being and the risk of depression, and hobbies and interests. This information sets a detailed baseline for reviews which are undertaken each month. The second part of the care plan provides a summary of each persons needs in an easy to read format for staff. Further documents are also maintained regarding a sleeping assessment and the promotion of a good nights sleep, continence management, food and fluid intake, and the risk of falls. There was evidence that people are consulted about their care plans at the time of writing and at each monthly review. The care plans and assessments are kept in each room so that care staff can access them and complete them easily. The home is commended for having such a thorough and detailed assessment and careplanning document. Staff were able to describe peoples care needs in detail, particularly for one person who was unwell and required nursing support from the District Nurses. Records are maintained for all visits to the home by social or health care professionals, such as the District Nurse and the GP. People who have become terminally ill or who require nursing care are able to remain at the home if the care staff and the District Nursing Service can continue to meet their needs. The home is commended for its medication system that considerably reduces the risk of medication errors as no one persons medication is held with another persons. Each bedroom has a locked cupboard that the medicines are stored in and dispensed from. The care staff are allocated a specific area of the home to work within each day and only the staff member in that particular area administers medicines to people in these rooms: medication records are also separated into these specific areas. The Registered Manager confirmed that all staff responsible for administering medicines have had training in safe medication practices. People are encouraged to retain responsibility for their medication once identified that it is safe for them to do so, and several people in the home had chosen to do this. A fridge is available to keep medicines cool and the temperature of this is taken and recorded every 24 hours to ensure it is maintaining the correct temperature. During a tour of the home staff were observed going about their duties and were seen interacting with people appropriately, joining them into conversations and talking with them individually. Routines were seen to be flexible with people getting up for the day at their preferred time. Staff were seen and heard knocking on doors before entering peoples bedrooms. Care Homes for Older People Page 13 of 28 Care Homes for Older People Page 14 of 28 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A lot of effort is made by the home to provide an activities programme and social interaction/stimulation for people who live in the home. People are able to maintain contact with family and friends and exercise choice and control over their lives. People receive a wholesome appealing diet and staff are available to provide assistance if required. Evidence: Nine of the 11 people who returned a survey said there were always or usually activities arranged for them to take part in: two people said sometimes. People said they looked forward to the daily activities and a timetable, included in the Service User Guide, described the planned daily activities facilitated by staff. In addition, different entertainers visit three times a month and an Occupational Therapist visits every Friday and does group sessions encouraging people to take part in gentle exercise. A mobile shop run by one of the local shopkeepers from the village visits the home every two weeks for people who are unable to go to the village. The home is situated on a bus route and many people are able to go into Exeter or the local village should they wish. There were visitors seen coming and going during the inspection and the atmosphere in the home was homely and friendly. The home is commended for Care Homes for Older People Page 15 of 28 Evidence: recognising the need to provide a variety of leisure and social activities to meet peoples differing preferences and interests. People can have their own TV, radio and/or telephone (they are responsible for the individual bill) in their room. There are also several lounge areas and a dining-room where people can spend time. During the inspection people were being asked where they would like to go within the home and people spoken with said that they had freedom to spend their time where and how they liked. Attention had been paid to providing communal space for peoples differing needs, for example, there were two television areas on the ground floor and one on the first floor, a small reading room with books provided by the local library and a conservatory with no television. The owner has a dog that spends most of his time in and around the home; people are very fond of him and the 2 house cats. A donkey from the local sanctuary visits the home from time to time and is taken in the home and into peoples bedrooms if they are unable to join others in the lounge rooms. As a result of these visits, the Registered Manager said people have asked for other animals to visit and she is looking into other sanctuaries that could visit. There is plenty of outdoor space for people to enjoy and seating and a gazebo are provided for their use. The Registered Manager said that the home does an annual firework/ bonfire display that is enjoyed by the people living in the home and their relatives. Residents meetings are held monthly and a variety of topics are discussed and the minutes of the last meeting were available. This gives people the opportunity to discuss any areas of concern or ask any questions they may have. The home is involved in the local community and the local vicar visits the home weekly. People spoken with said the food was very good: this was supported by the 11 people who returned a survey with nine people saying the meals were always and 2 people saying usually liked the meals. People are asked daily what they would like to eat and alternatives to the main menu choice are always available. One relative said if she was visiting at a mealtime she was always offered a meal. People can eat in their rooms or in the dining room and staff are available to offer assistance to those that need it. Snacks and drinks are available 24 hours a day. The lunchtime meal on the day of the inspection was faggots, potatoes and vegetables. Alternatives included baked potatoes, sandwiches, eggs and salads. Homemade cakes are baked daily and were seen when the kitchen was viewed. The kitchen was very clean and tidy indicating that regular cleaning takes place. Care