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Inspection on 06/07/05 for Trees Nursing Home

Also see our care home review for Trees Nursing Home for more information

This inspection was carried out on 6th July 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Trees provides a consistently high standard of nursing care to older people. The home has a competent and confident group of staff who are well supported by management, and who have a good understanding of residents needs and how those needs can be met. Residents said that the staff are kind and caring and `only want what`s best for them` said one resident. Another said that the staff know she is `fussy` about some things and how they are done but the staff do not mind at all, and do things her way. The home is well maintained and resident`s own rooms are furnished in a homely style and to a good standard.

What has improved since the last inspection?

The management continue to promote professional training opportunities for all staff and there are currently four staff undertaking NVQ training. The training is also prompting staff to ask questions about practice and aspects of residents care, and provide a good service.

What the care home could do better:

There are no outstanding issues to address in this home and the service is constantly under review by the management. The care planning system has over time become a series of documents rather than a single working file, therefore a radical review of the process has begunto ensure the planning system provides greater resident involvement and is easier for staff to use and consult. ( see requirement)

CARE HOMES FOR OLDER PEOPLE Trees Nursing Home 12 Candlers Lane Harleston Norfolk IP20 9JA Lead Inspector Susan Golphin Unannounced 6 July 2005 at 10:00 th 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 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. Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Trees Nursing Home Address 12 Candlers Lane Harleston Norfolk IP20 9JA 01379 853919 01379 853919 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) Mrs Susan Nolan Mr Nicholas Francis Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (20), of places Physical disability (1). Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 05 January 2005 Brief Description of the Service: The home is situated in the centre of the small market town of Harleston. The services and facilities are of a good standard and all sited on the ground floor. The home can accommodate 20 older people over the age of 65 years who may have care or nursing needs, and one service user who may have a physical disability. There are 21 single rooms (17 with en-suite facilities). There are attractive landscaped gardens with flower beds and paths around the property that can be accessed by service users. There is ample parking space to the front of the premises. The home is supported by local GP surgeries and appropriate health care services. Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection which took place between 10am and 2pm.Some areas of the home were seen whilst talking to four residents and three staff. A small sample of care plans and records were also seen. The views and comments of the residents and staff are reflected in the report. The registered manager was on leave on the day of the visit. At the end of the inspection feedback was given to the duty manager Mr Gary Stear, and by telephone to Mrs Susan Nolan, the registered provider. What the service does well: What has improved since the last inspection? What they could do better: There are no outstanding issues to address in this home and the service is constantly under review by the management. The care planning system has over time become a series of documents rather than a single working file, therefore a radical review of the process has begun Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 6 to ensure the planning system provides greater resident involvement and is easier for staff to use and consult. ( see requirement) 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 Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,5 The service users guide and statement of purpose provide prospective service users with good information about the home, enabling them to make an informed choice about where they would like to live Prospective resident’s and their representatives or family are invited and encouraged to visit the home prior to making any decisions about the suitability of the home. EVIDENCE: Residents said that the information about the home is readily available. One resident said that her family had visited the home on her behalf, but she was able to make her own mind up about living at Trees and her decision to live in the home had been the right one. Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,10 There is a care planning process in place which provides staff with the care information they require to meet residents needs. Personal support in this home is offered in such a way as to promote resident’s privacy and dignity. EVIDENCE: Four care plans were seen on the day of the inspection and the information about residents care is clear and well documented, however some elements of the plan are maintained separately and in a variety of ways; making them cumbersome to use. The daily records show a greater emphasis on the physical and practical needs of resident’s care with only brief comments about personal interests and feelings . A radical review of the process is underway which will provide a plan which can be used easily by everyone and allow greater resident involvement. ( see requirement) Residents said that staff are kind and caring, only one resident was able to speak with any confidence about her plan of care; others were aware that the home holds information about their care and their personal needs but could not recall being involved in the process. Two residents said that the staff look after everyone very well and recently one lady had been very upset about Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 10 something and the staff had been compassionate and kind and kept checking on her to make sure she was alright. One resident said that she is never embarrassed when being cared for because the staff are discreet and respectful when helping her to bathe and dress. Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 The dietary needs of the residents are well catered for with a balanced and varied selection of meals available to meet individual choices and tastes. EVIDENCE: The menu is displayed in the hall and staff remind residents about the meal of the day and the options available. Residents said that they can choose from a range of meals available. One resident said that the meals are nice and that she especially likes the more traditional dishes like stew with dumpling and beef pattie and soups. One resident said that they have a good appetite and always get good portion sized meals. Residents said they can take their meals in the dining room or in their own rooms as they wish Staff were observed serving the lunchtime meal, and discreetly helping residents to eat and drink. Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home have a good complaints procedure in place, and promote an open relationship with residents and their families. Issues and concerns raised with the staff and management are addressed quickly and effectively. EVIDENCE: There have been no formal complaints this year. Residents said that they know who to talk to if they have any problems, and added that all the staff are very good at dealing with any situation they are unhappy about. One resident said that she is not afraid to speak her mind if there is a problem or to share any worries with the staff, as they will always try to help or put things right. One resident said that the manager and the owner of the home regularly ask if things are alright, which is very reassuring. Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The standard of the environment in this home is high and provides the residents with a comfortable and homely place to live. All areas are well maintained to a good standard. EVIDENCE: A short tour of the premises was undertaken during the talks with residents and staff. Resident’s rooms are well furnished and personalised to a good standard. One resident said that her room is very comfortable and it is kept nice and clean and tidy by the staff. The sitting and dining rooms were also seen and are comfortably furnished and decorated in a homely style and are also well maintained. Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 The home has a well established staff group who have a good range of skills and experience to meet the needs of the residents. EVIDENCE: The residents are supported by adequate and numbers of experienced and trained staff. Three staff were spoken to on the day of the inspection, and expressed a wide variety of positive views about the way they work as a team, and support each other. They spoke competently about the way they care for residents especially those who are very frail and need lots of physical care and were able to give good examples of care practice. The staff group also spoke openly about their workload saying that the work is quite heavy at times as a number of the resident group are fully dependent on the staff for all their needs. However they do try to balance the practical care and give some social time to residents too. Four staff are currently undertaking NVQ training, and one member of staff said that the training is helping to prepare her for any work eventuality whilst also prompting her to ask questions about practice and care options. Recently this member of staff had dealt directly with the family of a resident who had died and that her training to date had helped her to deal with this sensitive situation with a professional and comforting approach. Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, The home is well managed with positive leadership from the registered owners . This style of management promotes the resident’s care and interests at all times. EVIDENCE: The manager and owners of the home regularly seek residents views and comments about their care and environment to maintain good standards. Residents said they are very happy with their care and that the staff are understanding and helpful even when being a ‘fusspot’ as one resident said. It is clear that the staff and management have a good understanding of residents personal needs and wishes and focus their energies on meeting them. Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 4 x x x x x x x STAFFING Standard No Score 27 4 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 3 x x x x x x Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 17 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 7 Regulation 15 Requirement The registered persons must continue to review the current care planning process to ensure the system devised is concise and user friendly and allows for residents or their representatives to be involved. Timescale for action November 30th 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard none. Good Practice Recommendations Trees Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 3rd Floor - Cavell House St Crispins Road Norwich NR3 1YF 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 Nursing Home I55 s15693 Trees v228051 (un) 060705 Stage 4.doc Version 1.30 Page 19 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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