Care Home: Pear Tree Lodge

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What the care home does well An effective assessment procedure means people move into the home confident they will receive the support and care they need and with an understanding about the running of the home. Good care planning means people receive support and care in the way they like. Good assessment processes and prompt referral to health care professionals meets health care needs of people living at the home. People living at the home have the opportunity to take part in meaningful activities and to maintain contact with their family and friends. An effective complaints procedure means that people living at the home and their representatives are confident if they voice concerns or complaints these will be dealt with promptly and effectively.People living at the home are protected from the effects of abuse by a staff team that has a good understanding about safeguarding adults. Good staff development programme ensures people living at the home are supported and care for by people who have the skills and knowledge to do so. What has improved since the last inspection? Recruitment practices have improved. Records evidence that all recruitment checks including references, CRB and POVA first if necessary and evidence that the person is entitled to work in the country are obtained before a person commences employment at the home. This helps to ensure people living at the home are receiving care and support from people who are suitable to work as carers. A procedure has been put in place about the management of administering and storage of insulin should it be required. A dedicated activity coordinator has been employed to ensure activities offered are of interest to the people living at Peartree lodge. The extension and refurbishment of the home has recently been completed resulting in improved facilities for people living at the home. The decor and furnishings have been purchased following advice from the Alzheimer`s association with the aim of improving outcomes for people living at the home who have dementia type illnesses. CARE HOMES FOR OLDER PEOPLE Pear Tree Lodge 1-3 Beech Grove Hayling Island Hampshire PO11 9DP Lead Inspector Gina Pickering Unannounced Inspection 23rd July 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Pear Tree Lodge DS0000064204.V367615.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. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pear Tree Lodge Address 1-3 Beech Grove Hayling Island Hampshire PO11 9DP 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) 023 9246 2905 023 9263 7922 lynnmcgregor1@aol.com Pear Tree Care Limited Mrs Marie Ann Abolins Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (23), Old age, not falling within any other category (23), Physical disability (4), Physical disability over 65 years of age (4) Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. All service users must be at least 60 years of age. No more than 4 service users in the PD and PD[E] categories in total may be accommodated at the home. 30th August 2007 Date of last inspection Brief Description of the Service: Pear Tree Lodge is a thirty-bedded care home, located in a pleasant residential area of Hayling Island. The service is set up to provide accommodation and care for older people, a number of whom have dementia. The service also has service users with additional physical disabilities accommodated on the ground floor. Pear Tree Lodge may also accommodate up to four service users who have an age related mental health problem, if their care needs are similar to the needs of the existing service users. Since the last inspection building work has been completed and during the course of our visit to the home the providers received notification from our registration unit that the extra bedrooms resulting from the building work have been registered. This results in the home having eight double bedrooms and twelve single bedrooms. Completion of the building work has resulted in improved communal facilities for people living at the home. The home weekly fees range from £395.00 to £410.00. Pear Tree Lodge DS0000064204.V367615.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 two stars. This means that the people who use this service experience good quality outcomes. The inspection considered information received by the Commission about the service since the last key inspection in August 2007. Information provided to the Commission in the form of the home’s Annual Quality Audit Assessment form in which the registered provider or manager tells the Commission how the service has developed over the past twelve months and how they propose to continue to improve was considered during the inspection process. We surveyed people who use the service, relatives, staff and health care professionals who have input into the service. Information received from these surveys has been used to inform the inspection process. A visit was made to the service on 23rd July 2008. We looked at documentation relating to six people using the service. We had conversations with the manager, registered providers, and four staff members, four people who live at the home and four visitors as well as looking at various documentation as part of the inspection process. What the service does well: An effective assessment procedure means people move into the home confident they will receive the support and care they need and with an understanding about the running of the home. Good care planning means people receive support and care in the way they like. Good assessment processes and prompt referral to health care professionals meets health care needs of people living at the home. People living at the home have the opportunity to take part in meaningful activities and to maintain contact with their family and friends. An effective complaints procedure means that people living at the home and their representatives are confident if they voice concerns or complaints these will be dealt with promptly and effectively. