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Inspection on 30/01/06 for Yew Tree Nursing Home

Also see our care home review for Yew Tree Nursing Home for more information

This inspection was carried out on 30th January 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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 home is well managed by a competent manager who has the necessary skills and expertise. Medication is handled safely and internal audit procedures are in place. Care plan documentation ensures staff have enough information to care for residents and all residents are assessed prior to admission to the home by a registered nurse. Observation during the course of the afternoon further evidenced staff were meeting residents needs and staff spoke to residents in a quiet and gentle manner.

What has improved since the last inspection?

The new building which will accommodate a further six residents is due for completion at the end of May 2006. These rooms will further enhance the accommodation already on offer to residents. The requirement from the last inspection report regarding recording bath temperatures when residents are bathed has been addressed.

CARE HOMES FOR OLDER PEOPLE Yew Tree Nursing Home Yew Tree Place Romsley West Midlands B62 ONX Lead Inspector C Presley Unannounced Inspection 30th January 2006 14:30p 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 Nursing Home DS0000004156.V277348.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 Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Yew Tree Nursing Home Address Yew Tree Place Romsley West Midlands B62 ONX 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) 01562 710809 01562 710592 Yew Tree Nursing Home Limited Mrs Sharen Ellen Guise Care Home 29 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (29), of places Physical disability (4), Physical disability over 65 years of age (29) Yew Tree Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. An age limit of 55 - 65 years applies to people with needs in category PD. 12th October 2005 Date of last inspection Brief Description of the Service: Yew Tree Nursing Home is a 29-bedded care home providing 24-hour nurse care. It is situated in Romsley, northwest of Bromsgrove. Located within a green-belt area, the home benefits from large, accessible grounds that can be accessed by service users. The home is located on two floors, which are accessed via a central passenger lift, or two staircases. The home provides in-house catering and laundry services. Accommodation and communal space is provided on both floors of the home. The village of Romsley provides local resources (shops, public houses et cetera) that are accessible to service users. An extension which will provide a further six bedrooms is due for completion at the end of May 2006 Yew Tree Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place during the afternoon, time with spent with the registered nurse on duty and the administrator. A number of residents and staff were greeted during the course of the afternoon. This inspection focused on standards not inspected at the last inspection, care records, medication handling and administration and policy documents. What the service does well: What has improved since the last inspection? What they could do better: Environmental risk assessments required reviewing and updating to ensure risks are identified and dealt with on a regular basis. Documentation regarding nutrition would benefit from further development in the care plans. Yew Tree Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 6 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 Nursing Home DS0000004156.V277348.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 Nursing Home DS0000004156.V277348.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): 3&4 Residents are assessed prior to admission to ensure the home can meet their assessed needs and provision for specialised equipment if required is provided. EVIDENCE: Assessment of need documentation was seen in care plans of four residents. The assessment covered all aspects of care and was informative. It was noted that one document was unsigned by the assessing nurse. A further assessment of need is completed on the day of admission; this further enhances the information gathered and enables the trained nurses to write a core care plan. Staff have the necessary training and knowledge to care for residents; during the afternoon staff were heard speaking kindly and gently to residents and changing television programmes at the request of residents. Call bells were responded to promptly. Yew Tree Nursing Home DS0000004156.V277348.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, 8, 9 & 10 The written format of the care plans which is indexed ensure residents care needs are identified and addressed, and staff have access to relevant information at all times. Medication is handled and administered safely within a risk framework. EVIDENCE: Care plans were indexed which made inspecting information an easy task. Original assessment of need and a further assessment of need on admission were located at the front of the care plan and were based on the activities of daily living. Care plans had been developed to cover all aspects of care needs in one case there was evidence that not all aspects of the care plan had been reviewed monthly. Residents are weighed regularly and weights recorded. At times this information was not passed from one file to the other and a resident who had lost weight recently was not being weighed or having their BMI recorded often enough. The home had identified her weight loss and she was being given meal supplements this was not clear in the care plan. Yew Tree Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 10 Pressure sore care plans were excellent and there are clear instructions for dressing wounds, at times information was not followed up such as a swab was taken but there was no information regarding the outcome. Medication is handled and administered safely. The registered manager undertakes a regular internal medication audit. Medication records were checked and there were some medication signature gaps noted. The medication fridge temperatures had not been recorded on some days. There were no residents self-medicating and residents being given covert medication had signed consent forms in place. Yew Tree Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 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): None of the standards in this section of the report were inspected at this visit for further information refer to previous inspection report EVIDENCE: Yew Tree Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 12 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): None of the standards in this section of the report were inspected at this visit for further information refer to previous inspection report EVIDENCE: Yew Tree Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 13 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): None of the standards in this section of the report were inspected at this visit for further information refer to previous inspection report EVIDENCE: It was noted fire records and training appeared in order. Worn towels and flannels were seen on a trolley in the home, this was discussed with the registered nurse who said she would ensure they were discarded. Yew Tree Nursing Home DS0000004156.V277348.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): None of the standards in this section of the report were inspected at this visit for further information refer to previous inspection report EVIDENCE: Yew Tree Nursing Home DS0000004156.V277348.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): 35 & 38 The registered manager ensures the health and safety of all residents, staff and visitors to the home through appropriate and ongoing risk assessments. EVIDENCE: The registered manager is the health and safety officer and has the relevant training to undertake this role. Staff have ongoing training in moving and handling, infection control, food hygiene, health and safety including COSHH (the use and health implications of hazardous substances). The home has a trained nurse and a first aider on duty at all times. Equipment such as the lift, bath hoists, call bell and fire systems are regularly serviced by outside contractors. Yew Tree Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 16 The home has a legionella risk assessment in place and water tanks have been recently cleaned and chlorinated. The premises are secure and the gardens are well maintained even though building work is in progress. The environmental risk assessment had not been reviewed by the agreed review date in some instances. Resident’s monies are handled safely; valuables and money can be kept in the homes safe for short periods. Residents and relatives are encouraged to oversee their own personal finances. There was no evidence in care plan documentation that discussion about not offering residents lockable storage space in their bedrooms had taken place. Yew Tree Nursing Home DS0000004156.V277348.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 x x 3 3 x 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 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x 3 x x 3 Yew Tree Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 4 Standard OP7 OP7 OP19 OP24 Regulation 12 13 &17 16 12, 13 Requirement All aspects of care plans must be reviewed at least monthly Robust systems must be in place for residents identified as being nutritionally at risk Worn flannels and towels must be replaced Residents must be provided with lockable space for medication, money and valuables and a key which he or she can retain (unless the reason for not doing so is explained in the care plan) Environmental risk assessments must be reviewed on a regular basis Timescale for action 30/01/06 31/01/06 28/02/06 28/02/06 5 OP38 13 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Yew Tree Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Nursing Home DS0000004156.V277348.R01.S.doc Version 5.1 Page 20 - 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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