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Inspection on 19/07/06 for Yew Tree House Residential Care Home For The Elderly

Also see our care home review for Yew Tree House Residential Care Home For The Elderly for more information

This inspection was carried out on 19th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service offers well - equipped and comfortable surroundings for the residents; bedrooms are very personalised to the individual. Newly built accommodation, adjacent to the main building, has created two bed-sits where the resident has additional space and facilities and encourages the maintenance of independence. Information is provided to the prospective resident prior to moving into the home, which residents said they felt was adequate and informative in making a decision. The Proprietor is very much involved with the residents on a daily basis and spends much time with individuals, supporting them in a variety of activities, both in house and accompanying on shopping trips, hospital and other medical appointments, etc. Staff work closely together with the Proprietor, in the daily attention to individual needs and requirements; residents expressed much praise for the staff team and the attention given to ensure their comfort at the home. Residents said that they were able to make choices and that these were always respected. Documentation in respect of care planning for the individual is clear and detailed and as such identifies daily care needs and support required.

What has improved since the last inspection?

The keeping of written records relating to `medication practices` has been developed, in accordance with the requirements identified during the last Inspection of the home. Documentation in general has been reviewed and attention given to the maintenance of required records for registration purposes. Practices have been put into place to protect the privacy of the two persons sharing a bedroom. The registration of the new building adjacent to the main house has necessitated the involvement of the Fire Officer and in association the assessment of procedures. An assessment has been made involving the Fire Officer in regards to the locking of the laundry room fire exit door; this has now been resolved. Radiators within the home have been fitted with a guard. Temperature controls to hot water taps are in the process of being installed throughout the home.

What the care home could do better:

There is a need for exterior garden areas to be made safe and for access to the greenhouse to be risk assessed. There is a need to ensure that all Mandatory training is kept up to date, with current emphasis to particularly focus on `Adult Protection`, `Infection Control` and `Fire Safety`. There is a need to ensure that all staff receive sufficient training in Dementia Care in accordance with the home`s registration. A written record to be kept of hot water temperatures within the home.A review of the future use of the shared room as single accommodation.