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 6 People living at the home are protected from the effects of abuse by a staff team that has a good understanding about safeguarding adults. Good staff development programme ensures people living at the home are supported and care for by people who have the skills and knowledge to do so. What has improved since the last inspection? What they could do better: The service needs to ensure there is a cabinet for storing controlled medications that complies with the Misuse of Drugs (Safe Custody) Regulations 1973. Please contact the provider for advice of actions taken in response to this Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 7 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. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Effective assessment procedures they will receive the support and care they need. The home does not provide intermediate care. EVIDENCE: The AQAA told us that a detailed assessment process is completed before a person moves into the home. We looked at four assessment documents as part of the inspection process. The assessments detail the personal, physical, health and mental health needs of the person as well as information about their social interests and hobbies, next of kin and any legal instructions. Staff told us that there is good information about a person when they move into the home to allow care and support to be given to as needed immediately. The manager told us that for those people being admitted by care management processes a copy of the social service assessment and care plans are obtained. Copies of Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 10 social services assessments were available in people’s files. There was also documentation from specialist health care professionals such as community psychiatric nurses detailing the care and support needed by the person moving into the home. Because of the mental health of people living in the home they were unable to remember the processes that took place before and during moving into the home. But their representatives, mainly relatives, told us that somebody from the home visited their relative to assess their needs before the decision was made by the home to offer a place for them. This meant that they were confident that the home would be able to meet their relative’s need before they moved into the home. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good care planning processes mean that people living at the home receive the support and care they need in the way they like. People living at the home have their health care needs met by effective monitoring and assessments and by prompt referral to health care professionals when needed. Good medication practices mean that people using the service have their wellbeing protected. Good care practices means that a person’s privacy and dignity is protected. EVIDENCE: The AQAA told us that the home has increased its use of detailed assessments in the care planning process. We looked at documents and care plans belonging to four people living at the home. Assessments included those for mobility, risk of developing pressure sores, risk of falls as well as assessments Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 12 for the personal care needs. Care plans are in place for all identified risks and needs. Care plans and assessments are reviewed on a monthly basis and amended as required. Included within the care planning process is a detailed assessment of the persons emotional and social care needs. This is also reviewed monthly and a plan of care developed according to the persons needs. At the last key inspection it was noted that it was unclear as to how people living at the home and their representatives were involved in the care planning process. It is detailed in the information provided to people when they move into the home that they and their representative can be involved on they care planning process. The care plans we looked at had the signatures of representatives of the person living at the home, usually their relative, indicating some involvement and awareness of the plan of care. Relatives told us they know about the care plans and are consulted if the care required for that person changes. The care plan documents detail the contact people living at the home have with health care professionals. These include, among many, GP’s. District nurses for advice about wound care, community psychiatric nurses for advice and support about mental health needs of people living at the home. Visitors told us that medical treatment is sought promptly if some one becomes unwell and the home always keeps them informed of the health conditions of their relative living in the home. Polices and procedures are in place about the management of medications. This includes details about the administration of insulin. At the last key inspection a requirement had been made about the need for a written procedure for the storage, handling and administration of intravenous medication. This was around an issue relating to a person living at the home who had been receiving insulin and this was detailed in the report as being intravenous insulin. The manager told us that the person had not been receiving intravenous insulin but was receiving subcutaneous insulin. She told us that if a person required intravenous insulin that would necessitate a hospital admission. At the time of our visit to the home there were no people living at the home who were prescribed subcutaneous insulin. We looked at a sample of medication administration record sheets, medications in the cupboards and the ordering books evidencing that a clear audit tail is available for medications ordered, delivered and administered to people living at the home. The home has a separate medication cabinet inside the main medication cabinet for the storage of controlled medications. At the time of our visit nobody living at the home was prescribed any controlled medications. But the present storage does not meet the requirements as detailed in the Misuse of Drugs (Safe Custody) Regulations 1973. The manager and providers said they will ensure a controlled medication cabinet is obtained and secured to the wall in a way that complies with the Misuse of Drugs (Safe Custody) Regulations 1973. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 13 Throughout the inspection process information was obtained evidencing the Privacy and dignity of people living at the home is promoted and protected. Care plans detail people’s wishes about how they are supported with their personal care. Screening is available kin all the shared rooms to protect the privacy of the people sharing the room. Staff members were observed talking with and assisting people at the home in a friendly and pleasant manner. No breaches of privacy were observed throughout our visit to the home; staff were always seen to knock on a person’s bedroom door and wait for a response before entering the room. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 14 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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home have the opportunity to take part in meaningful activities and to maintain contact with their family and friends. People living at the home are able to exercise choice and control over their life. People living at the home benefit from a varied and healthy diet. EVIDENCE: The AQAA told us that an in-house activity coordinator has been employed to have responsibility for coordinating activities at the home. The interests and hobbies of people living at the home are detailed in the care plans. This helps to ensure there are suitable activities planned that people who live at the home have an interest in. On the day of our visit to the home people were enjoying games such as hoopla and skittles in the garden. For those people who did not wish to join in with this activity the activity coordinator spent time chatting to individuals ensuring they got some individual attention. There is variety of seating areas for people to use. The main lounge has the seating arranged into two areas, each having it’s own television. People living at the Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 15 home are able to chose which television programme they want to watch and on the day of our inspection neither television competed against each other in terms of noise. There is a quiet lounge and a sensory room. The manager told us that she is still waiting the delivery of sensory equipment she has ordered. She spoke to us about the advice she has sought from the specialists in dementia such as the Alzheimer’s association and relevant health professionals about the activity equipment she should provide for people with dementia. This indicates that the service is committed to providing meaningful activities for people with dementia type illnesses. As the service still waiting delivery of some of the equipment we were unable to fully assess how the provision of such equipment will improve outcomes for people living at the home. This will be followed up through the ongoing inspection processes. The AQAA told us that there are no limitations on visiting times; people at the home can choose when to receive their visitors. Visitors we spoke to during our visit to the home confirmed they can visit at anytime of the day, they are always made to feel welcome and that staff at the home support them as well as supporting and caring for the persons they are coming to visit. The visitors record evidenced that visitors enter the home at various times of the day. Throughout the inspection process evidence was gathered confirming that people living at the home are able to make choices in their daily lives. Examples of these include being able to make choices about involvement in activities and their wishes regarding care support being included within the care planning process. People were observed being able to move freely or with assistance around the home, choosing whether to use the communal areas or sit in their bedrooms. Discussion with staff at the home evidenced that they believe that Peartree lodge is the home of the people who live there; their choice about what to do in their own home must be respected. The service users guide details that people can choose where to take their meals, be it in the dining room, one of the communal areas or their bedrooms. During our visit to the home we observed staff encouraging people to have their lunch in the dining room, but people who did not want to sit in the dining room were able to have their meal in their bedrooms or in one of the other communal areas. A new cook has recently been employed at the home. She explained she is in the process of revising the menu plans to give a greater choice and flexibility in meals for people living at the home. She explained that people are given choices at all mealtimes. Generally, for example, at lunch there is one planned main meal, but if on discussing the menu plan with people that meal is not wanted variety of alternative meals are offered. Any assistance required at meal times is detailed in the relevant persons care plans. We observed staff assisting people at lunchtime with sensitivity. Snacks are available throughout the day. We observed plates of fruit appearing out of the kitchen at regular periods. In the afternoon when people who live at the home were in the garden playing games a large plate of quartered oranges Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 16 was prided for them to refresh themselves as well as plenty of cold and warm drinks. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 17 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 who live at the home are confident that complaints will be taken seriously and responded to promptly. A staff group that have a clear understanding about safeguarding adult procedures protects people living at the home against the effects of abuse EVIDENCE: People moving into the home are made aware of the homes complaint procedure in information provided to them during the assessment process and through conversations in the assessment process. A copy of the complaints procedure is displayed in the home. Relatives told us they would voice any concerns to staff and the manager and they are confident that the manager will attend to any concerns or complaints promptly. All relatives we spoke with told us that they can approach the manager with any concerns and they feel that there is unlikely to be any complaints because the manager would resolve issues before a complaint is raised. Some of the people living at the home were able to tell us if they were unhappy they would tell one of the staff members, but because of their mental health conditions they were unable to give any more details. