Care Home: Lime Trees

Similar services:

• Abbey The
• Snydale Care Home
• Hawkhills
• Larchfield Manor
• Beeches The - North Yorkshire County Council
• Carentan House
• Ravensworth Lodge

What the care home does well People said that they received good support for personal and health care. They felt that there was a good range of activities, and the use of a minibus for frequent outings. They liked the meals, and they liked their rooms. People also felt that the recent changes in ownership and management were positive, saying things like, `I now feel that I am listened to.` There was also praise for all the staff, saying things like `they are good to me, and kind`. What has improved since the last inspection? The menus have been changed using comments and input from the people at the home. This has helped people feel more in control of their lives. The care plans have been developed and people have more input into them, giving them much more individualised care and choices. Staff have been recruited to vacant posts, and the staff team have been reorganised giving people more continuity. As well as more team work, training and supervision, staff morale has improved and they like being part of the changes. Some refurbishment of the premises has also taken place and more is planned. What the care home could do better: The new management team and staff team need to build on the improvements and changes to establish these as good quality practice. They already have a plan of what they want to achieve and should be commended for the way they have improved this home. The completion of the refurbishment of the building is one such area. Consideration should also be given to suitable storage for equipment in toilets so that they are more dignified. Whilst the records were generally very good, the daily records of care given should be more specific so that they describe actual care given. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lime Trees Devon Road Off Barnsley Road Sheffield South Yorkshire S4 7AJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephanie Kenning     Date: 2 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Lime Trees Off Barnsley Road Devon Road Sheffield South Yorkshire S4 7AJ 01142617701 01142617702 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Leyton Healthcare (No 3) Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 60 Number of places (if applicable): Under 65 Over 65 0 60 dementia old age, not falling within any other category Additional conditions: 60 0 The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender - Either Whose primary care needs on admission to the home are within the following categories: Dementia Code DE, maximum number of places 60 Old age, not falling within any other category - Code OP maximum number of places 60 the maximum number of users who can be accommodated is 60 Date of last inspection Brief description of the care home Lime Trees is the new name for The Grosvenor. It is a purpose built home for up to 60 older people, and can take people with Dementia and people who need nursing care. It is situated just off a busy main road in a residential area, near to the city centre and to The Northern General Hospital. As well as a new name, there is a new owner Leyton Care Homes for Older People Page 4 of 25 Brief description of the care home Health Care, and a new manager Margarite Law. The building has three floors accessed by stairs and a lift. There are bedrooms and communal areas on each floor. Each of the bedrooms has an en-suite toilet and washbasin. There is an excellent activity room on the ground floor, and another large room that can be used for entertainment. There are gardens to the rear of the building and a car park at the front. Information about the home is available from the manager, including up to date fees, that vary according to needs. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection carried out by Stephanie Kenning, Regulation Inspector, and was the first inspection of this service since its owners Leyton Health Care took over the home. The site visit took place between the hours of 09:15 and 16:30. The Manager Margarite Law was present during the visit, and received feedback at the end of the day. Prior to the visit the manager had submitted an Annual Quality Assurance Assessment (AQAA) which detailed what the home was doing well, and any plans for improving the service in the next twelve months. Information from the AQAA is included in the main body of the report. Care Homes for Older People Page 6 of 25 Surveys were sent to people using the service, staff and visiting health professionals. These asked about care and support provided by the home, and comments from these have been included in the report. On the day of the site visit opportunity was taken to make a tour of the premises, inspect a sample of care records, check records relating to the running of the home and check some of the policies and procedures. Time was spent observing and interacting with people, whose comments contributed to the findings. The inspector checked all the key standards and some additional standards. The inspector wishes to thank the people at the home for their time, friendliness and co-operation. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service have information about the home before making a decision. The personalised needs assessment means that their diverse needs are identified and planned for. Intermediate care is not provided at this home. Evidence: We wanted to understand peoples experiences when they decide whether to choose this care home, and what it is like for people if they did decide to move there. We spoke to people at the home, staff, visitors and the manager. We also used information from completed questionnaires sent to us. We looked at the information the home give to people and how they assess whether they can meet peoples needs. People seemed to have had sufficient information about the home before making choices, and had opportunities to visit the home, though not many did. Information had been updated with the new owners and managers details, and with information Care Homes for Older People Page 10 of 25 Evidence: about the nursing care now being offered. People had some of their own possessions in their rooms that they felt was important to help them settle. Prior to decisions about people moving to the home the manager and staff undertake a pre-admission assessment in order to ensure that they can meet that persons needs. A new two week assessment process was being implemented following admission, to enable staff to gather more detailed information from which to write care plans. Individuals and their relatives were able to contribute to this process so that they could get the care they needed. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have their health and personal needs met and receive medication safely. Evidence: We wanted to find out if peoples individual needs and choices were being met. We looked at the care plans of several people including some recently admitted. We spoke to people living at the home, staff, visitors and the manager. We also had information from surveys returned to us including from visiting health care professionals. We observed daily life at the home and watched the way people interacted with each other. All of the care plans have been revised by the new manager and nurse unit manager, and had been updated. A number of people were moved to other nursing homes last year before the home obtained the new nursing registration. People at the home have received health care from the relevant professionals and relationships with these outside agencies has improved. This has improved the quality of care people receive in Care Homes for Older People Page 12 of 25 Evidence: the home. A new system of care plan documentation was being introduced, but even the old care plans were found to be up to date. Some of the daily recordings could be improved by being more specific. For example, hygiene needs met does not describe the care that person required. The new managers were aware of this and had planned to do some further training with staff. There was evidence of visits from other health professionals and of the purchase of significant amounts of pressure relieving equipment to prevent pressure sores, and improve the health of people in the home. Staff were observed to be polite, considered and friendly towards people in their care. People living at the home were complementary about the staff and seemed to enjoy their company. Personal care was carried out in private, and people were presented in a dignified manner. Medication is administered by a monitored dose system provided by a local pharmacy who also train the staff and offer advice. Staff were observed to use safe procedures when administering medication and storage was clean and well organised. The manager does a monthly audit of medication and is introducing a new recording system for controlled medication to further improve safety. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have a good range of activities to participate in and can make some choices in their daily lives. Evidence: We wanted to understand peoples daily experiences and opportunities for social and leisure activities. We observed the routines and the activities taking place and spoke to people in the home and staff and visitors. We looked at the records of activities, routines and meals. The people living in the home were calm and content throughout most of the visit. Most people sat in the lounge areas between meals unless they were taking part in an organised activity. In the lounges some had appropriate music playing, others had televisions on. There were always members of staff in attendance in or near these areas so that people could summon assistance easily. Two activities staff were taking groups of people to the activities room downstairs for different activities. There was a coffee morning get together that included some lovely singing as well as discussions. During the afternoon some people went out by minibus Care Homes for Older People Page 14 of 25 Evidence: to Wentworth Garden Centre. At mealtimes these two staff helped to assist people who needed help. They produce a monthly newsletter giving details of events planned for each day, and this described such things as chairobics, organ music and making things. People enjoyed the activities and enjoyed going to the downstairs room as it felt like they were going somewhere different. The staff hold monthly meetings with people living in the home and relatives in order to address issues and plan new things. The minutes show discussions about food and menus and how they have been revised because of comments received. Meals at the home were also enjoyed on the day of the visit. Mealtimes were more relaxed than at the previous visit, with less people requiring assistance and the process being less hurried. Menus were displayed around the home on white boards but some were difficult to read and not always in places associated with meals, reducing their meaning to some people. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are protected by the procedures in place and are listened to. Evidence: We wanted to understand how people were protected from abuse or neglect and how the service responds to complaints. We looked at records, policies and procedures and spoke to people living and working at the home. Written procedures for making complaints and dealing with vulnerable people were available in the home. No complaints had been received by the home since the new manager had been in post. Previous investigations under adult safeguarding procedures have been concluded and resulted in a review of peoples needs and care, with some people being moved to nursing care in other homes. The home now has a nursing registration. Staff have training in adult protection and the no secrets document was prominently displayed for staff to read. Staff were familiar with safeguarding people and tackling poor practices, and felt that the new manager listened to them and acted appropriately, thus improving life at the home. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is safe, comfortable and meets their needs. Evidence: We wanted to understand what it was like to live in the premises and whether they were appropriate for the lifestyles of the individuals living there. We looked around the premises including some of the bedrooms when people invited us. We looked at records of maintenance and routine checks to see if equipment was working well and safely. There has been a programme of refurbishment that remains ongoing, but has already improved lounges, the entrance hall, and some corridors and bedrooms. Some dining areas, bedrooms and toilets are in need of attention and are planned to be done. There are good communal areas giving people choice of places to sit and good use of the downstairs activity room. A conservatory was used as a smoking area, but the home plans to be non- smoking in the future, as stated in the information about the home, and this may cause confusion. People liked their rooms, and liked having en-suite toilets attached to them. Some of the bedrooms had a good amount of personalisation, showing the input of individuals, Care Homes for Older People Page 17 of 25 Evidence: but some others had minimal. Mainly the home was clean, tidy and fresh, and problem areas had been identified and were being worked on. Many new mattresses had been purchased, improving the comfort and health of people living there. There was some storage of equipment such as pads and gloves in communal toilets that appear undignified, and could easily be put away in cupboards. Records show that routine checks and maintenance are carried out to ensure equipment is working well and safely. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by staff who are recruited to thorough procedures and trained well, to protect individuals. Evidence: We wanted to understand how staff were recruited and trained to ensure that they could carry out their jobs well. We talked to people living in the home, visitors and staff, including the manager. We checked the recruitment files and the training records to see if procedures had been followed. We looked at surveys sent to us and noted the comments they had made. People living at the home and their visitors were positive about the staff and new managers. People liked the staff and felt well cared for, but were particularly pleased that some staff had now gone. Communication had been a problem at times when a high proportion of the staff did not speak English as their first language. This has now been redressed with a better balance and mix of staff. It was noticed that some people did have excellent English language skills, whilst others did struggle a little to be understood. This did not seem a problem as the individuals were patient and people living at the home seemed fond of them. The recruitment files demonstrated that all the necessary checks and procedures had Care Homes for Older People Page 19 of 25 Evidence: been followed before someone was recruited in order to safeguard the people at the home. The training records showed that people working in the home had a range of training courses they had to undertake and some additional ones to develop their roles, including attaining NVQs in care. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and people are protected by the systems put in place by the manager. Evidence: We wanted to understand how the home was managed and ensuring the quality of service for people living there. We talked to people in the home, visitors, and staff and used information from the surveys. We looked at some records, and monitoring used by the manager. The Manager is Margarite Law who is an experienced nurse and manager. She started working at the home in October 2008 and has implemented a number of changes since her arrival. The atmosphere at the home was friendly and welcoming, and people said that they could approach her, and felt confident that she listened to them. She has already implemented some monitoring of the quality of areas such as Care Homes for Older People Page 21 of 25 Evidence: medication and care plans. She has produced action plans outlining areas for improvement and lists of things she wants to implement. She has attended meetings to hear what things others want to improve and has explained why she has made some changes. People were very positive about the changes she had made. Systems for staff supervision were in place to help develop staff and monitor their performance. Records of financial transactions on behalf of people living at the home are kept and appeared accurate. Other records were clear and up to date, and kept securely. A range of checks, maintenance and training were in place to ensure that the building, equipment and its use were safe for people living and working there. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 7 19 19 Daily records of care plans could be more specific regarding actual care given. Complete the improvements planned for the building. Provide suitable storage for equipment such as pads and gloves in toilets and bathrooms so that it is more dignified. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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!