CARE HOMES FOR OLDER PEOPLE Yew Tree House Residential Care Home For The Elderly Yew Tree House 9 Station Road Headcorn Ashford Kent TN27 9SA Lead Inspector Ms Patricia Green Unannounced Inspection 19th July 2006 10:00 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 House Residential Care Home For The Elderly DS0000024096.V300721.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 House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Yew Tree House Residential Care Home For The Elderly Yew Tree House 9 Station Road Headcorn Ashford Kent TN27 9SA 01622 890112 Address 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) Mr Michael Francis Discombe Mr Michael Francis Discombe Care Home 13 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (11) of places Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th January 2006 Brief Description of the Service: Yew Tree House is a detached property with accommodation on two floors. There are 8 single bedrooms and one double. Each room has a call point and a television point. The home does not have a shaft or stair lift installed, which therefore limits the use of the upstairs bedrooms to those who are physically able. Communal facilities comprise toilets and two bathrooms and a large lounge with a dining area to one end. The homes kitchen is located on the first floor with meals being served via a dumb waiter to the dining room below. The arrangement allows for more bedrooms to be located on the ground floor. The home is located in Headcorn village near to the railway station. There is good access to shops and other amenities close by. Car parking is currently limited to two spaces at the front of the home due to building work. The homes senior staffing team comprises the owner/ manager, and a trainee home manager. The home also employs 11 care staff working across a 24-hour roster and two part time catering staff. In addition to the main house a separate building has recently been erected to the front of the premises providing 2 single en-suite studio bedrooms. The current Fees are in the range £390 - £450. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was unannounced. During the visit the premises were toured, a range of documentation was viewed and staff and residents were spoken to. At the time of the visit the Proprietor was away on holiday and the home was being managed and overseen by the Senior Carer, whom works closely with the Proprietor in the daily management of the service. This visit gave evidence of the commitment and focus that has been given to addressing Requirements and Recommendations that had been identified during the last Inspection of the home. The service offers a very relaxed and homely environment where the individuality of the resident is respected and is foremost in planning the individual’s required care and support. What the service does well: The service offers well - equipped and comfortable surroundings for the residents; bedrooms are very personalised to the individual. Newly built accommodation, adjacent to the main building, has created two bed-sits where the resident has additional space and facilities and encourages the maintenance of independence. Information is provided to the prospective resident prior to moving into the home, which residents said they felt was adequate and informative in making a decision. The Proprietor is very much involved with the residents on a daily basis and spends much time with individuals, supporting them in a variety of activities, both in house and accompanying on shopping trips, hospital and other medical appointments, etc. Staff work closely together with the Proprietor, in the daily attention to individual needs and requirements; residents expressed much praise for the staff team and the attention given to ensure their comfort at the home. Residents said that they were able to make choices and that these were always respected. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 6 Documentation in respect of care planning for the individual is clear and detailed and as such identifies daily care needs and support required. What has improved since the last inspection? What they could do better: There is a need for exterior garden areas to be made safe and for access to the greenhouse to be risk assessed. There is a need to ensure that all Mandatory training is kept up to date, with current emphasis to particularly focus on ‘Adult Protection’, ‘Infection Control’ and ‘Fire Safety’. There is a need to ensure that all staff receive sufficient training in Dementia Care in accordance with the home’s registration. A written record to be kept of hot water temperatures within the home. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 7 A review of the future use of the shared room as single accommodation. 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 House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3,4 & 5 Standard 6 not applicable to this service QUALITY IN THIS OUTCOME GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents benefit from receiving information about the home prior to moving in and are safeguarded by the home’s pre-assessment procedure. EVIDENCE: Residents said that they had been given information about the home prior to moving in and had been able to visit. A Statement of Purpose and Service User Guide has been produced, with each resident receiving a statement of their ‘terms and conditions’ of stay at the home. Prior to moving into the home a pre-assessment of need is undertaken with this being recorded and developed into the individual care plan for the Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 10 resident. The senior carer confirmed that as part of the initial assessment process, compatibility is taken into account and the capacity of the home to meet the identified needs. The home has developed close contact with families, with the relative/s being very much involved initially as part of the preassessment process. Residents spoken to said that they were very happy with their choice to come to the home and praised the owner and staff for all the help and support they had received on moving into the home; they said they had been encouraged and supported to make their own room to their liking, bringing many items, such as pictures, photographs, ornaments etc. with them on moving into the home. A resident moving into the home will normally do so on a long- term permanent basis. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 11 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 GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents needs are clearly identified through the home’s assessment and care planning process and by the regular reviews and monitoring undertaken. EVIDENCE: Much attention has been given to reviewing and developing care planning documentation to ensure this clearly identifies the individual needs of the resident; care plans were noted to be detailed in content, including risk assessments relating to care needs. Daily records are kept as well as a ‘daily activities record’. Regular reviews of care are in place and these are recorded within the care plan documentation. The Health Care needs of residents are identified as part of overall care planning, with residents receiving assessment and treatment as required through their GP, District Nurses and other health professionals as appropriate. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 12 Residents commented that they are well supported by the owner and staff to attend hospital and clinic appointments as necessary. It was evident from this visit that much attention has been given by the owner to ensure that the residents individual needs and requests are met; during conversation with the residents several examples of specific support given were discussed, including identified daily support needs as well as support and encouragement given to continue with activities of special interest (including escorting and supporting within the community). Residents expressed how they felt their choices and privacy were always respected; improvements made to the home’s environment with the building of ‘bed-sit’ accommodation has given residents in this part of the home, additional privacy with the focus on the maintenance of independence. Medication practices have been reviewed in accordance with the requirements made during the last Inspection of the home. Medication was seen to be stored securely with administration records signed up to date; records are now kept of all medication taken by the resident out of the home while staying for a period away; a record is now also maintained of non-prescription medication, this non-prescription medication having been approved by the GP. A Controlled Drugs register will be introduced if this becomes necessary in the future. The senior carer confirmed that only staff whom have undertaken training and deemed as being competent to administer medication will do so; currently 4 staff have undertaken ‘safe handling of medication’ training and it was confirmed that only these named staff will be involved in giving medication to residents. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 13 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 GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. EVIDENCE: The owner and staff have given much focus to ensuring that residents are well supported in all areas of their daily life, including individual interests and activities they wish to be involved in. Residents said that the staff are ‘extremely helpful’ and commented that they are well supported to be involved in activities within the community as they choose; the closeness to the village centre of Headcorn enables easy access for residents to be able to go to the shops, post office etc. Staff commented that if the resident’s mobility is limited then they can have the use of a wheelchair, with staff support, to go to the local shops, etc. A very individual approach is taken in the residents care, with the owner being very much involved in the daily life of the home, supporting residents and accompanying them to the shops, community activities, hospital appointments, etc. Residents said that their choice of how to spend their day is respected and in discussion with residents, it was evident that individuals have a wide range of personal interests that they are able to pursue; one resident has a particular Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 14 interest in plants, having been able to grow her own since moving into the home; another resident has an specific interest in embroidery which she continues to enjoy. It is evident that respecting and encouraging the individuality of the resident is seen as very much a vital component of offering support and care; residents are in control of their daily life with very positive relationships having been developed between residents and staff; a very relaxed atmosphere was noted within the home, with staff being very attentive to residents needs on what was an exceptionally hot day of the year. As an important aspect of offering care to the resident, positive relationships with relatives is fostered; residents said that their relatives are able to visit at any time and are welcomed at the home, with refreshments being offered. Within the newly created bed-sits, there is a kitchenette area, where relatives will have the opportunity to make tea/coffee independently with the resident. Residents commented that they were satisfied with the choice and range of meals available within the home; they said they were able to request an alternative to what was on the menu. It was noted that focus is given to using local fresh produce as part of the daily diet. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 15 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 GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents are protected by the home’s complaints procedure and by being supported by staff who have received guidance in Adult Protection; however there is a need to ensure that all staff have received adequate training, with regular refresher/updates in the area of Adult Protection. EVIDENCE: The home’s complaints procedure is discussed with the resident on moving into the home and written information is included within the Service User Guide/Terms & Conditions; residents said that they were aware of the complaints procedure and felt very able to approach the owner or a member of staff should they have any worries or concerns. They particularly commented how helpful they found the owner and staff and said that ‘any problems’ are quickly responded to. The Commission has not received any recent notification of complaints or incidents occurring within the home. The home has produced an Adult Protection policy which is detailed and which is included as part of Induction training for a new member of staff; the senior carer on duty said that guidance had been given to all staff in this area and training is arranged as part of the mandatory training programme. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 16 However as discussed with the senior carer a requirement is made in this report, to monitor closely the need for updating of Adult Protection training within the staff team and to ensure that all staff have undertaken this training in sufficient depth. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 17 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, 23, 24 & 26 QUALITY IN THIS OUTCOME GROUP IS ADEQUATE. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents benefit from living in an environment which is clean, comfortable and well maintained. There is a need to ensure that the grounds/garden to the rear of the premises is made safe for residents use. EVIDENCE: The home offers residents a very comfortable and homely environment, where residents have been encouraged to bring many items of their own to personalise their bedroom. On touring the home it was noted to be clean and generally well maintained; residents bedrooms are very individual in appearance and very much reflect the choices and interests of the person Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 18 residing in the room. The registered shared room within the home is separated into two defined areas with screening; however in future planning it is advised that this room be considered for conversion to single use occupancy so as to aid comfort and privacy. Residents said that they are very comfortable at the home with no restrictions placed upon them; residents were noted to be using both the communal areas of the home as well as their own bedroom. Advice has recently been sought from the Fire Officer in regards to the laundry door exit; the situation regarding the use of this door in an emergency situation has now been resolved. The recent building of adjacent premises to the main house offers accommodation in the form of 2 single bed-sits (with kitchenette and en-suite facilities); a resident who has recently moved into one of the bed-sits, transferring from accommodation within the main house, said she was very pleased with the new accommodation and valued the additional facilities it offered. The new building is linked by call-bell and intercom to the main house; the resident spoken to said that staff are in regular contact throughout the day and they are always available through the ‘systems’ in place. It was noted during the visit that following the building of the new part of the home, attention has been given to the garden at the front of the premises; however it was noted that the area of grounds/garden to the side and rear of the home still requires attention to be made safe; the greenhouse in this are is in need of some repair with the garden in general appearing to have been given low maintenance. This area detracts from the overall aims of the Proprietor to offer a safe and homely environment and therefore requires urgent attention to meet these aims and make safe for the residents. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 19 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 GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents are safeguarded by being supported by staff who are skilled and well supervised by management. There is a need to ensure that staff receive sufficient and appropriate training in Dementia Care. EVIDENCE: During the visit a selection of staff files were viewed which demonstrated the home’s robust recruitment procedure in practice; all applicants are asked to complete an application form, with 2 written references being requested, an identity check carried out and CRB/POVA check undertaken. On commencing employment the new member of staff is subject to an Induction period of training, being closely supervised by the owner and the senior carer; it was confirmed by the senior carer that as soon as is practicable staff will undertake mandatory training as part of the Induction programme. Training is an area that has been developed, with evidence gathered during this visit of training undertaken by staff in First Aid, Food Hygiene, Health & Safety and Moving & Handling. Confirmation was also given of NVQ training undertaken; five staff have completed training at Level 2, one staff member at Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 20 Level 3 and the senior carer has completed training at Level 4 and has gained the Registered Manager Award. In acknowledging that training is an area that has been focused upon, there is still a need however to ensure that all staff have a clear and good understanding of Dementia Care as in accordance with the registration of the home; it was also identified during this visit of the need to ensure that all staff receive updated training in Infection Control and Fire Safety (see next section). In discussion with residents they praised highly the owner and staff for the support and care given and it is evident that staff do have a very good understanding of the individual care needs of residents. The owner and senior carer are very much involved in daily working with the staff team which enables close monitoring of practice; as part of her role the senior carer is very much involved in one to one supervision of staff. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 21 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): 31,33,36 & 38 (St. 35 The home is not involved in residents personal finances) QUALITY IN THIS OUTCOME GROUP IS GOOD. THE JUDGEMENT HAS BEEN MADE USING AVAILABLE EVIDENCE INCLUDING A VISIT TO THE SERVICE. Residents are safeguarded by living in a home which is well run, with strong leadership and focused management approach. EVIDENCE: The Proprietor is very much involved in the daily life of the home and has responsibility for day to day control; with the employment of the senior carer, some management responsibilities are now shared. The senior carer manages the home in the Proprietor’s absence (as on this occasion while the Proprietor away on holiday) and also has shared responsibility in certain areas, including care planning and one to one supervision of staff. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 22 Evidence from this visit demonstrated that the home is being well run and managed by strong and focused leadership; the owner’s involvement in the day to day life of the home is evidently much appreciated by the residents whom in discussion praised him and the staff team for their support and responsiveness to personal requests made. Evidence gained clearly demonstrated the owner’s commitment to running the service in the best interests of residents. As part of the senior carer’s role one to one supervision of staff is in place; the senior carer said that in addition to these sessions, staff are welcome to come and discuss issues/concerns at any time with herself or the owner. It was evident from this visit that the staff team work closely together, with very positive interaction noted between the residents and staff and between the staff themselves. A Questionnaire has been produced in line with Quality Assurance practices; the senior carer confirmed that this is given out annually to the residents and their relatives for feedback on the service. Evidence of responses received was seen during the visit; responses are collated to assess if any action is required to be taken in regards to the content of the responses. In discussion with staff on duty it was evident that there is good awareness of Health & Safety issues; the required attention to the grounds/garden area is included within this report under the Environment section. As identified with the senior carer there is a current need to ensure that mandatory training in Infection Control and Fire Safety is kept up to date and therefore a requirement has been made in this report. Fire Alarm testing records were viewed during the visit and gave evidence of regular testing of the equipment. As identified during the last Inspection of the home there is a need to ensure that records are kept of hot water temperatures within the home; it is acknowledged that temperature control valves are being installed throughout the home. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 23 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 3 3 3 x 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 2 3 x x 3 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x x 3 x 2 Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 24 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 OP18 Regulation 13(6) Requirement All staff to undertake training in Adult Protection and for refresher/updating training to be made available. The grounds/garden to the rear of the property to be made safe, including access to the greenhouse. As in accordance with the home’s registration, there is a need to ensure all staff receive sufficient training in the area of Dementia. The registered person shall ensure that records required by regulation/ schedule are available in the home for inspection. In that: There were no records of hot water temperatures to wash hand basins or records of the actions taken by the home to secure service users Staff to receive/update training in Infection Control and Fire Safety Timescale for action 30/09/06 2. OP19 13(4)(a) 31/08/06 3. OP30 18(1)(a) (c) (i) 30/09/06 4. OP38 17(3)b,13 (4)a,b,c 30/09/06 13(3) 13(4)(c) Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 25 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 OP23 Good Practice Recommendations It is recommended that the future use of the shared bedroom should be reconsidered with a service user offered sole use of the room. Yew Tree House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 House Residential Care Home For The Elderly DS0000024096.V300721.R01.S.doc Version 5.2 Page 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!