Homes for Older People Page 16 of 28 Care Homes for Older People Page 17 of 28 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 living in the home and their relatives/friends are well informed and know how to make a formal complaint. People can be confident their concerns or suggestions are listened to, taken seriously and dealt with promptly. Evidence: Those people spoken with said they were happy living at Treelands and felt comfortable bringing any concerns to the attention of the staff and the Registered Manager. This was supported by the 11 people who returned a survey with all knowing how to make a complaint. Neither the home nor the Commission had received any complaints about the service over the past 12 months. The complaints procedure is made available in every room and displayed in the main entrance way. There is a comment/complaints book in the reception area allowing people to make any concerns known anonymously if wished. The Registered Manager was aware of the local authoritys policy with regard reporting concerns over potential abuse and confirmed she was in discussion with them to provide training in the protection of vulnerable adults for the staff team. Care Homes for Older People Page 18 of 28 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Treelands is a spacious, comfortable and well maintained home, with sufficient aids and facilities to meet the needs of those currently living there. Evidence: People said they found the home warm and comfortable. The home was found to be clean and tidy with no odours: people spoken with said it was always clean and this was supported by those who returned a survey. The home employs housekeeping staff 7 days a week. There is variety of communal areas giving the impression of living in a much smaller home, giving people choice of where and with whom they spend their time without having to be in their rooms. On the ground floor there are two large connecting lounge rooms, one with a television; a conservatory/sunroom; a small reading room and a dining room and on the first floor, a large lounge room with a television. A small area in one of the lounge rooms on the ground floor had been designed to offer a second small television area. All rooms are tastefully decorated and had views over the local countryside. One lounge room had a gas open fire which was very attractive. Seating is provided throughout the hallways to enable people to rest while walking around the home. Care Homes for Older People Page 19 of 28 Evidence: Accommodation is provided over both floors and a lift with a seat and a stair-lift provide access to the first floor. Many of the rooms exceed the National Minimum Standards for size and have good views of the grounds and surrounding countryside. Some rooms on the first floor benefit from a balcony where people can sit out and many on the ground floor have direct access to the gardens. Peoples rooms contained personal items including furniture, ornaments and pictures that reflect their personality and interests. The majority of radiators are covered to reduce the risk of people burning themselves should they came into contact with them. Many of the rooms are en suite and there are a number of toilets and bathrooms situated throughout the home. The garden areas are extensive and seating is provided for people to enjoy in pleasant weather. Mr Jordan, the owner, carries out day-to-day maintenance around the home. Staff write any faults or health and safety concerns in a book and Mr Jordan checks this daily and highlights the entry to show the work has been completed. Two people had asked for changes to their rooms and the Registered Manager said the owner had been more than happy to do this. One person had requested a shower to be fitted into their en suite toilet area and as the room was large enough the owner had refurbished and re-tiled this room, fitting a shower cubicle as requested. Another person had requested secure handrails to enable her to feel more secure when using her sink: the owner had discussed her needs with her and fitted two poles from floor to ceiling to allow her to hold onto these at her sink and whilst walking from her chair to the sink. Poles had also been fitted in the bathroom to aide people to move more easily from the bath and between the toilet and sink. Although these poles looked a little unsightly, people said they greatly aided their mobility and feeling of security. The home is commended for giving consideration to peoples needs and requests. Other equipment to aid with moving and handling, such as lifting hoists and sliding sheets were seen to be available. Records indicate this equipment is serviced regularly to ensure it is maintain in good working order. Extensive building works are currently being undertaken by Mr Jordan to create a new laundry room, kitchen and food storage area, office and 6 en suite bedrooms. The first part of the building work, to create the laundry room, has been completed, and once the remainder has, it will allow for an increase and rearrangement to some of the communal areas and office space in the main home. Care Homes for Older People Page 20 of 28 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. There are sufficient numbers of staff with appropriate skills and knowledge to meet the needs of the people living at the home. The homes recruitment procedures protect people living at the home from being placed at risk of harm or abuse by ensuring, as far as possible, only suitable people are employed at the home. Evidence: People spoken with said that there are always staff available when they need them and they get the help they want. This was supported by the 11 people who returned a survey: 10 people said there was always and one person said there was usually staff available when they wanted them. At the time of the inspection there were 26 people living in the home. The Registered Manager and staff confirmed there were usually 5 care staff on duty during the day, 4 care staff during the evenings and 2 care staff on duty during the night. These numbers did not include the Registered Manager or the two owners who were in attendance most days. The Registered Manager said the staffing levels are flexible dependent upon the number of people living in the home and their care needs: there are bank staff available who can be contacted at short notice to cover unexpected absences, such as sickness, or when someones care needs change and more staff are required. Care staff are supported by catering, housekeeping, laundry and Care Homes for Older People Page 21 of 28 Evidence: administrative staff. The Registered Manager confirmed that staff turnover was generally very