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 18 We looked at the homes complaints log book which gave details of complaints and concerns received in writing or in conversations by the home, the action taken to resolve the complaint or concern and whether the persons who had made the complaint or concern was satisfied with the response. The AQAA tells us that all staff members undertake training about the protection of vulnerable adults. Looking at staff training records evidenced this. Policies and procedures are in place about the protection of vulnerable adults and since the last key inspection the home has obtained a copy of the local authorities procedures for safeguarding adults. Discussing with staff member and the manager evidenced that staff have good understanding about different types of abuse and the action to take should they suspect abusive incidents have occurred. There have been no safeguarding referrals made in the past twelve months. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 19 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 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from living in a safe and comfortable environment, which has recently been refurbished to meet the needs of people living at Peartree Lodge. EVIDENCE: Since the last key inspection building work has been completed. A visit was made by one of the registration inspectors on 2nd July to assess compliance with the Care Home Regulations 2001 with regard to the extension and refurbishment of the home. During our visit to the home the manager and providers received confirmation from our registration team that the extension had been registered. The extension has regulated in a further two double bedrooms and five single bedrooms, all having en-suite facilities. All other Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 20 bedrooms at the home have been refurbished with the exception of two bedrooms; we were told the people living in the bedrooms did not want their rooms refurbished. Bedrooms are to varying degrees personalised with the person’s own belongings such as ornaments, pictures and small items of furniture. Bedrooms that are shared have screens to promote the privacy of each person. There are variety communal areas for people to make use of. The main area is a large lounge that has seating arranged so people can sit in groups rather than around the walls of the room with television and music playing facilities. A quiet lounge is available for people to use who do not want to watch the television or listen to music. A sensory room has been developed for people with dementia type illnesses; this room is still in the process of being equipped and the manager told us she has sought advise from then Alzheimer’s Society about the best equipment to purchase to meet the needs of people with Dementia. The refurbishment of the home has also included the landscaping of the garden making it a pleasant area for people to sit out in. Planting of the borders remains to be completed. There are sufficient bathing and toileting facilities for people who live at the home. This includes a large walk in wet room that has been built as part of the extension and the refurbishment of the bathrooms, some with assisted baths and all with raised WC pedestals making it easier for people living at the home to use. The home has been completely redecorated. The home has followed advice from the Alzheimer’s Society about the décor of the home to best meet the needs of people suffering from dementia type illnesses. Policies and procedures are in place about hygiene practices and the control of infection. The AQAA tells us that these were last reviewed in January 2008. A team of housekeepers are responsible for the cleaning of the home. One of them told us they always have the necessary equipment to ensure the home is clean, tidy and free from malodours and that there are sufficient numbers of them to maintain high cleaning standards. During our visit the home was observed to be clean and tidy with no offensive odours. The homes laundering facilities are on the ground floor. The position of laundry and good laundry practices reduce the risks of cross infection from dirty laundry. The laundry floors and walls are easily cleanable and were clean and tidy on the day our visit. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 21 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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good staff development and training provision is ensuring people living at then home are cared and supported by a skilled and knowledgeable work force in suitable numbers. Robust recruitment procedures mean that people living at Peartree Lodge are supported and cared for by staff suitable to work in the caring profession. EVIDENCE: A staff rota displayed in the home details who and in what capacity, such housekeeping, kitchen or care staff, is on duty at any one time. People living at the home and their relatives told us there are usually sufficient staff on duty to meet their needs. Staff also told us there are usually enough staff on duty to give the support and care needed to people living at the home. Observation during our visit to the home showed that staff members have time to sit and talk with people living at the home and call bells were answered promptly indicating that there were sufficient numbers of staff on duty at that time. We looked at a sample of staff records. These evidence that good recruitment practices are followed ensuring that no one commences employment at the home prior to two written references being received and CRB and