Inspection on 12/08/05 for Trees

This inspection was carried out on 12th August 2005.

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

Trees 16/03/09

Trees 12/02/07

Trees 23/01/06

Trees 02/12/04

Trees 22/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Trees 20 Old Derby Road Ashbourne Derbyshire DE6 1BN Lead Inspector Vanessa Davies Unannounced 12 August 2005 10.00am 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Trees Address 20 Old Derby Road Ashbourne Derbyshire DE6 1BN 01335 300767 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Homelife Limited Vacant Care Home with Personal Care 3 places Category(ies) of 3 places with Learning Disability in both gender registration, with number of places Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection Brief Description of the Service: Trees is a small home providing accommodation and personal care for three people with a learning disability. The accommodation is a domestic style dormer bungalow, which has large well maintained gardens. The bungalow is located in a residential area of Ashbourne, close to the centre of the town. Residents accommodation is located on the ground floor, with the staff sleep in accommodation on the first floor. Each resident has their own private bedroom. There is a bathroom with toilet close to residents bedrooms, and a separate toilet in the utility room. There is large lounge area, and kitchen/dining room. Individual activities plans are in place for each resident, and support is provided both inside and outside the home. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and 1 member of staff along with one resident was available throughout the inspection. The information was gathered by reading records, looking around the home and observing the staff member with the resident. The manager was not available on this occasion. What the service does well: Trees is a well presented, pleasantly decorated and tastefully furnished home, providing service users with a home to be proud of. All service users have an assessment of need and regular reviews of care with social services. Prospective service users are invited to visit the home prior to any move, although the service user group is very settled and have lived together for a while. Each of the files has detailed information relating to the service users to assist staff with meeting the needs of the service users. Each service user has the opportunity to have an annual holiday, a detailed diary is completed to give service users a permanent record. Service users are supported to be as independent as possible and to become involved with the management of the home. Service users have access to the community daily. Medication is administered by trained staff. It is kept in a secure cupboard within a secure cupboard. Each service user has a single bedroom with access to a communal bathroom. All bedrooms are lockable. The manager completes health and safety audits on a regular basis to ensure the safety of the service users. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 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. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,4,5 Assessments of need for all service users provide staff with information to ensure they are able to meet their needs. EVIDENCE: The inspector examined 3 files. There was input from both the service users and the relatives. Each file had a care plan/assessment in place, this was reviewed on a 6 monthly basis along with the Social Services review. Each of the care plans had detailed information about each of the service users. The member of staff spoken with stated that prospective service users would be invited to visit the home prior to any move, the service users at the home have lived there for a long time, therefore there has been no need to invite prospective service users. Each of the files examined had a copy of the terms and conditions of residence signed by a relative. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10 The clear care planning system in place and valuable information within files assists staff, however as not all needs highlighted within the assessment have a care plan or risk assessment, this could potentially prevent staff from fully meeting needs and put service users at risk. EVIDENCE: Each of the files had a detailed service user plan in place. There was evidence of service user or relative input. There was evidence of good practice; detailed information regarding past and present key-workers, daily diary during an annual holiday and some life story work. In one file examined there was an incident relating to an aggressive outburst, however there was care plan or risk assessment in place to address this. Another file had a detailed description of the service users behaviour and stated ‘eats non-edible things’, however there was no risk assessment in place. The manager had detailed this service users behaviour in an ‘essay’ format, it is recommended that this be developed into a care plan and risk assessment format to enable the service user and new staff to easily understand. It was evident on the day of inspection and within files that service users are supported and encouraged to make decisions about their lives. As the home is Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 10 small service users tend to be involved with all of the changes in the home. The member of staff on duty stated that all service users are supported to be as involved with decision making as possible. All information relating to service users is kept in a set of drawers in the lounge. All information is accurate and up to date. