This inspection was carried out on 7th January 2009.
CSCI found this care home to be providing an Poor service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.
Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Treetops Care Home 23/25 Station Road Epping Essex CM16 4HH The quality rating for this care home is: The rating was made on: zero star poor 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Derek Brown Date: 0 7 0 1 2 0 0 9 Information about the care home
Name of care home: Address: Treetops Care Home 23/25 Station Road Epping Essex CM16 4HH 01992573322 01992570241 treetopsepping@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Epping Care Home Ltd care home 52 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category 0 Over 65 52 Conditions of registration: Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 52 persons) Date of last inspection Brief description of the care home Treetops Care Home is a large detached property set in a residential area within five minutes walking distance of the town centre of Epping. Epping Care Home Ltd owns the home and the registered manager is Mrs Vivienne Clancy. Treetops Care Home is located close to the railway station and a bus service runs regularly. Local shops, banks, post office, library and other facilities are within easy reach in Epping Town centre. This is an adapted property that provides accommodation for older people on four floor levels, which are serviced by passenger lifts. Premises refurbishment work is currently taking place. The home provides a residential care service for older people. The fees at Treetops Care Home range from between 550.00 and 600.00 per week. There are additional charges for items of a personal nature. These should be discussed Care Homes for Older People
Page 2 of 10 directly with the home. The home has a Statement of Purpose and a Service Users Guide. Copies can be obtained from the home. Care Homes for Older People Page 3 of 10 What we found:
We wrote to you on 11th December 2008. To comply with Regulation 13(2) of the Care Homes Regulations 2001 you were required by 31st December 2008 to: 1. Promote and make proper provision for the health and welfare of service users by ensuring that prescribed medicines for service users in safe control and custody of the home are given in accordance with the doctors instruction as specified by the pharmacy issuing the medication. 2. Put in place effective arrangements at the home to ensure that any omissions in the administration of prescribed medication and the reasons for these are clearly, legibly and promptly recorded, including any necessary actions taken in response to medication not being taken. 3. Put in place suitable arrangements at the home to ensure accurate records are maintained in relation to medications received into, and managed by, the home. 4. Put in place suitable arrangements and processes that ensure the safekeeping of stored prescribed medication in the care home particularly in relation to refrigerator storage. and in order to comply with Regulation 12(1)(a) of the Care Homes Regulations 2001 you were required by 31st December 2008 to put in place: 1. Suitable arrangements to promote and secure the proper provision for the health and welfare of service users to effectively meet their needs and reduce potential risks. 2. A process to ensure service users medication needs are understood by staff; reviewed and managed more effectively. 3. A process for identifying the steps to be taken to ensure service users are supported effectively thereby decreasing the need for sedating medication. What the care home does well: What they could do better:
We saw that medication in one residents room was unsecured, openly accessible to other residents and not all of this medication was listed on his medication form. The residents care plan stated that he had been provided with lockable facilities to store medication but this was not used for all his medication. His care plan also did not contain a suitable risk assessment or risk management plan and there was no review process in place. Previous requirements have been made concerning the security of medication in the home and both photographic evidence of the medication and copies of documents were taken under Code B of the Police and Criminal Evidence Act 1984. We will be taking legal advice on how to proceed. Care Homes for Older People
Page 4 of 10 Although the care file for one person had been reviewed and updated following the key inspection of 23/10/08, some aspects remain confusing and provide little information as to the current care needs/risk areas of the resident and how these are to be proactively managed and met by care staff. There was evidence to show that the risk assessment had been reviewed in relation to their agitated behavious, however the review of the care plan recorded, care plan unchanged and care remains ongoing. Additionally risk assessments examined showed little understanding by the management team of the home that risks to individual people are clearly identified/understood and control measures were seen to be inadequate. Daily care records for the above person were generally seen to be informative. However records showed on several occasions that they regularly refused meals/refused to eat. On inspection of their care plan/review of care plan, the above had not been updated to reflect the change in care needs. Nutritional records were observed to be inconsistently completed and not clearly identifying the diet taken by the resident on a daily basis and the weight chart showed that the person had lost approximately 3KG in weight over the past month. 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 2. Care Homes for Older People Page 5 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 7 13(4) Risk assessments to be completed for all areas of assessed risk, so as to ensure peoples safety and wellbeing. The previous timescale of 31/07/08 to meet this requirement has not been achieved. This requirement has not been met and we are now considering enforcement action. Following the random inspection on 6/8/08, a Statutory Requirement Notice was issued. Compliance to meeting the Statutory Requirement Notice was not achieved at the inspection of 23/10/08 and we are now considering further enforcement action. 06/08/2008 2 7 12,13,15 Every resident must have a 06/08/2008 detailed current care plan in place. This document must include all aspects of health and welfare, medication administration, adequate risk assessments and demonstrate that residents has been consulted about their personal choice, control and preference to ensure residents? assessed needs
Page 6 of 10 Care Homes for Older People are addressed. The previous timescale of 31/05/07, 31/01/08 and 31/07/08 to meet this requirement has not been achieved. This requirement has not been met and we are now considering enforcement action. Following the random inspection on 6/8/08, a Statutory Requirement Notice was issued. Compliance to meeting the Statutory Requirement Notice was not achieved at the inspection of 23/10/08 and we are now considering further enforcement action. 3 9 13(4) When people look after and take their own medication, any risks to themselves or other people who use the service must be assessed and managed. This will protect people from harm. 31/08/2008 Care Homes for Older People Page 7 of 10 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 1 7 13 Risk assessments must be devised for all areas of assessed risk. Information must include the specific nature of risk and the steps to be taken by staff to minimise the risks. This will enable staff to minimise any risks for residents and to ensure their health and safety. 31/01/2009 2 7 15 Care plans must clearly identify individual residents care needs and how these are to be met by staff. This will enable staff to deliver care in line with peoples care needs. 31/01/2009 3 9 13 Medication must be stored safely and securely at all times. This will protect people from harm and their medication from being taken by unauthorised people 31/01/2009 Recommendations Care Homes for Older People
Page 8 of 10 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 Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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). 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. Care Homes for Older People Page 10 of 10 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
