Inspection on 11/12/08 for Tripletrees

This inspection was carried out on 11th December 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Tripletrees 18/02/08

Tripletrees 18/07/07

Tripletrees 11/05/06

Tripletrees 04/10/05

Tripletrees 24/05/05

Tripletrees 07/10/04

Tripletrees 15/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

1 Marten Road

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Tripletrees 70 Ferndale Road Burgess Hill West Sussex RH15 0HD     The quality rating for this care home is:   two star good 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. Lead inspector: Ann Peace     Date: 1 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) 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. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Tripletrees 70 Ferndale Road Burgess Hill West Sussex RH15 0HD 01444243054 01444248344 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Follett Care Limited care home 28 Number of places (if applicable): Under 65 Over 65 0 0 28 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 28 28 0 The maximum number of service users who can be accommodated is: 28 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia - DE Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home Tripletrees is a care home, registered to provide personal care for a maximum of twenty-eight older persons to include a maximum of three residents with dementia/mental disorder. Tripletrees is a large detached and extended property, situated in Burgess Hill, being close to shops, local amenities and transport links. The accommodation is arranged on three floors and comprises of twenty-four single bedrooms and two double rooms that are served by a passenger lift and stair lift. Care Homes for Older People Page 4 of 27 Brief description of the care home Residents benefit have the use of a large lounge and dining room on the ground floor. The home is owned by Follett Care Limited and is managed by Mrs M Follett. The current fees are 425 pounds to 595 pounds per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A visit to the home was made on 11th December 2008 by Mrs A Peace Regulatory Inspector. The previous visit to the home was in February 2008. The Annual Quality Assurance Assessment (AQAA) completed by the home was returned in good time for it to inform this inspection and gave us information about how the home has been performing since the last inspection. During the visit we met people in the communal areas of the home and in their bedrooms, we spoke to as many residents and their visitors as we could and observed staff and residents interactions throughout the visit. We observed residents to be comfortable, relaxed and content in the home and had good relationships with the staff who were looking after them. Residents told us that Care Homes for Older People Page 6 of 27 they are well looked after in the home by a caring team of staff. What the care home does well: What has improved since the last inspection? What they could do better: In line with the Care Home Regulations 2001 17(1)a Schedule 3, all residents must have a photograph of themselves available in the home. It would be good practice to keep these photographs with the medication records to minimize the risk of medication errors. Residents must also have care plans for specific problems that have been identified e.g. Diabetes so that care staff know how to care for them. All care records should be consistent and updated on a regular basis and all residents must have a nutritional assessment carried out and be weighed on a regular basis. Paper hand towels should be available for staff to minimize the risk of spread of infection. The medication procedure at night should be reviewed to ensure all residents are able to take their medication with them if they are admitted to hospital in an emergency. Staff who are expected to handle food should be up to date with safe food handling training and the carer who undertakes activities should have access to appropriate training. The environment should be adapted with appropriate signage and stimuli which will aid and stimulate residents with dementia or who are mentally frail. A risk assessment should be carried out in regards to the open access to the front of Care Homes for Older People Page 8 of 27 the property and the road from the rear garden. The AQAA told us how the home hope to improve in the next year and includes plans for: An ongoing redecoration and refurbishment. Another quality assurance review of all aspects of health and social care will be carried out in January 2009 including an audit and review re adherence with policies and procedures. To expand and facilitate the increased use of IT with the new computer. To have all of the staff holding accredited qualifications. 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents of the service and their representatives have the opportunity to make a fully informed choice about whether or not the home is suitable and able to meet the individual persons needs. Evidence: The home has a statement of purpose and service users guide which is available to anyone interested in moving into the home, this is kept with a copy of the latest CSCI report near the entrance to the home. Residents and visitors told us during the visit that they had been given sufficient information about the home to be able to make sure that it was the right place for them. Staff said that they are given up to date information about residents to be able to look after them the way they would wish. All prospective residents are fully assessed before they are admitted to ensure the Care Homes for Older People Page 11 of 27 Evidence: home will be able to meet their needs. We examined a random selection of residents records and all contained detailed information regarding personal choices and individual preferences plus other information related to health and personal care. Care records examined during this visit were seen to have assessments and some risk assessments carried out and all residents had basic care plans. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are cared for by a caring, friendly and well trained team of staff who respect their privacy and dignity, some care records need updating and all residents must have an up to date nutritional assessment carried out. Evidence: Residents are cared for by a caring, friendly and well trained team of staff who respect their privacy and dignity. The majority of care plans do give clear information to assist with all aspects of personal care needs, so that the changing needs of residents living at the home can be monitored. However some of the care records are disorganized with old records mixed in with present ones and not all residents had appropriate care plans or risk assessments in place. All residents must have a photograph with their records. All residents had a basic care plan which covered areas of daily living and provides staff with information about how each residents wishes to be supported they also included preferences for daily and night time routines. Daily records and a staff Care Homes for Older People Page 13 of 27 Evidence: handover book showed that staff are aware of peoples needs and by observing staff throughout the visit we could see that they know the residents needs very well. Records show that the home works well with other health professionals and records are kept of any visits made with any instructions from health professionals recorded for staff to follow. Surveys completed by visiting health professionals were positive about the home and the staff. The majority but not all of care records had been updated on a regular basis to show any changing needs of residents, however not all residents had a nutritional assessment in their care records and no residents had been weighed since August 2008. A record in the weight book stated that the scales were out of order but were seen to be working on the day of the visit. Mrs Follett told us that she would ensure that residents were weighed and the records updated as soon as possible. Some of the care records were disorganized with records going back to 2004 mixed in with present records and should be sorted out. Where a specific problem had been identified e.g.Diabetes, residents should have a specific care plan to instruct staff how to care for residents with this problem, what to look out for, and what to do if the condition changes. Where residents are also in bed more that usual they should have a risk assessment for pressure area risks. On the day of the visit we observed staff with residents and noted that the staff were kind and caring in their approach while respecting residents wishes. All residents and visitors spoken to were very complimentary about the staff and the way they look after them. One resident told us that she had not wanted to give up her home but is glad she moved into Tripletrees as she could not be looked after any better. Another resident who had gone back to bed told us that they can choose when to get up or go to bed and that staff always respected their wishes. A monitored dosage system for medication administration is in use in the home and records show that staff that administer medication have received training. Medication was securely stored in a well organized and clean medication trolley and medication administration records had been completed appropriately. On the day of the visit a carer undertaking NVQ training was being supervised administering the lunchtime medication. We noted that if a resident is admitted to hospital during the night, night staff are not able to access all of their medication. This procedure must be reviewed to ensure that when there is an emergency the residents medication is accessible to emergency staff Care Homes for Older People Page 14 of 27 Evidence: in case the resident has to be admitted to hospital. Mrs Follett agreed to review this procedure. An external NVQ assessor was also visiting the home to assess another carer. From observing staff, talking to the Manager Mrs Follett, staff, residents and visitors we concluded that at the time of their death residents and their families would be treated with care sensitivity and respect. Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents living at the home have opportunities for entertainment and activities, families and friends are made welcome in the home and good home cooked food is served. Evidence: The home offers a range of daily activities and entertainment is also arranged on a regular basis. During our visit residents were either watching television, reading newspapers or talking to each other and the staff. Activities arranged include: Board games, manicure and hand massages, singing, scrabble, bingo, quizzes, musical memories and cards. Residents told us that they had been making Christmas decorations and they were looking forward to an entertainer coming to the home on the afternoon of our visit. Records are kept of who likes to take part in activities and who does not, these wishes are respected, the carer who carries out the activity program also sees residents on a one to one basis so no one gets left out. Residents told us and we observed that residents can spend their days how they want to. Some go out to clubs and some shopping. One resident goes out every day for a walk or to the shops. Photographs Care Homes for Older People Page 16 of 27 Evidence: were available to also evidence activities. Although the carer who does carry out activities is doing a very good job she has not had any formal training, Mrs Follett told us that she has found a course that would be suitable so will be arranging this training in the near future. We are told that the rear garden which is laid to lawn with flower beds and shrubs is often used in better weather and has seating for residents to use. There is a path at the side of the house which is not gated. Mrs Follett was advised to carry out a risk assessment in case a resident were to wander off unobserved. On the day of the visit the chef had phoned in sick so an experienced carer had stepped in to make the meals. Other care staff were bought in to make sure that residents did not suffer because of this. The main meal of the day was chicken curry followed by bananas and custard which most of the residents seemed to enjoy. Residents who did not want the main meal did have an alternative and one resident who wanted a different meal after the other residents were finished was given what they wanted. We sampled the chicken curry and found it to be tasty. Likes and dislikes are recorded and residents said staff respected this. Records are kept of the food ordered by residents and staff were seen to observe whether residents were eating and who needed promting or help. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes complaint procedure enables those people using the service to know that any complaints will be taken seriously and responded to. Residents living at the home are safeguarded by the homes safe guarding adults procedures. Evidence: The home has a complaint procedure and a notice of this is displayed in the home. Mrs Follett told us that if residents or their representatives or relatives have a concern they usually come straight into the office so any concerns are dealt with immediately. A visitor did confirm this. Mrs Follett did tell us that The Environmental Health Department had recently received a complaint about Tripletrees but had visited and found the complaint to be unsubstantiated. Staff receive training in safeguarding adults procedures and when staff were asked they could explain the procedure. Mrs Follett was advised to make sure that safeguarding was recorded on the basic induction training for all staff including ancillary staff. The majority of care staff have NVQ training which covers all aspects of safeguarding. When residents who could offer an opinion were asked they did say they felt safe in the home. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Tripletrees offers a clean, homely, safe and comfortable environment. People said they were happy with the facilities offered. Evidence: Tripletrees offers residents a clean, warm, safe and comfortable environment. The rooms are situated on three floors with the communal areas of a large lounge and a dining room on the ground floor. Since the last inspection many areas have been re decorated and re furbished and we were told that there is an ongoing programme of decoration and refurbishment, this is to include bathrooms some of which are outdated. Residents bedrooms are comfortable and have been furnished in a homely fashion with residents able to bring possessions in with them to personalize their rooms. The call bell system was noted to be in working order with staff promptly answering call bells. Since the last inspection a number of bedroom doors have been fitted with devices that would close the door automatically in the event of a fire. Mrs Follett was advised to ensure all residents who wished to have their doors open have the opportunity to have automatic closures fitted. The home is clean and hygienic but Mrs Follett was advised that it would be good Care Homes for Older People Page 19 of 27 Evidence: practice for staff to have paper hand towels in the staff toilet as there is an infection control risk from traditional hand towels used by a number of people. The open access to the front of the property from the back garden should be risk assessed and if any measures are needed to keep residents safe taken. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents living at the home are cared for by a well trained team of staff and residents are protected by the recruitment procedures followed by the home. Evidence: Staffing rotas showed that there are sufficient numbers of staff on duty to meet the needs of the residents living at the home, surveys and people spoken to on the day of the visit told us that staff are kind and caring and always listen to and act on what residents tell them. On the day of the visit the chef had phoned in sick but a carer who is experienced in the kitchen took over the duties and other staff were called in to the home to fill the carer hours left vacant. Mrs Follett was reminded that all staff who work in the kitchen or who serve and handle food should be regularly updated with food hygiene training. Staff were observed to be friendly, respectful and caring towards residents. The recruitment records of three new staff were seen and showed that the home has a safe recruitment procedure. Staff receive induction when they first commence work at the home and other mandatory training is given although the complete training records could not be accessed during the visit. Care Homes for Older People Page 21 of 27 Evidence: Staff told us that they are well trained and the majority of the staff have either achieved a National Vocational Qualification or are in the process of undertaking one. Mrs Follett told us that she is planning to access training for the carer who carries out activities. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, run in the best interests of residents and staff and residents benefit from the leadership approach of the manager. Some care records need updating. Evidence: Mrs Follett is the registered manager for the home and is assisted day to day by a deputy manager. Mrs Follett and the deputy manager have the experience and the qualifications to run the home. Residents and their families spoke highly of Mrs Follett, the staff and the way the home is run. All those spoken to on the day of the visit were very complimentary and there were no complaints or concerns raised. A quality assurance system is in place but should be expanded to ensure a complete circle of self audit in all areas of the home. The results of any survey should be Care Homes for Older People Page 23 of 27 Evidence: available in the home for residents and their relatives or representatives to show how the home is improving following consultation. Staff on duty said they were supervised and we were shown a chart of specified dates when supervision takes place or is due to take place. We saw records related to the running of the home and these were in good order however the care records need sorting out and updating. Mrs Follett told us that they do not manage any money on behalf of residents. A requirement made following the previous inspection relating to providing automatic closures has been complied with. Although all residents should be offered the choice. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 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 Recommendations 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 26 of 27 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 27 of 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. 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!