POVA Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 22 information being obtained. These processes protect the welfare of those living at the home. Staff surveys confirmed that checks such as references and CRB were obtained prior to them commencing employment at the home. Staff records also contained copies of certificates for courses attended and qualifications obtained by staff members. The manager maintains a training record for each staff member that details the training they have received and training they need to so in the next year. Training records detail that in he past 12 months staff have undertaken training about fire safety, first aid, health and safety, infection control, abuse, food hygiene, medication and moving and handling and dementia. Plans for training in the next six months include updates on fire safety, moving and handling, infection control, food hygiene and dementia. New staff members undertake an induction programme that meets the skills for care common induction standards. All care staff are encouraged to obtain NVQ qualifications in care. The manager told us that out of 13 care staff employed at the home two have NVQ level 4, one has level 3 and she is training for level 4, seven staff members have level 2 with six of them studying for level 3 and a further three are studying for level 2. The cook also has a NVQ level 2 in her field of work. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 23 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 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a home that is effectively managed and is seeking the views of those using the service to influence the development of the home. Procedures ensure that the finances of people using the service are protected. Good health and safety practices protect all people at the home. EVIDENCE: The manager has been in post for three years and was registered by us in February 2006. She has had many years experience in carer and has obtained NVQ level 4 in care and the registered managers award. Staff, visitors and people who live at the home speak highly of the manager. Relatives spoke of Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 24 how she supports them; she is always available for a shoulder to cry on or a talk if they are finding it difficult to come to terms with their loved one having to move into a care home. The manager told us she believes that if she supports the relatives and family of people living at the home that will reduced any frustrations expressed by relatives and therefore make life more settled for the people living at the home. The manager spoke of her working relationship with the registered providers evidencing that they work together to improve the service at the home and consequently outcomes for those living at the home. This can evidenced by the major building work and refurbishment that has been completed along with much of the décor being done in line with advice from the Alzheimer’s Society to improve outcomes for people with dementia type illnesses. The AQAA told us people who use the service; their relatives and visiting professionals are surveyed about the service provided at the home. Information from these is used to influence the running and development of the home. Examples of this include the employment of dedicated activities coordinator and the provision of a sensory room. Other examples of listening to people who live at the home is the example previously stated that two people chose not have their bedrooms refurbished. We looked at a sample of surveys sent to people living at the home and their relatives indicating that people have a good choice of food at meal times, have choice where to take their meals, the home protects and promotes their privacy and they receive the medical attention they require. The provider’s monthly reports about the quality of the service provided by the home contribute to quality assurance processes at the home. These reports are available at the home and include views of the people who live at the home as well as audits of documentation and the environment and views of staff at the home. Procedures are in place about the handling of money for people who live at the home. The home does not manage any money belonging to people living at the home. There are lockable drawers in each person’s bedroom where they can store money and valuables if they wish. The AQAA told us the home has a health and safety policy that was last reviewed in April 2008. Records indicted that staff receive training about health and safety issues. Risk assessments are in place for the environment and a risk assessment has now been made for the water feature in the garden. The fire logbook indicates that fire safety checks are carried out in accordance with the Fire and Rescue Services guidelines. The home has a policy for the control of substances hazardous to health known to staff. Chemicals and other items are securely stored in locked cupboards. A Food Hygiene inspection was carried out in April 2008 following which “safer food better business” procedures have been implemented to assist with the documenting of records to evidence food is prepared and stored at the correct Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 25 temperatures to ensure good food hygiene. Staff training records evidence that all staff undertake training about food hygiene. We looked at a sample of service certificates evidencing that services and equipment are maintained at manufacturers recommended intervals. This protects the wellbeing of all at the home. Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 26 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 X 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 3 13 3 14 3 15 3 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 27 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. Standard Regulation Requirement Timescale for action 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 Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI Pear Tree Lodge DS0000064204.V367615.R01.S.doc Version 5.2 Page 29 - 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!