Inspection on 29/06/05 for Treetops

This inspection was carried out on 29th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Treetops 19/07/07

Treetops 07/07/06

Treetops 14/12/05

Treetops 01/02/05

Treetops 19/07/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Treetops St Clements Road Keynsham Bath & N E Somerset BS31 1AF Lead Inspector Andrew Pollard Unannounced 29th June 2005 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. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Treetops Address St Clements Road Keynsham Bath & N E Somerset BS31 1AF 0117 9869700 0117 9860063 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) Shaw Healthcare Limited Mrs Teresa Eileen Handford Care Home with Nursing 24 Category(ies) of MD(E) Mental Disorder -over 65 registration, with number MD Mental Disorder of places DE Dementia DE(E) Dementia - over 65 Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The total number of people who may be accommodated in the home at any one time shall not exceed 24. Staffing Notice dated 23/04/1999 applies Manager must be a RN on parts 3 or 13 of the NMC register The home may accommodate people aged 55 years and over. The home may not admit any service users with a definitive diagnosis of mental disorder (which is their primary care need) until the qualified staffing skill issues have been satisfactorily addressed and agreed by the NCSC. The manager is a RMN The staffing notice peviously issued by Avon Health Authority is complied with. Date of last inspection 0/02/05 Brief Description of the Service: Treetops is registered as a Care Home for a maximum of 24 service users with dementia and or mental disorder requiring nursing care. Due to a deficit in the staffing skills the CSCI have agreed an imposed condition of registration with Shaw Care which prevents the admission of service users with a diagnoses of mental disorder until such time as the home provides adequate first level registered nursing staff on parts 1 or 13 of the register.The Home is situated in the grounds of Keynsham hospital, which easy access to local community facilities and is within easy access to Bristol and Bath. It can be accessed by car or by bus with a short walk. The Home is purpose built, providing a mix of single and en-suite rooms. Care is offered on the ground floor only, which is divided into 3 units. Each unit offers bedrooms, lounge-dining room and bathroom facilities. There is a communal common room and open plan smoking area. There are also pleasant gardens to the rear and side of the property. All parts of the home are accessible to wheelchair users as well as the ablebodied. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The following methods of evidence gathering has been used in the production of this report; observation, discussion with residents and staff, relative and residents comment cards, tour of the home and sampling policies, records, care plans and viewing meals. Treetops is a well run home offering a good standard of care. The residents were happy, settled and secure which was evident from observations and conversations during the inspection. A very limited number of residents are able to engage in conversation due to advanced dementia. What the service does well: What has improved since the last inspection? Medication is stored and signed for properly. Written consents are signed for the use of bed rails and lap straps. The NMC list of suspended and deregistered nurses is available each month. Training records have been brought up to date. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 6 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. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.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 Treetops D56_S20257_Treetops_V235767_290605_ Stage4.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) 1,2,5 Prospective clients and their families are given relevant information in written or verbal form about the home. The assessment process is rigorous and detailed. Introductory visits are arranged for prospective clients. Contracts and terms and conditions of services are provided to all clients. EVIDENCE: The statement of purpose (SOP) and service user guide SUG documents meet the regulatory requirements are comprehensive, written in plain English and user friendly. The complaints policy included has reference to the CSCI; it’s address and telephone number. The home caters for older people with continuing social, mental health and physical health care and nursing needs. The majority of the current residents have organic dementias. The 24 beds at Treetops are contracted via the PCT and co-ordinated by Dr N Moore consultant psycho geriatrician. All referrals are made to Dr More and admissions are taken on a priority of needs basis. When a vacancy arises Dr More liaises with the manager who then visits prospective residents prior to admission to assess their needs. Local authority funded service users also have a care management assessment and care plan form completed and available to the home prior to admission. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 9 The inspector reviewed the last two admissions to the home; both had completed pre-admission assessment documentation readily. The previous inspection found that the staff had a range of skills and training relevant to the needs of the resident group. The manager has refused admissions that she felt did not meet the admission criteria or skill mix of the staff, The inspector was also informed the home sends a letter confirming the home’s ability to meet the needs to all prospective residents or their representative. Placement review is regularly carried out that confirm that needs are being met. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 10 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 Residents and their families are involved with the assessment and care planning/goal setting process. Detailed care plans are written. The homes philosophy promotes resident’s individuality, self-direction and empowerment. Risk are properly identified and managed EVIDENCE: A person centred approach influenced by dementia care mapping is used in the home. The Care planning documentation, assessments and evaluations are based on the Activities of Daily Living. Individual files, were holistic and prescriptive of care. Where possible residents and families are involved with this process. A 14-day observation period after admission informs the care plan development. Three case files were reviewed and they were found to be comprehensive and detailed and one was not entirely up to date this matter was being raised with the nurse responsible. There was evidence of evaluation and updating. Mental state assessments and ABC – antecedence, behaviour and consequences records are made. Daily reports from the registered nurse in charge are written. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 11 There are individual risk assessments for moving and handling, pressure sore development falls and nutritional risk that are regularly reviewed and updated. There was little recorded evidence of resident consultation / involvement. This is due to the advanced dementias of the residents. The resident’s ability to exercise choice or make decisions is in general grossly diminished by cognitive impairment and staff or relatives advocate on their behalf. Staff were observed to be knocking on doors before entering service user rooms. The manager informed the inspector that privacy and dignity issues are discussed during induction. The multidisciplinary team meets quarterly to discuss individual residents and their quality of life. A number of residents require limited restraint for their own protection from falls. Consent to restrictions such as bed rails, lap straps and Quantic chairs are formally recorded and kept under review. OT and the nursing team assess use of theses item. None of the residents are safe to go out of the home without escort. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 12 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) 12,14,15,17 Residents have opportunities to take part in a range of leisure activities. The recreational and occupational arrangements in the home are varied. There is evidence of family inclusion and consultation where appropriate. The menus offer a varied and balanced diet. EVIDENCE: The activity organiser is on extended leave but it is unclear if she will return. At present the care staff are arranging activities as and when they are able to. Events are displayed on notice boards. The home has access to mini bus transport owned by the organisation; recent outings include pub meals, Cadbury garden centres and various shopping centres. Checks had been undertaken on staffs ability / legality to drive. The home has ‘pen profiles’ included in the care documentation for each person which gives relevant information about past history, social preferences etc and is utilised by staff in planning activities. Staff escort residents into the local high street to go to shops, cafés and other community services. The local Cof E an RC clergy attends the home for pastoral visits and hold services; a number of residents also attend a local church. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 13 The home has an open visiting policy. Family and friends are welcome to visit. Visits can be made in people’s rooms or the conservatory areas. In the past relative / residents forums have been held; however as attendance was poor these have lapsed. Relatives are encouraged to participate in care reviews and care planning. A number of residents have regular contact with family members or friends including home visits, however in some cases residents have lost contact with family or do not wish to have contact. A summer fete has been arranged to which family, friends had been invited. Local community entertainers attend the home on a weekly basis and include a Hawaiian dancer, musicians and singers. Residents or their families are encouraged wherever possible to manage their own finances. At present only one person manages his or her own pocket money. The residents spoken with who were able to express an opinion enjoyed their meals, said they had choice and that the quantity was sufficient and they were happy in the home. The chef transferred from care to the chef position and having worked in a care position for several years had a good knowledge of service user likes and dislikes. The menus are a four-week rotation, which do not have formal choice. Residents are asked each morning if they would like an alternative, which is always provided upon request. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 14 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) 19,20 The staff provide appropriate personal and nursing care in a sensitive manner to maintains residents health and well being. Proper arrangements are in place for residents to access primary healthcare services. The staff properly manage and administer medication. EVIDENCE: All residents can remain registered with their own GP if they wish, however at present all are registered at the local St Augustine’s practice. Dr Blackwell visit the home every two weeks or upon request from the home. The consultant psycho geriatrician also visits Treetops. A multidisciplinary meeting including Dr’s Moore, Jelly and Hewitt the GP, nursing staff, social workers and relatives are held quarterly to review residents care and well being and is also on call for advice and support. Arrangements are made when requested for people to attend their own or a local dentist / optician. Domiciliary optical services are provided annually and dental reviews on request to the home for those who are unable to access the community facilities. All other specialist services are accessed by referral if there is an assessed need. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 15 The home uses an individual blister pack dispensing administration system and nursing staff have responsibility for its management. No residents are safe or able to self-medicate. The resident’s drug profiles are being reviewed and typed up. The receipt, administration, disposal and CD records were up to date and in order. Temazepam is stored in a CD cupboard as required. Temperature recordings for the drug’s fridge are monitored and recorded daily. An old BNF kept for reference should be replaced with a current edition. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 16 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) 22,23 There are robust and comprehensive policies in place to manage complaints or allegations of abuse. There are good arrangements in place for staff training and awareness of POVA matters. EVIDENCE: There has been one complaint since the last inspection from a member of staff regarding two members of night staff sleeping on duty. Both people were suspended pending an investigation and subsequent disciplinary interviews, which have now concluded and appropriate action taken. No other complaints have been received. The complaints policy and procedure contained all the required information and was available in the service user guide. The home had formulated written procedures for adult protection; whistle blowing, management of aggression, management of service users money/valuables. The home also had the Protection of Vulnerable Adults (POVA) inter-agency reporting procedure. The Home Manager stated there have been no incidents of reported abuse. The majority of staff have undergone in house and NVQ based training in understanding and dealing with verbal and physical aggression, abuse and management of challenging behaviours including breakaway training. All bar six of the staff have attended BANES, POVA training and they have training booked later in July. Resident’s allowances and valuable are held in the office safe; records of receipt and expenditure are maintained and two signatures are recorded for all transactions. Each person has his or her own wallet and ledger sheet. Only the manager, deputy and administrator have access to the safe keys. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 17 The accounts were subject to an external audit in March and all was found to be in order. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 18 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) 24,25,30 The home is fit for its purpose and suitable for the current resident group. Bedrooms suit the needs and tastes of the residents. The home is generally well maintained, clean, safe and comfortable. EVIDENCE: The home was purpose built to care for elderly people and has three individual units within the building. Dementia Voice visited the home to advise on environmental considerations suitable to meet the needs of persons with dementia type illness. Each individual unit provides one double bedroom, single bedrooms and a communal lounge/dining area, conservatory and access to the secure garden. The units are centred on the communal reception area, which accommodates an open plan area and enclosed common room. The central communal area has a large fish tank, which is enjoyed by all. The home is at ground level, which ensures level access to all areas. Resident areas are fitted with appropriate aids such as grab rails, mobile and fixed hoists. Residents can chose to socialise in one of the more populated areas or have quiet time in their own room or one of the less used communal rooms. The redecoration and refurbishment programme are ongoing. Most bedroom doors Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 19 had the resident’s photograph and name. The bedrooms were appropriately equipped and decorated. Those able to express an opinion liked their rooms and were able to personalise them as they wished. The bathroom doors etc contained pictorial as well as named identification signs. There are 3 shared bedrooms; people who share make a positive choice to do so and are made aware of this on admission if only a double room is available. All rooms have a telephone point from which residents can make and receive private calls. All rooms have a call system that is linked to an audible alarm facility. New Kings Fund beds have been acquired and further are on order. The cleaning rota was up to date. The home was in good general order, the standard of cleanliness was good and no mal odours were evident. An air purifier system has been installed in the three units. The kitchen was clean and in good order. Fridge, freezer and probe temperatures are recorded. Sluice areas included a sluicing disinfector on each unit. The laundry had two washing machines and two tumble dryers with appropriate programmes. There are arrangements in place for the service and maintenance of plant and equipment. Maintenance staff are employed by the organisation. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 20 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) 32, 34,35 The home is adequately staffed with a combination of regular, bank and agency staff that are appropriately trained and experienced. The recruitment procedures and records are in good order. Appropriate training arrangements are in place for care staff. EVIDENCE: The staffing levels were in accord issued by Avon Health Authority. Registered Mental Nurses are on duty for at least 3.24 whole time equivalent hours per week. There are three first level general nurses employed whose skills are valuable for this resident group however at present there are 108 hours vacant There are vacancies for care staff but interviews are pending. There is moderate use of agency most extra duties being covered by bank staff and in general continuity of supply is sought. There were sufficient ancillary and catering staff to meet the needs of the home. The home operates an equal opportunities employment policy. All staff are issued with written terms and conditions. The manager interviews all prospective employees with another member of staff present and make the final decision on who is employed in the home. The recruitment procedure is actioned and coordinated at Shaw Homes head office, including all recruitment paperwork, which remains stored at head office, with copies available in the home. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 21 The NMC validations of RN qualifications were up to date an in order. The NMC monthly up date of struck of Nurses is available in the home. There are current vacancies for care staff and domestic staff. The personnel records seen held all the required records. CRB checks had been completed through the personnel office for all staff. A log record of these checks is sent to the manager and was checked. All care staff have been issued with the GSCC code of practise. All new staff are enrolled on a formal induction programme, which consists of classroom induction, mentorship and the completion of an induction file. Care staff then complete a foundation programme obtaining a ‘certificate in care practice’, so can then progress to the NVQ programme facilitated through Cirencester College. Mandatory training needs such as food hygiene, first aid, load handling, fire and health and safety were recorded for all staff. The RN clinical training records had been updated. The records indicated that in general RN’s are maintaining their learning in accord with PREP. There was one exception who will be dealt with by the manager in supervision. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 22 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) 39, 42,43 There are various methods and systems in place to monitor the quality of care and facilities. The management structure provide clear lines of accountability and support. The manager is well qualified and experienced for her post. The home has good Health and Safety and maintenance arrangements. EVIDENCE: Mrs Handford is a Registered Mental Nurse and has several other relevant qualifications including a BSC in Professional Practice, with a specialist practitioner qualification, a diploma in H.E. she is an NVQ assessor and external verifier. Mrs Handford has recently completed a Post Graduate Certificate in Education, A leadership skills course and a basic CCM course. Mrs Handford is accountable to the area manager and has regular supervision sessions and considers she is well supported by the organisation. At present there is not a formal service user forum. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 23 Two recent thank you cards were seen that gave high praise to the care provided by the staff. Due to the impaired cognitive ability of the residents only limited information could be gained in discussion with them. Two residents were able to comment and felt well looked after and found the staff friendly and helpful. The food was said to be good. There were no complaints and in the general impression given was that the residents were happy and looked well kempt. There is a quality audit based on the B&NES 10 components of good care. The most recent audit was conducted in Dec 04 and the collated results show an overall high standard of attainment. The home had recently been audited for the ‘investor in people’ status and was again accredited. Accident records were viewed and mostly evidenced minor falls, follow up comments were recorded until the accident had been concluded. Regulation 37 notices are submitted as required. The fire log book, drills and training records was up to date and in order. Ms Carpenter has delegated responsibility for H&S matters and is the trainer for load handling. Regular H&S audits and environmental risk assessments are carried out to protect the residents from injuries. All residents have individualised risk assessments. Water temps are monitored and recorded. The landlord’s gas safety certificate was in date. Load testing and hoist maintenance certificates were in order. Testing of portable electrical equipment had been carried out. Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 24 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 3 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 3 2 3 Standard No 31 32 33 34 35 36 Score x 3 x 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Treetops Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 3 D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 25 yes 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 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. 3. Refer to Standard 20 35 16 Good Practice Recommendations Acquire an up to date edition of the BNF. check that all RNs complete the necessary clinical updating in accord with PREP requirements. Endevour to e-establish the relative and resident forum Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 26 Commission for Social Care Inspection Commission for Social Care Inspection 300 Aztec West Almondsbury BS32 4RG 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 Treetops D56_S20257_Treetops_V235767_290605_ Stage4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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