low and many of the staff confirmed that had worked at the home for many years. Three staff recruitment and training files were looked at. All held the required pre-employment documents including an application form, 2 written references and a Criminal Records Bureau check, ensuring as far as possible only suitable people are employed at the home. Training records for these 3 staff indicated they had received the necessary mandatory training such as safe moving and handling, fire safety and first aid. The staff spoken with and the two staff members who had returned a survey confirmed they received the training they required and felt well supported in their work. They said both the owners and the Registered Manager were very approachable and supportive. It was not possible to easily review the training undertaken by the staff group as whole as an overview of training was not available. The Registered Manager said that she ensures staff are provided with in-house training as part of their induction to the home whilst waiting for the training from external trainers to be arranged. For example, the owner, Mr Jordon is a moving and handling trainer, and one of the senior staff has the responsibility for providing fire safety training and undertaking practice fire drills. The Registered Manager was advised to keep an overview record of the training undertaken by all staff to ease reviewing and ensure no one member of staff goes without the training required for their job. New staff are provided with a 4-week in-house training programme where they work alongside an experienced member of staff until they feel confident and have been assessed as competent. The Registered Manager uses an external provider for their training and said the organisation can tailor make training sessions to their specific requirements. The Registered Manager said the majority of staff had either obtained a National Vocational Qualification in Care (NVQ) or were in training. She confirmed staff were encouraged to undertake training and were supported to undertake further NVQs to levels 3 and 4 in association with the local college. Staff meetings and managers meetings are held and minutes were available showing a variety of subjects are covered and allowing staff to comment about the running of the home and their own training and development needs. Staff also received individual and workplace supervision to monitor their performance and give them the opportunity to talk in private with the Registered Manager: records of these sessions were seen in the three staff files looked at. Care Homes for Older People Page 22 of 28 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Treelands is a very well managed home. The Registered Manager and her staff team strive to provide a safe and supportive home for the people living there. Evidence: The Registered Manager has worked at the home for several years and has a National Vocational Qualification in Care at level 4 and the Registered Manager Award; both qualifications required the manager to demonstrate her skills, knowledge and competence in managing a care home for older people. The owners show a responsible attitude toward promoting and protecting peoples health, safety and welfare. The staff team share the responsibility for managing care an a day-to-day basis. Each member of staff works in a particularly area of the home for one week, overseeing the care for people in that area and administering their medication. Senior care staff are responsible for reviewing care needs at least every month and discussing these needs with the person concerned and the Registered Manager. Care Homes for Older People Page 23 of 28 Evidence: Staff meetings ensure important information is communicated between the staff team and a permanent record of this is kept for future reference. Meetings between the Registered Manager and the owners, and the Registered Manager and the senior care staff ensures the smooth running of the home and identifies any areas for improvement. The home has a formal Quality Assurance process to consult with people living in the home and their relatives regarding their views of life in the home and the service provided. The results of the most recent consultation from October 2008 were available and showed a high level of satisfaction. A summary of the results and an action plan to address the issues raised had been written and discussed at the regular residents meeting. These meetings allow the people living in the home to express their views, share information and contribute to the running of the home. The staff spoken with demonstrated a clear understanding that Treelands was a home to each person living there and very much promoted this attitude. Routines were relaxed and people were able to spend the day how they wished. Care plans reflected a person-centered approach and the staff team promoted peoples independence. The home is commended for its person centered approach to care and providing a home from home. The home does not deal with peoples personal finances. A second safe is provided in the bedrooms for money and personal items. For those unable to manage their own finances, the home obtains receipts, for example, from the hairdresser, and these are forwarded to the next of kin for payment. Other bills such as for newspapers are sent directly to the person or their representative. The Annual Quality Assurance Assessment states that most of the policies and procedures regarding work practices had been reviewed in March 2008 to ensure they reflected the current practice and up to date guidance for staff: these are available to staff at all times. The fire logbook was looked at and showed the system had been tested weekly and serviced ensuring it was maintained in good working order. Accidents were recorded and should someone have a fall or accident, the staff make 1/2 hourly checks on them for 24 hours to monitor for any injury that may not have been immediately apparent at the time. This demonstrated very good practice and the home is commended for this. Care Homes for Older People Page 24 of 28 Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Older People Page 26 of 28 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 Requirement 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 Requirement Timescale for action 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 18 Staff should receive adult protection training to ensure all are aware of the local authoritys policy in how to deal with a suspected issue of abuse. Care Homes for Older People Page 27 of 28 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). 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