Inspection on 30/06/05 for Treetops Residential Home

This inspection was carried out on 30th 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 Residential Home 03/12/08

Treetops Residential Home 07/01/08

Treetops Residential Home 08/01/07

Treetops Residential Home 25/01/06

Treetops Residential Home 07/02/05

Treetops Residential Home 14/09/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Treetops Residential Home Old Ipswich Road Claydon Suffolk IP6 0AE Lead Inspector Cecilia McKillop Unannounced 30th 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 Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Treetops Residential Home Address Old Ipswich Road Claydon Ipswich Suffolk IP6 0AE 01473 830829 01473 833057 None Mrs Jane S Hewson 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 Sheila Gillians Care Home 7 Category(ies) of Learning Disabilities; 7 registration, with number of places Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 07/02/05 Brief Description of the Service: Treetops provide care and support to seven adults with learning disabilities whose behaviour can be challenging. The home was first registered in March 1996 and is owned by Mr. and Mrs. Hewson under the name of Cephas Community Care. Mr. and Mrs. Hewson jointly own a number of residential homes for people with learning disabilities within Suffolk. Treetops is a detached two-storey “dorma” style bungalow, set well back from the road and situated at one end of the village of Claydon. Service users can easily access the amenities within the village and the home is also a few minutes from the A14 allowing easy access to the other main towns within the east of Suffolk. All service users are provided with single room accommodation, which is furnished and decorated to individual tastes and needs. The home has the advantage of an indoor heated swimming pool. Treetops provides day services to the service users which is created around personal interests and learning skills. The home has its own transport and all service users are therefore able to access local community facilities in the east Suffolk area. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out in the morning and afternoon. During the inspection time was spent with service users and staff, and the inspector was given a tour of the accommodation by two of the service users. What the service does well: What has improved since the last inspection? The home looked clean and was odour free. The manager informed the inspector that following the last inspection communication with service users was discussed at staff meetings and clear guidance given. Staff were observed speaking with residents in a respectful manner and the inspector was informed that the use of the guard in the car when a service user was in the car had ceased. The complaints procedure has been updated and a review of all the procedures and staff guidance was underway. During the inspection service users were observed being able to access the dining room when they wanted and china crockery was being used at meal times. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.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 Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4,5 Service users have an opportunity to visit the home before admission and are provided with written information however service users do not always receive a contract prior to their admission. EVIDENCE: A service user had been admitted the day before the inspection for a short stay. The service user had looked around the home before moving in and the manager and operational manager had also undertaken a pre- admission assessment with the service user. The admission had been organised at relatively short notice and while the assessment contained key information it was not very comprehensive. It was agreed that admissions of a long-term nature would require more a detailed assessment. Temporary registration had been organised with a local GP practice and the home had organised a review to take place within a week of the admission. There were no contracts in place for the newly admitted service user. The inspector was informed that the service user had been provided with a copy of the service user guide. The statement of purpose was not available at the home on the day of the inspection and it was agreed that this would be forwarded to the Commission. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,8 Service users all have care plans but these are not always up to date. Service users are consulted about the routines of daily living. EVIDENCE: A sample of care plans were examined and these were generally satisfactory, however some out of date guidance had not been removed from the records used by care staff. There was evidence of reviews taking place and records were being securely stored. Staff were observed offering choices to service users and ascertaining their views in a number of ways. Service users preferences had been taken in to account in the organisation of their recent holiday and one service user had been enabled to fly for the first time. The inspector was informed that the home plan to involve service users in future staff interviews which is a positive development. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,17 Service users are able to take part in a range of social activities and are provided with appetising meals. EVIDENCE: The home has its own indoor swimming pool and a snoozelum, which is sited in a separate building to the rear of the property with its own changing rooms, shower and toilet facilities. A portacabin is located in the rear grounds of the home and provides an activity room for service users. Each service user has an activity plan which outlines what they do each week. The activities are organised on an individual basis and those listed included trips out, swimming, arts and crafts and trampolining. The manager informed the inspector that the home have had difficulty finding individual work placements for the service users but they continued to make efforts to do so. Progress in this area will be followed up at the next inspection. Only one service user routinely attends social activities outside the home, although it was planned that the service users would shortly be able to access a summer scheme organised by the local authority. On the morning of the inspection two of the service users were undertaking crafts and another was tidying their Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 11 room. In the afternoon a number of the service users went out for a drive in the car. There was evidence of service users being able to maintain contacts with family and friends. Service users had recently returned from holidays to Holland and to Norfolk. Staff had accompanied the service users and the inspector was informed that the holidays had been very successful and this was confirmed by one service users who said that they had enjoyed the trip. On the day of the inspection service users were observed being offered a choice at lunch. All the service users chose the savoury mince, which was prepared by one of the care staff and looked appetising. Service users all ate at the dining table and a choice of drinks were available. Service users appeared to enjoy the meal. It is recommended that the home look at the organisation around dining, as the table was not set until the meal arrived. There was a discussion at the end of the inspection about ways that the staff could make the dining room more homely. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Service users were able to make choices about how they wished to be cared for. EVIDENCE: The pharmacist examined medication systems and a separate report is available from CSCI. The systems in place were largely satisfactory and small number of requirements and recommendations have been made. There was evidence that routines within the home were flexible and one service user was observed getting up mid morning and being given a late breakfast. Service users were all appropriately dressed. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 13 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 The home is developing systems to help involve service users have better access to how the home is run. EVIDENCE: There was a complaints procedure in place and the manager said that this was currently being updated and it was planned that it would be provided to service users in a symbol format. Progress with this will be followed up at the next inspection. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 14 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) 24,26,28,30 Service users live in a comfortable home, which was clean. Privacy would be enhanced further for individual service users. EVIDENCE: The building is a “dorma” style bungalow, which provides a large lounge and a kitchen dining room on the ground floor. There are four bedrooms on the ground floor and thee bedrooms located on the first floor. There is a chair lift between the ground and first floor. All bedrooms are for single occupancy and one bedroom has an ensuite shower and toilet facilities. The home has been required to look at the service users privacy as there is no door to the ensuite. The inspector found that the building was being maintained to a good standard of decorative order. There were a small number of repairs outstanding including the communication board in the kitchen, which was out of use on the day of the inspection. One of the bedrooms which were examined was without window coverings and it was recommended that this was addressed as a matter of some urgency. The standard of cleanliness was good and there were no unpleasant odours. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 15 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) 34,36 The recruitment of staff was generally sound however it should be further strengthened to protect service users. EVIDENCE: There were 4 care staff on duty on the day of the inspection with the 7 service users. A student nurse was undertaking a short placement at the home and was working on a supernumerary basis. The recruitment records of two newly appointed staff were examined and these were generally satisfactory however the home are required to follow up at interview where there are gaps in employment history. The home must also maintain records to evidence that there has been an identity check undertaken. The supervision records or the supervision rota was not available on the day of the inspection and it was agreed that evidence of supervision would be forwarded to the Commission. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 16 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) 40,42 The manager is experienced and there is a clear management structure within the home. The policies and procedures were being reviewed to ensure that staff receive the appropriate guidance. Safety of service users is taken seriously. EVIDENCE: The manager has managed the home for a number of years and is assisted by a deputy manager. The manager receives additional support from other staff in the organisation, including the operational manager and the personnel manager who was visiting the home on the day of the inspection. Regulation 26 visits are undertaken and the CSCI have been receiving regular reports. The homes policies and procedures were being re-examined by staff and a number of them had been amended to take account of changes to the regulations. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 17 The inspector was informed that the home was developing a number of questionnaires for service users and progress with this will be followed up at a future inspection. Fire safety training for staff and service users was underway on the day of the inspection and as part of the training an evacuation of the building was undertaken Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 18 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 2 x 3 x 2 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x x x 2 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Treetops Residential Home Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x x x 3 x 3 x I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 19 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. 2. Standard 1 1,5 Regulation 4 5 Requirement A copy of the statement of purpose must be forwarded to CSCI. Service users must be provided with a contract which outlines the services and facilites that will be offered before admission. A copy of this and the service user guide must be forwarded to the commission. Window coverings must be provided on windows in service users bedrooms. A door must be fitted to the ensuite bathroom to ensure service user privacy. A full employment history must be available for all staff and gaps in employment must be clarifed at interview. Evidence of identity checks must be maintained. Timescale for action 01/09/05 01/09/05 3. 4. 5. 26 27 34 16 16 19 01/08/05 01/09/05 01/08/05 6. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 20 Treetops Residential Home 1. 2. 3. 4. Standard 12 17 11 36 The range of activities for service users could benefit from expansion. The serving of the meals should be reviewed and staff should examine how this could be better organised. The communication board should be repaired. The provider is requested to send to CSCI evidence that staff receive regular supervision. Treetops Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 5th Floor St Vincent House 1 Cutler Street Ipswich Suffolk, IP1 1UQ 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 Residential Home I54-I04 S24514 Treetops V237945 050630 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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