Inspection on 06/02/06 for Yew Tree Care Home

This inspection was carried out on 6th February 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 24/07/06

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 Vanessa Gent Unannounced Inspection 6th February 2006 02:00 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.V282527.R01.S.doc Version 5.1 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.V282527.R01.S.doc Version 5.1 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 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.V282527.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th October 2005 Brief Description of the Service: Yew Tree Care Home is a former old 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 a full range of amenities including 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, mature gardens laid to wooded areas, lawns and flowerbeds, with spaces for car parking. A conservatory leads from the lounge and gives access from the house to a patio which overlooks the garden at the rear. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours by one inspector. The main method of inspection used is called ‘case-tracking’. This involves selecting a proportion of residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and any visitors, and observation of care practices. A partial tour of the building was undertaken. Three of the seventeen residents’ assessments and care plans were examined. Two of the four staff on duty, four of the sixteen residents and three relatives were spoken with. One comment card was received. Some policies and procedures were examined and records concerning the safety of the home were also seen. What the service does well: What has improved since the last inspection? Care plans now contain all risk assessments needed to adequately tell staff how to care for the residents. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 6 About half of the staff team have received training in the awareness and prevention of adult abuse; staff feel confident that they are able to safeguard residents from harm. Some re-decoration has taken place in communal areas and a further programme of decoration has been planned on an ongoing basis. Some training in food hygiene and COSHH procedures has been undertaken using handouts but staff would like more relevant training to be given in these and other areas. Policies and procedures have been updated by the manager who continues to oversee the updating process. 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.V282527.R01.S.doc Version 5.1 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.V282527.R01.S.doc Version 5.1 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 The home has a comprehensive statement of purpose and service user guide which give prospective residents a clear picture of what the home offers. EVIDENCE: A statement of purpose and service user guide are in place, clearly describe the facilities, services available and philosophy of the home and contain all the information necessary for prospective residents to make an informed choice about living at the home. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 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, 11 Care plans are adequate to enable staff to provide a caring service to all residents in the home and all residents are treated with dignity and respect. EVIDENCE: Care plans contain all risk assessments and documentation necessary to enable staff to care responsibly for the residents. Funereal plans are recorded where available. A photo of each resident should be in the care plans, as required in Schedule 3.2. Care plans are reviewed monthly although documentary evidence is this is scant in some care plans examined. During the inspection, the manager and some staff were attending the funeral of a former resident and flowers had been sent from the home. Staff say that they are trained to treat all residents with courtesy, dignity and respect at all times but especially at the end of life. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 10 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, 15 Activities are provided in enough quantity and variety to satisfy the wishes of the residents; food is nutritious, attractively presented and enjoyed by all residents. EVIDENCE: Although no activities organiser currently works at the home, staff provide activities for the residents and the manager often joins in, which is appreciated by all. Staff say and residents confirm that there is always a member of staff in the lounge with the residents. Formal entertainers attend the home usually about six times a year. The public transport to the town of Bourne is infrequent although the bus to Grantham is daily. The manager, however, can and does transport people in her car should they request or need it. The food provided is served hot, looks appetising and nutritious and is enjoyed by all residents spoken with. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 11 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): 18 Although their induction includes safeguarding the residents, not all staff are yet trained specifically in preventing adult abuse to ensure that all residents are safe. EVIDENCE: A lecture and a video on and training in prevention of adult abuse have taken place and seven staff have attended. Further dates are booked to ensure that all staff are trained and knowledgeable to safeguard the residents. Staff say that they get training in their induction on how to protect the residents and keep them safe, that they are aware of the home’s policy on whistle blowing and feel they can talk with the manager and providers to safeguard the residents. They feel confident that they are able to care for the residents in a safe and protective manner. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 12 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, 20, 25 In most areas of the home, the residents are comfortable and warm but staff need to monitor carefully where the heating system is faulty to ensure the residents in these areas are not at risk of hypothermia. EVIDENCE: The home has been undergoing a re-decoration and refurbishment programme, which is ongoing. The roof over the laundry has been replaced and other roof areas are designated for renovation and replacement within the home’s business plan. Communal areas have been re-decorated and de-cluttered to brighten the hall and corridors. Residents say they are comfortable and enjoy living in the home. The boiler of the heating and hot water system in the annexe part of the home is faulty and the manager stated that they were awaiting a part for it repair. However, residents’ rooms in this part of the house were cold and the water Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 13 either cool or cold in their sinks. Although a resident sitting in his room said he was not cold, the rooms were not suitably warm for residents getting ready for bed. Until the heating system is repaired, the staff need to frequently monitor the temperature in the rooms to ensure residents will not be cold when they wish to sit in their rooms or go to bed. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 14 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, 30 The home’s provision of adequate staffing numbers and skill mix, thorough induction and a comprehensive variety of training enables staff to care safely and efficiently for the residents. EVIDENCE: According to the staff duty rotas and the residents and staff spoken with, the staffing levels are adequate to care for the residents safely. Six of the staff are nurses trained overseas who are working at the home in the capacity of carers. Those spoken with say their induction was thorough and they felt supported, having a senior member of staff to ‘shadow’ until they felt confident in their practice. One staff is waiting to do her ‘adaptation’ to gain recognition of her trained nurse status but wishes to remain at the home for the foreseeable future. Staff meetings are held regularly at which staff feel confident to speak up and feel they are listened to. Staff supervision takes place regularly, the minutes of which are signed by both staff and supervisor, although staff files were not available for inspection. Staff say that training is encouraged and most mandatory training was seen to be up-to-date, although staff records were not available for checking. Some staff still need to access adult protection training. Other training has been undertaken such as dementia care, challenging behaviour management and diabetes care. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 15 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): 33, 35, 36, 37 Measures are in place that protect the residents from harm, provide staff with knowledge, support and encouragement to work efficiently, enjoy their jobs and care well for the residents. However, the views of residents and relatives should be taken into account more, to give the residents more autonomy and choice in their lives. EVIDENCE: Although the Provider visits the home regularly, no audit of these visits is recorded or report written, as required. Quality auditing is not undertaken by the manager and it is some time since the views of the residents and relatives were obtained in a survey or questionnaire. Some residents’ finances are managed by the manager. The statement of purpose should reflect accurately what is taken from these personal allowances for facilities provided individually. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 16 Receipts are kept for all purchases for residents and two signatures obtained for auditing these records. Staff say they receive regular supervision although this could not be confirmed as staff records were not available. Staff say they feel supported and encouraged by the manager, that “she is a good boss”, that they can talk to her and she always listens, encourages and is there for them. They also say the providers are often available and are very supportive. Many policies and procedures have been updated between July 2005 and January 2006 and the manager believes most are now up-to-date and reflect more the current situation or requirements. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 17 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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 3 X X X 3 2 X STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 2 3 3 X Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 18 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 OP25 Regulation 23.2 Requirement Timescale for action 28/02/06 2. OP33 3. OP35 The heating and hot water systems must be fully operational to keep residents warm, comfortable and have hot water for their personal needs. The temperature of the hot water in residents’ bedroom washbasins must be monitored and a record kept to ensure it is suitable for its purpose. 24.1,3, The responsible person must 26.1,3,4,5 visit the home on a regular monthly basis, monitor the service provided and supply a copy of each visit to the manager as required. Residents’ views must be obtained to ensure they have autonomy and choice in their lives. 4.1, 16.2 Residents’ finances must be safeguarded at all times. The statement of purpose must clearly state what services are provided. 31/03/06 31/03/06 Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 19 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 OP7 OP33 Good Practice Recommendations A photo of each resident should be kept in the care plans, as required in Schedule 3.2. The views of residents and their families should be sought and their wishes and opinions made into a quality audit tool to ensure that the home is providing the service that residents want and need. Yew Tree Care Home DS0000060593.V282527.R01.S.doc Version 5.1 Page 20 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.V282527.R01.S.doc Version 5.1 Page 21 - 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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