Inspection on 18/01/08 for Yew Tree Rest Home

This inspection was carried out on 18th January 2008.

CSCI found this care home to be providing an Good service.

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 10/01/07

Yew Tree Rest Home 15/02/06

Yew Tree Rest Home 15/09/05

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 Key Unannounced Inspection 18th January 2008 12:30 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.V358420.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 Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Yew Tree Rest Home Address 356 Boldmere Road Boldmere Sutton Coldfield West Midlands B73 5EY 0121 350 0631 F/P 0121 693 0399 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.V358420.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2007 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 the others who live there. There are three bedrooms available for people who live there. 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 people currently living in the home 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. The reader would need to speak to the home about the fees charged. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection was carried out by one inspector over part of a day during January 2008. As part of the inspection the home was asked to complete and return the Annual Quality Assurance Assessment(AQAA). The fieldwork visit was carried out prior to the return of the AQAA but it has been used in writing up the report. Also as part of the inspection both the people living in the home and the owners of the home were spoken to. Several documents including care plans, health and safety records, medication records and safekeeping of money records were sampled. One of the bedrooms occupied by one of the people living in the home and communal areas were seen. No complaints had been logged at the home and none had been lodged with the Commission regarding the home. No issues of adult protection had arisen at the home. What the service does well: What has improved since the last inspection? What they could do better: Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 6 The manager could try to ensure that the people living in the home receive more variety on a day-to-day basis in what they eat to ensure that their diet contains a variety of nutrients and remains balanced. The manager needed to ensure that the records for the management of money and medicines are kept up to date. 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. The summary of this inspection report can be made available in other formats on request. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager was aware that an assessment of need would have to be carried out before any new admissions to the home were made. EVIDENCE: There had been no new admissions to the home. The two gentlemen had lived in the home for several years. Contracts were not checked on this occasion as they had been in place previously. The manager told the inspector that they had not had any referrals from the social services department. The manager was aware of the need for an assessment to be carried out before any admissions were made. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 9 The AQAA indicated that the manager was aware of what would be good practice in the event that someone new moved into the home. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans were basic but the needs of the individuals living in the home were met in a personalised way that was in accordance with their wishes. They were receiving their medicines as prescribed but the records were not always being completed appropriately. Health care needs of the individuals were being monitored and reviewed. EVIDENCE: The inspector spoke with both of the people living in the home. One tended to get up early and have a routine that was determined by mealtimes and television programmes. The other tended to get up late in the day as he tended to watch television into the early hours of the morning. At the time of the inspector’s arrival one of the individuals was sitting in the lounge/dining room and the other was just getting out of bed at 1pm. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 11 One of the people living in the home told the inspector how well he was cared for saying “I get my medicines with my porridge at breakfast. I am well looked after. They said I could go to Ireland but I’m too old and don’t know anyone there. I’d like to finish my days here.” When asked if he had had his hair cut recently he stated “ Its too cold to have your hair cut in the winter” indicating he was well able to express his views and make choices. He also indicated that he was assisted by the manager’s husband to wash, change and shave as he was not able to manage shaving any more. The other individual was looking well and stated that he was happy and got all the assistance he needed. He had specific dietary needs and was on a low fat diet. There was evidence that he had been seen regularly by the doctor for blood tests and blood pressure monitoring. Both the people living in the home were on small amounts of medicines that were administered to them by the manager. It was evident that the individuals were getting their medicines but unfortunately, on auditing the medicines it was noted that two painkillers had probably been given but not recorded on the medicine administration record as indicated by the fact that there were two tablets short in the box. Also two other tablets had been taken out of a box but not signed as given on the records. The manager needed to ensure that the records were kept up to date and medicines signed for as soon as they were given. The AQAA stated that medicines were returned to the pharmacist at the end of the prescription cycle if they had not been used up. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home lived individualised lives and dietary and social needs were met. EVIDENCE: The people living in the home were leading their lives as part of a family but had very individualised routines. Both individuals appeared to be content and happy with their lives. They could make choices about whether to go out, when to go to sleep and when to get up. Special days such as Christmas and birthdays were celebrated. One individual went to bed late and got up late. The other tended to go to bed early and rise early. He said ‘I can go to my bedroom if I want or I can snooze in the chair during the afternoon if there is nothing on the television.’ There were no restrictions on visitors and family were encouraged to visit or keep in contact over the telephone. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 13 The two individuals had very different dietary needs. One individual had set fillings for sandwiches at lunchtime. The inspector observed him having salmon sandwiches, yoghurt, banana and tangerine and a cup of tea at lunchtime. He had asked the manager to blend his main meal as he didn’t wear dentures. The other individual was on a low fat diet and tended to eat more fish than meat. The food records were examined and although they showed some variety it was evident that on some occasions there was too much repetition in the main meal of the day. For example, there was one occasion where chicken was served four days running. The records did not record how the chicken had been prepared for example, roast, casserole or curry and the vegetables and fruit provided were not identified. The food records needed to have the name of the individual and date to which they referred clearly recorded. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home were safe and listened to. EVIDENCE: Both the people living in the home appeared to be happy and relaxed in the home. They said they were ‘well looked after’. They both spoke to or saw other people on a regular basis that would give them the opportunity to raise any issues if they did not feel able to raise them within the home. Both individuals were able to express their views without fear. There was a poster on display in the home that gave the two people living in the home access to the telephone number of the Commission. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The needs of the people living in the home were met in a homely environment. EVIDENCE: No physical changes had been made to the premises since the last inspection. The AQAA indicated that a new central heating boiler had been installed in the home. The people living in the home had their own bedrooms that they could access at any time during the day. There was a stair lift in place to assist those people with decreased mobility. The premises are suitable for people with good mobility with steps leading to the front door. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 16 The ground floor bedroom remained empty but neither of the people living in the home wanted to move into it even though their rooms were smaller. There were lounge areas that the people living in the home could use providing adequate sitting space for them. There was a lounge at the front of the home and a dining/sitting room at the rear of the home. During the inspection the two people living in the home sat in separate lounges to watch different television programmes. There was a bathroom with a toilet on the first floor and a separate toilet on the ground floor. The bathroom was not adapted but met the current needs of the people. The home was clean and odour free. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The needs of the people living in the home are met by the owners of the home as part of a family unit. EVIDENCE: No additional staff were employed at the home and Mr and Mrs Clarke assist the individuals living in the home. They had been caring for the two individuals for many years and had undertaken some basic training. Mrs Clarke had undertaken the Registered Managers Award and had been a trained nurse. It was recommended that if another person was admitted another member of staff was employed to enable Mr and Mrs Clarke to take some time off. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run as a family home and the people living in the home are treated as members of that family. EVIDENCE: Mr and Mrs Clarke provide care for the current two people living in the home as part of a family unit. The manager is a nurse and has undertaken NVQ level 4 in care. The care plans and risk assessments are basic but adequate as the only people supporting the two individuals living in the home are Mr and Mrs Clarke and the two people are well able to make their views known. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 19 The manager needed to be more careful with the recording of the medicines ensuring that the records are signed as soon as possible after they have been given to the individuals and ensuring the balances of any monies being looked after tally with the amounts of money kept in safekeeping. An error was identified during the inspection however, a couple of days after the inspection the inspector was made aware of how the error was one of unclear writing rather than an actual error. The home was safe and well maintained. Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 2 2 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 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 N/A 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 21 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. Standard OP15 Regulation 16(2)(i) Requirement The manager must ensure that there is less repetition in the meals eaten by the people living in the home. Timescale for action 01/04/08 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 OP9 Good Practice Recommendations The manager must ensure that the medication records are signed as soon as medicine is given out. This will ensure that the records are kept up to date and ensure the people living in the home receive their medicines as prescribed. Consideration should be given to the employment of a member of staff if another resident is admitted. This will ensure that there are sufficient staff to meet the needs of the people living in the home. The records of the monies held in safekeeping must be kept in good order. This will ensure that the people living in the home are kept Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 22 2. OP27 3. OP35 safe Yew Tree Rest Home DS0000017056.V358420.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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