Inspection on 15/09/05 for Yew Tree Rest Home

This inspection was carried out on 15th September 2005.

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.

Other inspections for this house

Yew Tree Rest Home 18/01/08

Yew Tree Rest Home 10/01/07

Yew Tree Rest Home 15/02/06

Yew Tree Rest Home 26/07/04

Yew Tree Rest Home 17/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Yew Tree Rest Home 356 Boldmere Road Boldmere Sutton Coldfield West Midlands B73 5EY Lead Inspector Kulwant Ghuman Unannounced Inspection 15th September 2005 10:30 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 Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 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 Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Yew Tree Rest Home Address 356 Boldmere Road Boldmere Sutton Coldfield West Midlands B73 5EY 605 9719 9999 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 Oswald Clarke Mrs M Clarke Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15 March 2005 Brief Description of the Service: Yew Tree Rest Home is a privately owned care home registered to provide personal care and accommodation for up to 3 older people. It is owned by Mr & Mrs Clarke. The home is located in Sutton Coldfield in the West Midlands and is close to a group of shops and other amenities. This is the home of Mr and Mrs Clarke and three service users. There are three bedrooms available for service users. One is located on the ground floor and the other two are on the first floor. The bedroom on the ground floor is of a good size and meets the spatial requirements of the National Minimum Standards. The other two bedrooms are small and do not meet the standards. On the ground floor there is a combined lounge and dining room, a separate lounge and a kitchen. There is a stair lift going most of the way up to the first floor but there are a few steps to negotiate for which there is no stair lift. The current service users are able to climb these stairs to access their bedrooms. There are no en-suite facilities but there is a toilet on the ground floor and a combined toilet and bathroom on the first floor. There is a garden to the rear of the home. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by one inspector over part of a day. It is the first of two statutory inspections for the 2005/2006 inspection cycle. There were only two residents in the home as one of the previous residents had moved to nursing care. Both the residents were spoken with and they expressed their satisfaction at their lives in the home. What the service does well: What has improved since the last inspection? 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 Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 Page 6 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 Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 Page 7 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 Information was available to enable the residents to make an informed decision about whether to live at the home and residents knew what they were paying and what services were being provided by the home. EVIDENCE: There was a statement of purpose in place that would provide the necessary information to residents. There was a copy of the service user guide on the files. There were terms and conditions of residence available on the files sampled. There had been no new admissions to the home for some time. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 Page 8 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 care plans provided sufficient information to ensure that the care needs of the residents were met. Residents’ medical needs were being met. EVIDENCE: The residents care plans had been updated and there were risk assessments in place. The inspector observed that the kitchen door was kept locked when Mr and Mrs Clarke were not in the area. This was discussed and there appeared to be health and safety reasons for this, however this was not reflected in the risk assessment for the individual. Both residents received appropriate medical attention when it was required via their GP and by attending hospital appointments. Neither of the residents managed their own medicines and both were on very little medication. The medicines were well managed and stored appropriately. One of the medicines was to be used on an ‘as required’ basis. The daily notes did not accurately reflect the reasoning as to why this medicine was given on some days and not other days or why it was used twice on one day. There needed to be some guidance recorded on his file as to what behaviours would lead to this medicine being given. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 Page 9 There appeared to be no issues that indicated that the privacy and dignity of the residents were not observed. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 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, 14, 15 Residents were able to live according to their wishes and contact with relatives was encouraged. Their dietary needs were being met. EVIDENCE: Both the residents led lives that suited them. One preferred to spend the majority of time in his bedroom whilst the other preferred to sit in the lounge/dining room and watch the television as his preferred activity. One resident went out on occasions with the owner. One of the resident’s family had recently renewed their contact with him and they continued to visit him and the resident was happy with this situation. One of the residents was on a low fat diet and mainly ate fish and poultry. Examination of the food records would tend to indicate that the menus were rather repetitive at lunch time however, this was because one of the residents preferred sandwiches. The evening meal was more varied. There were always fruits and yoghurts available. One of the resident was provided with Caribbean foods however this was not recorded and the manager needed to ensure that a record of his food was also kept. The weight records showed that both residents were not losing weight. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 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): 16 There was a suitable complaints procedure in place. There had been no complaints about the service. EVIDENCE: There was a complaints procedure in the home but Mr and Mrs Clarke would be made aware of any problems by the residents. Both the residents stated that they had no concerns about the home. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 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, 21, 22, 23, 24, 25, 26 The home provided care in a homely environment but was not suited to elderly people with high mobility or high care needs. EVIDENCE: Yew Tree Rest Home is an ordinary domestic property with few environmental adaptations. It is suitable for residents who have full mobility. Although there was a chair lift in place to assist the residents up to the first floor there are a couple of steps on the first floor that have to be managed without the chair lift. There was a ground floor bedroom that was suitable for someone with restricted mobility however, the steps at the front of the home could be difficult to negotiate. The access to the home was further restricted by the parking of cars on the front forecourt. There was sitting space available in the lounge-diner and was sufficient for two residents. There was an additional family lounge at the front of the house. The communal space would need to be taken into consideration when admitting a further resident. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 Page 13 There was a toilet on the ground floor and a combined bathroom and toilet on the first floor. Both had very limited adaptations but appeared to meet the current residents’ needs. There were wash hand basins in two of the bedrooms but not in the third. There was no emergency call system in the home. The ground floor bedroom was found to be spacious and well able to accommodate a service user in comfort. The two first floor bedrooms were both small, one being exceptionally small. If the small bedroom at the front of the home becomes vacant it needed to be taken out of use due to its small size and lack of wash hand basin. The radiators in service users bedroom were thermostatically controlled to enable people to individually alter the temperature. Some radiators had been covered. Hot water being delivered in the bathroom was restricted to 43 degrees. Emergency lighting was provided throughout the home. The home was found to be clean and free from offensive odours. There was liquid soap available in the bathroom. The home had accessed guidelines on infection control in residential homes. The washing machine continued to be sited in the lounge-diner. The washing machine did not have a sluice cycle and it was felt it was not required at this time. The home had a clinical waste contract. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 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 All care is provided by Mr and Mrs Clarke who know the needs of the residents well. EVIDENCE: Mr and Mrs Clarke did not employ any staff but provided 24 hour care for the service users themselves. Mr and Mrs Clarke both had extensive experience of caring for older people. The inspector had previously been concerned at the level of input required by the residents from Mr and Mrs Clarke, however this had reduced since the third resident had left the home. Mr and Mrs Clarke needed to be mindful of the amount of care that would be needed by a third resident in the home and that they may need to employ an additional member of staff. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 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): 31, 32, 33, 38 The home is managed well in a manner that provides an individualistic lifestyle for the residents. Issues of health and safety in the home are managed well. EVIDENCE: Both Mr and Mrs Clarke had many years experience of managing this home and were very familiar with the needs of the residents. Mrs Clarke had undertaken her management NVQ 4 and was planning to continue with some further training. Both Mr and Mrs Clarke had undertaken basic training in first aid. The home was run on the basis of a family home and as such the service users were included as members of the family. Although residents’ finances were not assessed during this inspection the manager had found it difficult to open individual accounts for the service users so that monies continued to be paid into the home’s accounts. The manager must ensure that records showing the income and expenditure for the residents is available for inspection. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 Page 16 There was no formal quality assurance system in place but day-to-day contact with the residents ensured that they were happy with the service provided. Health and safety were well managed with only the fire alarm service documentation not available in the home at the time of the inspection. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 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 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 X 1 2 2 1 1 2 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X N/A X 2 Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 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 OP9 OP15 OP24 Regulation 13(4)(c) 13(2) 17(2) Sch4(13) 23(1)(a) Requirement Individual risk assessments must cover all areas identified. There must be a protocol in place for any PRN medicines. The food records must show the actual food eaten by both residents. The smallest bedroom is not fit for purpose and as discussed at the last inspection the manager agreed that in the event that this bedroom became vacant it would not be re-used. Records must be available for residents’ income and expenditure. The daily records must indicate why PRN medication was necessary. Evidence that the fire alarm service has been serviced must be forwarded to the CSCI. Timescale for action 21/10/05 21/10/05 21/10/05 01/04/06 5 6 7 OP35 OP37 OP38 17(2) Sch4(9) 12(1)(a) 23(4)(c) (iv) 01/12/05 15/11/05 15/11/05 Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 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 Refer to Standard OP27 Good Practice Recommendations Consideration should be given to the employment of a member of staff if another resident is admitted. Yew Tree Rest Home DS0000017056.V250702.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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. 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