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,16,17 Good links with the community ensure that service users continue to develop positive social skills. Dietary needs of service users are well catered for with a balanced and varied selection of food available. EVIDENCE: The member of staff stated that the service users have access to a range of activities and on the day of inspection 2 of the service users were out shopping with staff. The home have a field close by with a range of animals and the service users each have a role both in the morning and the evening to ensure they are fed and safe. The home is in a residential area and the service users access the local community on a daily basis. All service users have a key to their bedroom. There is unrestricted access throughout the home. On the day of inspection it was clear that the staff member on duty had a good, positive relationship with the service user he was working with. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 12 The service user was seen assisting the member of staff with lunch preparation. A record of meals is kept and all service users have a choice at meal time, this was seen on the day of inspection. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,20 The medication at the home is well managed promoting good health. Personal support is offered in a way so as to promote independence and provide support where necessary. EVIDENCE: It was evidence within documentation that service users are encouraged to remain as independent as possible with care needs. Personal care is delivered in private, and the member of staff stated that male staff do not deliver personal care to female service users. The support and assistance required by service users was clearly detailed in the service user file. Each service user has a designated key-worker and a co key-worker. The small staff team and low turnover of staff assists with the continuity of care for service users. Medication is kept in a lockable cupboard within a lockable cupboard. Medication is administered using the Boots medi-dosage system. The member of staff on duty stated that all medication is administered by trained staff, training records could not be examined as the manager was not available. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: Standards were not assessed on this occasion as the manager was not available. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,30 The standard or décor and furnishing in this home is very good, providing service users with an attractive and homely place to live and be proud of. EVIDENCE: The home is very well decorated and furnished to a high standard. The service users can access all areas of the home without restriction. There is a large, comfortable communal lounge, a very large dining kitchen with an additional utility room. There is a large well kept garden with a variety of plants and vegetables growing. There is off road parking for the homes vehicle. Bedrooms are all personalised by the service users and lockable. All service users have keys to their rooms. All service users are supported to be as independent as possible and to help to manage the home, being involved with food preparation and other household activities. There is one communal bathroom with a toilet, the door is lockable and privacy is respected. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 16 Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33 Staff morale is good resulting in an enthusiastic workforce that works positively with service users to improve their quality of life. EVIDENCE: The member of staff spoken with was clearly aware of his role and responsibilities. Although the service user available was unable to comment he appeared to be aware of the staff members role. The inspector was not able to examine staff recruitment records or supervision records as the manager was not available. Staff tend to remain at the home long term and therefore provide continuity and stability for the service users. The home did have regular staff meeting documented throughout February 2005, the next and last one documented is 30.05.05. The manager should ensure that meetings are held regularly. The member of staff stated that service users are able to attend the meetings if they want to. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,42 A range of audit checks throughout the home ensure the safety of the service users, however the lack of a radiator cover or risk assessment could potentially put them at risk of burning. EVIDENCE: The home is clearly well run and well managed. The home completes a range of monitoring to ensure safe practices. The vehicle is checked regularly. Fire alarms are tested weekly, drills monthly, staff involved in the fire drills are not documented. Gas certificate tested 27.11.04. Water is tested monthly, fridge and freezer temperatures are tested daily. The home completes a 6 monthly Health and Safety audit, it details “chair to be kept away from radiator because of burning or scalding” there was no evidence of a risk assessment and the radiator in the lounge is not currently covered. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 3 3 3 x 4 Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 3 Standard No 31 32 33 34 35 36 Score 3 x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Trees Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 2 x C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 20 NO Are there any outstanding requirements from the last inspection? 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. 1. Standard 9, 42 Regulation 13.4 c Requirement Unnecessary risks to the health and safety of service users should be so far as possible eliminated Timescale for action 30.11.05 2. 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. 3. 4. 5. Refer to Standard 6 9 10 33 42 Good Practice Recommendations The manager should ensure that each need highlighted is care planned. All risks highlighted should be risk assessed. Service users records are confidential and should be stored in a lockable room or cabinet. Staff meetings should be held on a regular basis. Risk assessments for uncovered radiators should be completed and radiators covered as necessary. Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection South Point Cardinal Square Notitngham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Trees C52 C02 S20111 Trees V243960 120805 Stage 4.doc Version 1.40 Page 22 - 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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