Inspection on 24/07/06 for Yew Tree Care Home

This inspection was carried out on 24th July 2006.

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

Yew Tree Care Home 18/08/08

Yew Tree Care Home 20/08/07

Yew Tree Care Home 05/03/07

Yew Tree Care Home 06/02/06

Yew Tree Care Home 11/10/05

Yew Tree Care Home 20/12/04

Yew Tree Care Home 24/08/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Yew Tree Care Home 60 Main Road Dowsby Bourne Lincs PE10 0TL Lead Inspector Moya Dennis Key Unannounced Inspection 24th July 2006 1:15 X10015.doc Version 1.40 Page 1 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 Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 2 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. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Yew Tree Care Home Address 60 Main Road Dowsby Bourne Lincs PE10 0TL 01778 440247 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Yew Tree Residential Care Home Limited Patricia Gallagher Care Home 18 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (6) of places Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th February 2006 Brief Description of the Service: Yew Tree Care Home is a former rectory and is situated next to the church in the village of Dowsby, with several shops and a pub. It is six miles from the town of Bourne, in Lincolnshire, which has shops, banks, post office, pubs and leisure facilities. The home is registered to provide residential care for eighteen people of both sexes over the age of 65 years, twelve of whom may have the diagnosis of dementia. A single storey extension provides accommodation for ten residents; the first floor accommodation in the main building is accessed via a stair lift. There are twelve single rooms, two of which have en-suite facilities, and three shared rooms. The home is set back from the road and has large enclosed gardens with spaces for car parking. The home has a conservatory, which leads to the garden and patio. Fees range from £330 to £530 per week. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information provided, relating to Yew Tree Care Home, and by visiting the home. The inspection was unannounced and took place over 3 ½ hours. The method of inspection used involved tracking the care of selected residents, examining their records, speaking to care staff, observing general working practices and noting the views of residents and their relatives. The inspector also toured the building and examined a range of documentation. What the service does well: What has improved since the last inspection? A refurbishment programme has begun. The main reception area has been redecorated and individual rooms will be redecorated as they become vacant. Feedback is actively sought from residents, relatives and other professionals. The manager continues to oversee the updating of the home’s policies and procedures and the process will soon be completed. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 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. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 8 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 the following standard(s): 1,2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Prospective residents are given a full range of information before moving to the home, including written confirmation that the home can meet assessed needs, a written contract and a copy of the home’s statement of purpose, terms and conditions. EVIDENCE: Pre inspection information evidenced that prospective residents and their families are provided with sufficient information about the home and are encouraged to visit before making a decision. A member of staff from the home completes a full assessment of need before admission and residents and/or their families are informed in writing that the home is able to meet the assessed needs. All admissions are on a trial basis, to see if the home will be acceptable to residents and their families. Residents are advised not to dispose of any property until all parties are satisfied that the placement is suitable. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 7,8,9,10. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents’ care needs are fully met by care staff and/or other health professionals. Residents are treated with respect and accorded dignity at all times. EVIDENCE: Pre inspection questionnaires were received from three community nurses and two local GPs. All comments were positive about the care delivered. One GP commented that, “I find the service provided highly satisfactory”. The other; “I have always found the staff to be very helpful and professional”. No resident is able to self medicate. Staff are trained to administer medication and policies and procedures within the home are robust and followed at all times. Care plans seen were clear and comprehensive. All relevant information, including risk assessments was included, enabling staff to deliver care in the Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 10 appropriate, most acceptable way. Care plans are reviewed monthly, more often if necessary. Most residents are unable to contribute to these plans but relatives’ feedback confirmed that families are involved as fully as they wish. Pre inspection questionnaires from Social Service personnel were positive about the quality of care and staff/resident relationships. The inspector observed routine practice during the visit; this confirmed that staff did not trivialise residents’ needs, were not overly familiar and acted professionally at all times. The easy rapport between staff and residents was apparent. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service The home provides activities at a level acceptable and appropriate for the needs of all residents. Relatives and health professionals confirm they have a good working relationship with staff at the home. Residents are able to exercise choice and control over their lives, within the limitations of their illness. Residents have a varied diet, with meals well presented. EVIDENCE: Many residents prefer one-to-one activity, rather than organised events. Entertainers visit the home about six times a year. During the visit the inspector saw several members of staff interacting with residents. Relatives’ feedback mentioned that a member of staff is always present in the lounge with residents. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 12 Few residents are able to maintain links with the wider community but relatives say they are always made welcome and are kept informed of any changes in their relative’s well being. Written records, reviews and general observations evidence that residents are able to exercise choice and control over their lives. The home’s Service User Guide states that routines, interests, likes and preferences are recorded on admission and used to inform the care plan. The home operates a key worker system and one such worker told the inspector that they asked families to provide any information that could help them further engage with residents, in the form of a brief social history. Because the residents are largely unable to discuss their present preferences, available choices are limited. Residents are able to choose where they take their meals, what they eat, which seat to occupy in the lounge, bath times and which clothes to wear. During the inspection staff were seen and heard encouraging residents to make choices about all aspects of day-to-day routines. Residents sign reviews of care plans, if they are able, and relatives are consulted about any such changes. It is good practice for relatives to sign reviews and the manager agreed to ask them to do so in future. Meals are varied and looked appetising. Relative feedback rated meals in the home as ‘good’ or ‘excellent’. One commented, “Meals, in my experience, are balanced and wholesome, with good variety”. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Relatives rated the home’s response to any complaint or comment as ‘good’ or ‘excellent’. Staff induction is comprehensive and thorough. EVIDENCE: No complaints have been received by the home since the last inspection. A copy of the complaints procedure is given to each resident in the Service User Guide and a copy is available in the manager’s office. Ten relatives completed surveys and said they were aware of how to make a complaint. All rated the home’ response to comments as ‘good’ or ‘excellent’. None had ever felt the need to complain. The complaint file was made available for inspection during the visit. Staff confirmed they receive training during induction on safeguarding residents, recognising and preventing abuse. Staff spoken to demonstrated clear understanding of abuse issues and the home’s whistle blowing policy. They said they would feel confident in approaching the manager to discuss any such issues. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 19,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home is clean, comfortable, well maintained and meets residents’ needs. Rooms are personalised with residents’ own belongings. EVIDENCE: A tour of the home confirmed that lavatory and bathroom facilities continue to meet assessed need. Specialist equipment such as hoists, rotundas and wheelchairs is provided and service histories were made available for inspection. Bedrooms are safe, comfortable and personalised. Rooms are redecorated as they are vacated. The home is well maintained, clean and hygienic. There was a noticeably pleasant smell throughout the home. The boiler was repaired days after the Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 15 last inspection and the heating and water supply is back to standard. Day to day maintenance records were made available for inspection. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 16 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence, including a visit to this service. The home employs staff in sufficient numbers and mix of skills to meet the assessed needs of residents. Recruitment policies are inconsistently applied and may not protect the residents. Induction and training equips staff to do their jobs well. EVIDENCE: Duty rotas provided before inspection demonstrated that staffing levels are appropriate to care for residents. Inspection of selected staff records showed that four staff were recently recruited without Criminal Record Bureau or PoVA checks. All had local Police Checks and work permits. No copies of the original applications or written references had been provided by the recruiting agency to the employer. An immediate requirement was left for this standard. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 17 A staff-training programme was provided pre-inspection, demonstrating mandatory and other training offered, including dementia care, continence promotion and diabetes care. Staff said they felt confident to voice their views during staff meetings, minutes of which were made available for inspection. Formal supervision takes place and staff members and their supervisor sign records. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 18 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. An experienced and competent manager runs the home. The home has a sound quality monitoring system. Residents, other professionals and relatives are encouraged to give feedback. Financial recording procedures for residents’ personal allowances have been improved. EVIDENCE: The registered manager is well qualified, with many years experience in management and care. She has updated the home’s policies and instigated Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 19 regular feedback from residents, relatives, and health and social care professionals, as evidenced by pre-inspection questionnaires. The provider visits the home each week but fails to record the findings of the visits and provide the manager with a written report, as required. Currently, no resident is able to manage his or her own finances. Most have family to administer their financial affairs; others are subject to Power of Attorney. The manager holds the personal allowances of two residents. All transactions are fully recorded and signed by two members of staff. Staff are fully trained and have regular updates in safe working practice and relevant legislation. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 2 X 3 X X 3 Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes. 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 OP29 Regulation 17(2). 19(1) (b) (c) Requirement The registered person must ensure that correct recruitment procedures are followed for all staff. In addition to statutory checks, two written references are to be obtained before appointing any member of staff and any gaps in employment history explored. Copies of references and of original application to be retained on employee’s file. Timescale for action 27/07/06 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. Refer to Standard OP8 Good Practice Recommendations Suitable scales should be provided to enable the weight of residents to be monitored, as requested in care plans. Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Yew Tree Care Home DS0000060593.V305628.R01.S.doc Version 5.2 Page 23 - 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. 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