CARE HOMES FOR OLDER PEOPLE
Treetops Residential Home 3 Lower Northdown Avenue Cliftonville Margate Kent CT9 7NY Lead Inspector
Christine Grafton Announced 28 29 June 2005 10:00
th 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. Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Treetops Residential Home Address 3 Lower Northdown, Avenue, Cliftonville, Margate, Kent, CT9 2NJ 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) 01843 220826 01843 220826 Gracefind Limited Mrs Wendy Hughes Care Home 24 Category(ies) of Older People (23) Dementia over 65 Female (1) registration, with number of places Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 10/3/2005 Brief Description of the Service: Treetops is a three-storey detached building, with bedroom accommodation on each of the three floors. There are 18 single bedrooms (10 of which have ensuite facilities) and 3 doubles. There is a shaft lift to all floors. Each bedroom has a call bell and television point. There is a lounge and a separate dining room, with two additional lounge areas off each end, one of which may be used for people to smoke in. There is a secluded garden to the rear, laid to lawn, with 2 bench seats and a small patio with table and chairs, where residents may sit in warm weather. The home is situated in a residential part of Cliftonville, close to local shops and all public amenities. Public transport can be easily accessed and there is unrestricted on-street parking. Treetops has been under the same ownership for over 15 years. The staff team is lead by the Manager. They provide 24-hour care including a member of staff awake and one member of staff who does a split night shift that includes 3 hours sleeping in. According to its statement of purpose, the home aims to provide care and support to residents to help them live as independently as possible, consistent with their capabilities and disabilities. Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place over a day and a half and lasted a total of 11 hours 25 minutes. Additional time was spent in preparation and report writing. The manager and six staff members were spoken to, plus ten residents, one visiting relative, another visitor and a district nurse, who all provided valuable feedback about the home. Time spent in the home also included looking round the building and reading records. At the time of this inspection, there were 21 residents. The care of six residents was case tracked, by speaking with the residents, care staff, manager, looking at equipment provided and reading their care plans. Twelve relatives and visitors, plus four residents returned comments cards to the commission prior to the inspection. The majority of the responses indicated that the people were pleased with the care provided. One comment that more could be done to make visitors comfortable was discussed with the manager who agreed to consider ways to improve this. There is no extra space available in lounge areas for residents to receive their visitors, but one visiting relative was seen speaking with a resident in a garden patio area. The manager stated that relatives often use the dining area to speak to residents. Two other comments were followed through as part of the case tracking process where other evidence came to light, indicating that the issues raised were being dealt with appropriately. What the service does well:
Commendable standards were apparent in the management approach of this home, the care planning, the maintenance of residents’ dignity and the care of the dying and dealing with death. Good care practice was evident from observations, care plans and discussions with staff and residents. The manager carries out a thorough assessment of any prospective resident before admission and this is followed through during the first month’s trial period. Care plans contain all the information for staff to provide good quality care to meet residents’ needs. Staff have a good knowledge of the residents and spend time talking with them. The manager has developed care practices in the home to ensure that terminally ill residents are cared for with great sensitivity and respect. A staff member felt that the care of the dying is above normal, saying, “we come back at night”. The home has developed a good working relationship with the community nurses and the manager ensures that any necessary equipment to provide comfort, relieve pressure and reduce pain is obtained. The manager keeps a careful watch on staffing numbers compared to residents’ dependencies and adjusts the staff rotas accordingly, often working extra
Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 6 hours herself to cover evenings, nights and weekends, where necessary. This ensures that the staff team is supported to provide a high standard of care. Staff feel valued and are clear about their roles and responsibilities within the home. There is a commitment to training and development of staff. A staff member spoke of being encouraged to go on training courses, which had helped to build confidence. Staff spoken to were committed to their jobs and to working towards the common aim of providing residents with the best care possible. The manager provides ‘on the floor supervision’ to ensure that any actions that are not in the best interests of residents are quickly ‘nipped in the bud’. What has improved since the last inspection? What they could do better:
Medication procedures are generally sound, but improvements to the storage are needed to provide a separate, secure, dedicated medication refrigerator for the storage of medicines that must be kept cold. These were being kept in an unlocked refrigerator where some food and drinks were being stored. Also, facilities for the storage of controlled drugs are not sufficiently secure. There were no controlled drugs in use at the time of inspection, but the home needs to review its storage facilities so that if a controlled drug is prescribed for a resident, it can be kept properly in line with the legal requirements. Both these issues need to be addressed to maintain safety and keep drugs secure. Weight records are kept in residents’ care plans to monitor for signs of malnutrition or ill health. However, some residents with mobility problems who are unable to stand unaided, cannot be weighed as the home only has a set of floor scales. The provision of a set of sit on chair scales would be of benefit to residents’ care in this respect and should be considered. Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 7 Procedures to prevent the spread of infection in the home are generally satisfactory, but need to be tightened to make sure that appropriate facilities are available for staff when dealing with soiled articles or clinical waste. These need to include the provision of foot operated pedal bins for clinical waste and to make sure that supplies of liquid soap and paper towels are readily available for hand washing, in all areas where clinical waste is handled. These are necessary to protect residents and staff from the risk of infection. Recruitment procedures are generally sound, but the home must be able to show in its record keeping that gaps in employment are checked out for new staff employed and police checks and checks of the protection of vulnerable adults list have been made for all employees, prior to their start date. This is necessary to ensure that residents are properly protected. One of the registered providers visits the home weekly on an informal basis. However there have been no formal monthly visits to check on the way the home is being run. The registered providers must arrange for monthly unannounced visits to be made to the home. These should include a check of the building, speaking to residents and staff, looking at records and writing a report. Copies of the monthly reports must be sent to the commission and to the manager. This is necessary to safeguard residents and staff and as part of the home’s quality monitoring processes. 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 Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 8 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 Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 9 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 and 3 The service users’ guide and admission procedure provide all the information that prospective residents need to know when making the decision about moving into the home. Residents’ needs are thoroughly assessed and the care plan documentation shows how the home can meet the identified needs. EVIDENCE: The service users’ guide and a copy of the last inspection report are kept in the entrance hall with the visitors’ book. New residents are given their own copy of the service users’ guide and complaints procedure. The manager goes through this with them and their relatives to ensure they are provided with all the information they need to know before and upon moving in. The care of a recently admitted resident was case tracked, by reading the care plan, speaking with the resident, a care assistant and the manager. A detailed assessment of needs had been carried out prior to and upon admission. From this a comprehensive care plan had been drawn up, including risk assessments covering the risk of falls, skin integrity, nutrition and personal safety. Staff spoke with knowledge about the needs of residents. The manager and care staff spoken to recognise the importance of this assessment process, from which they feel confident that the home can meet the residents’ needs.
Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 10 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) 7,8,9,10 & 11 Care plans are of a high standard and contain all the information for staff to meet residents’ needs. Care staff have a good understanding of residents’ needs and the health needs of residents are well met. Medication administration procedures are generally sound, but some improvements are necessary with the medication storage to ensure safety. Personal care is offered in a way that shows great respect for residents’ dignity. Dying residents are cared for in an exemplary way and treated with great sensitivity and respect prior to and at the time of death. EVIDENCE: Care plans were very detailed, clear, up to date and covered all the needs identified in the assessment, setting out staff actions needed to meet all aspects of the health, personal and social care needs of the residents. The care plans are ‘person centred’ and ‘living’ documents that are reviewed as an ongoing process and regularly updated when new needs are identified, or needs change. The records of ongoing care, written by staff on a daily basis, show respect for the person and recognise both physical and emotional well being. The home works closely with health care professionals such as community nurses. A community nurse visiting on one day of the inspection said that the
Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 11 home always liaises with them and provides good care. This was evident in records seen and from other discussions. A resident spoke about their personal care needs and said “the staff are excellent.” Other residents spoke about the staff being kind and friendly and encouraging them to maintain their independence. Weight records are kept for residents who can stand, but not for non-weight bearing residents. Medications are stored in a secure lockable drugs trolley. A carer was observed administering lunch time medications in an appropriate way. Medication administration records were completed after the carer had seen the resident take their medication. Drugs that require cold storage are stored in a fridge with other drinks and food items. There were no controlled drugs prescribed at the time of inspection, but the home does not have a controlled drugs cupboard or register. Staff have a good understanding of the care plans and what is to be achieved when assisting with residents’ care. Staff were seen treating residents with kindness and respect. For example, sitting with residents and speaking to them about things they knew would stimulate conversation and in two particular cases residents’ faces were seen to ‘light up’ when staff spoke with them. The needs of a dying resident were discussed with a staff member and separately with the manager. From the discussions and the records, it was clear that this had been dealt with in an exceptional way. Specialist pressure relieving equipment had been obtained and the home had worked closely with the doctor, community nurses and family to ensure that appropriate attention and pain relief were provided. The manager has almost completed a palliative care course, which was a recommendation from last year’s announced inspection. Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 12 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) 12, 13, 14 & 15 Residents are given the opportunity to take part in a range of meaningful activities. The home encourages visits from families and friends. A varied menu is provided that meets the nutritional needs, tastes and choices of residents. EVIDENCE: A variety of activities are organised within the home to provide stimulation. A musical movement session was held on the first morning of this inspection, which eight residents were taking part in and clearly enjoying. A bingo session was held on the second day. Staff said that they also play ‘soft ball’ and other games that residents like. Several ladies were having their nails manicured. Staff were also seen providing light hearted entertainment, which involved dressing up and acting. This was clearly enjoyed by several residents. Care plans contain records of visitors and outings with families. Feedback from relatives’ comments cards indicates that they are welcomed. A visiting relative said that the staff are very friendly when she visits. The resident and relative spent time together in the courtyard patio area just off the bottom lounge. This provides a degree of privacy. One relative’s comment card mentioned that more attention could be paid to comfort for visitors. There is limited space in the lounges for additional armchairs, but dining chairs are available.
Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 13 Residents spoke of their various visitors whom they see either in the lounges, dining area or in their bedrooms. A four weekly menu plan provides a nutritious diet with a choice of two options at the dinner and tea time meals and a full cooked breakfast, or cereals and toast each morning. Staff were seen assisting residents with eating in a sensitive way. Several residents praised the food, one said “it was a lovely dinner”. Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 14 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’s complaints procedure ensures that complaints are taken seriously, fully investigated and acted upon. Complaints are responded to positively and used as a learning process to develop practice for the benefit of residents. EVIDENCE: Residents spoken to praised the home, saying they had no complaints and would speak to the manager if they had any concerns. Residents were appreciative of the manager’s daily contact with them, saying that she listens to them and if they have any problems, she makes sure they are sorted out. Residents are given the opportunity to raise any concerns at residents’ meetings and there is a more formal channel via the complaints procedure. The manager keeps good complaints records and a record was seen that showed a recent complaint had been taken seriously and investigated. The outcome was not yet completed, but the manager had taken the necessary action and was in the process of composing a final letter to the complainant. The manager discusses any issues raised with staff at staff meetings, or individually in their formal supervision meetings. Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 15 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, 22, 25 & 26 The standard of the environment in this home is good, providing residents with an attractive and homely place to live. Recent investment in the provision of specialist equipment has significantly improved comfort and safety for those living and working in the home. Good systems are in place to keep the home free from offensive odours. Hand washing facilities need to be improved in some areas to ensure safe hygiene. EVIDENCE: There is an ongoing programme for the routine maintenance and redecoration of the building. The old part of the building was in the process of being rewired at the time of this inspection and new electric plug sockets are being provided in bedrooms at suitable heights and in accessible positions for residents. Once completed, each bedroom will have four plug sockets. A new electric bed and air mattress have been purchased to help maintain tissue viability and provide extra safety. The bed can be positioned to reduce the risk of back injury when moving and handling and to provide extra comfort
Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 16 for the resident. A new recliner chair has been purchased for the residents’ lounge since the last inspection. The programme to guard radiators (to address the risk of burns) is now well underway. Several more sound activated door closures have been fitted to bedroom fire doors to keep them open safely. A new carpet cleaner has been purchased to shampoo carpets and staff said that this is really good in controlling odour. The home was clean, pleasant smelling and has procedures in place to control the spread of infection. Supplies of liquid soap and paper towels are provided in most areas where soiled articles and infected materials, or clinical waste, are handled. These were absent at the time of inspection in the laundry and there was no liquid soap in one toilet. Clinical waste bins are not foot operated and pose a risk of infection. Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 17 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, 28, 29 & 30 Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. Numbers and deployment of staff on duty are sufficient to meet residents’ needs. The management of this home is working hard to provide a trained workforce for the benefit of residents. Recruitment procedures are generally sound, but need to be tightened to ensure that residents are properly protected. EVIDENCE: There has been a low staff turnover since the last inspection and staff spoken to said that Treetops is a nice place in which to work, where they feel valued and where the residents’ bests interests are always put first. During the inspection, sufficient staff were on duty to care for the residents and were being deployed effectively around the home. There were additional staff on duty for meal preparation and cleaning. The manager keeps a careful watch to ensure that staffing numbers are adequate and adjusts them at times of high dependency, such as if a resident is dying. Copies of worked rotas were seen to confirm this. Six staff have completed their National Vocational Qualification (NVQ) level 2 in care. The manager is an NVQ assessor and works with staff to help them through the course. A qualified carer said, “ I have worked in a few care homes and I feel the care is really good here and the clients’ needs always come first. The manager is not afraid to work on the floor.”
Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 18 Four staff files were checked and included application forms, two references and good induction records. Appropriate criminal records bureau (CRB) checks have been obtained for all existing staff. Three new staff had been employed after the CRB check had been applied for and protection of vulnerable adults list check (POVA) first check had been obtained. The manager said that they were each being supervised on shift by an experienced carer, but the names of their designated supervisors had not been recorded. A fresh CRB check had not been obtained for one new staff member who brought their CRB disclosure with them from their previous employment. Staff training records were seen to cover a wide range of short courses in addition to the comprehensive induction programme and NVQ work. For example: courses on infection control, challenging behaviour, continence promotion, blind awareness and bereavement. Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 19 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) 31,32,33,35,37 & 38 Residents benefit from a well run home where the management is commendable. The manager provides clear leadership and staff demonstrated good understanding of their roles and responsibilities. Residents and staff are able to influence how the home is run. Records are well kept and safeguard residents’ best interests. Good Systems are in place to protect residents’ financial interests. The health and safety practices in place safeguard residents, staff and visitors to the home. EVIDENCE: The manager has a supervisory management qualification and has attended a variety of short courses to update her knowledge, skills and competence, including a recent palliative care course (see under ‘Health and Social Care’ section above). Evidence at this inspection indicates that the manager is very competent and experienced, but standard 31 specifies that registered managers should obtain an NVQ level 4 in management and care by 2005. The manager has stated that she does not intend to undertake this, but is
Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 20 clearly committed to managing the home to provide high quality care to residents. Therefore although this standard is scored a ‘2’ as ‘almost met’, the outcome of the standard is clearly met. Residents and staff were complimentary about the manager’s leadership approach and the way she runs the home. A staff member said the best thing about the home is the atmosphere, “what you sense when you come in” and went on to say that this was down to the manager and the open, positive approach she has developed. Another staff member said, “the best thing is the lovely atmosphere, everyone gets on really well. I’ve never met a manager like her, she chips in when needed, is easy to talk to, helps and has created good working relationships.” The staff member went on to praise the good team working spirit and said that the manager is motivated towards staff development, “she wants staff to do well.” A resident’s comment card stated: “This is a very nice home to be in, we’re well cared for here.” A relative’s comment card stated: “Very pleased with the care my mother receives at Treetops.” The manager’s quality monitoring processes include regular residents’ meetings, staff meetings and questionnaires. The manager stated that she discusses relevant issues with the registered provider, who can be easily contacted by telephone. The registered provider visits the home weekly, but there have been no recent formal monthly visits and reports as required under regulation 26. Records of residents’ monies held on their behalf were seen to be well kept. Good fire safety records were seen. Documentation was seen indicating that prescribed maintenance checks were being completed and that sufficient staff have been trained in moving and handling, health and safety and food hygiene. First aid update training had recently been completed. Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 21 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x 3 x x 2 2 STAFFING Standard No Score 27 3 28 2 29 2 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 2 4 2 x 3 x 3 3 Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 22 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 OP9 Regulation 13(2) Requirement Timescale for action 30/9/2005 2. OP26 13(3) 3. OP29 19 4. OP33 26 A separate. secure,medication fridge must be provided for the storage of medicines that need to be kept cold. The home must have a metal cupboard which complies with the Misuse of Drugs (Safe Custody) Regulations 1973 for the storage of any controlled drugs in use for residents. An appropriate controlled drugs register must be kept. Appropriate hand washing 31/8/2005 facilities must be in place and regularly topped up in all areas where clinical waste is handled. Foot operated pedal bins must be provided for clinical waste. New staff must not be employed 31/8/2005 unless they are fit to work at the care home and information is obtained as specified in Schedule 2. Recruitment procedures must ensure that gaps in employment are checked out and CRB/POVA checks are carried out for all employees prior to their start date. The registered providers must 15/8/2005 arrange for a responsible individual, or one of the
Version 1.30 Page 23 Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc partners, to visit the home monthly (unannounced), inspect the building, interview residents and staff and submit a written report to the commission and the manager. 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. Refer to Standard OP22 OP27 Good Practice Recommendations That a set of sit on chair scales is obtained to weigh residents with mobility problems who cannot stand unaided. That the managers hours are added to the worked rotas to provide supporting evidence of the times worked supervising and training staff during the evenings, nights and weekends. Treetops Residential Home H56-H05 S23613 Treetops V225060 280605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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