Care Home: Tall Trees

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What the care home does well The home has developed better relationships with the local general practice and a general practitioner visits weekly. There was evidence in people`s records that they saw other health care professionals regularly, including a chiropodist and optician. Everyone had a care plan which described their main care needs and which had been updated regularly. Residents told us that they were happy in the home and that the food was good. The menus are varied and meals are presented in an appetising way. Medication is managed safely and the initial difficulties which were identified in the last inspection report have been resolved. Records were up to date and people were receiving their medication reliably and as prescribed. Two people were reluctant to take their medication and lacked the capacity to understand the implications of this. A multi disciplinary team decision had been made, and recorded, to disguise the medication which was essential for these residents. We were told that this was an unusual occurrence. The atmosphere in the dementia care unit was calm and purposeful. Carers were observed to be interacting with residents in a kind and understanding manner. Carers were able to diffuse difficult incidents well and could clearly anticipate peoples` needs, when the resident could not articulate them well themselves. People were free to move around the unit and to sit where they wished. On the day of the unannounced visit a small group of residents was sitting in the garden with a carer and clearly enjoying tea in the sunshine. A copy of the complaints procedures is displayed in the entrance hall, although not in easily found location. Residents told us that their concerns were listened to. Records of written and verbal complaints are kept. Most staff have had training in safeguarding procedures and there is a plan in place to ensure that all staff are updated on the protection of vulnerable people regularly. We are not aware of any complaints or safeguarding referrals made to the local authority which is the lead agency in these matters. The manager and team are also undertaking training to ensure that they understand the implications of the Deprivation of Liberty Safeguards which are now in place under the Mental Capacity Act. The organisation`s quality monitoring processes have been implemented and the new manager said she was planning a residents and family meeting in the near future and said that she wished to develop the services in line with their views and wishes. What the care home could do better: Staffing levels are good and the home is currently recruiting more staff in order to open the first floor of the home. There is a need to ensure that staff induction and training is up to date and that all staff have training in safe working practices. The organisation has two pathways of learning. Pathway one covers basic mandatory training in safe working practices. Pathway two builds on that to give carers more specialist knowledge to care for people with complex needs. There is a need to ensure that all staff have completed pathway one and that a greater proportion than at present have progressed to pathway two. Registered nurses skills should be updated to ensure they can meet residents` needs. There is a need to update the infection control policies and procedures and to reflect current good practice guidance on hand washing and the use of alcohol hand gel. The manager was uncertain as to whether people shared hoist slings or bed slide sheets. This should be reviewed. People should not share these items to reduce the risk of cross infection within the home. Random inspection report Care homes for older people Name: Address: Tall Trees Tall Trees Burford Road Shipton-Under-Wychwood Chipping Norton Oxon OX7 6DB one star adequate service 07/10/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Chris Sidwell Date: 1 4 0 6 2 0 1 0 Information about the care home Name of care home: Address: Tall Trees Tall Trees Burford Road Shipton-Under-Wychwood Chipping Norton Oxon OX7 6DB 01993833833 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Caring Homes Healthcare Group Limited 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 Conditions of registration: 60 0 The maximum number of service users to be accommodated is 60 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection 0 7 1 0 2 0 0 9 Care Homes for Older People Page 2 of 8 Brief description of the care home Tall Trees is a purpose built care home situated in the village of Shipton under Wychwood near Chipping Norton in the north of Oxfordshire. The accommodation is provided over two floors in four 15 bedded units, with access via a passenger lift, and there are three quiet sitting rooms and four lounge/diner rooms. All the private rooms have ensuite toilet and shower and there are communal assisted bathrooms. Some of the rooms open onto their own garden areas, and there is a courtyard garden with an orchard and meadow at the rear of the home. There is a kitchen and laundry room, and hairdressing salon and treatment room. The home is run by the manager with the care team, the housekeeping and maintenance team, supported by the wider Caring Homes Healthcare Group Limited . Care Homes for Older People Page 3 of 8 What we found: The focus of this unannounced visit was to ensure that the home was being well managed, that peoples health and personal care needs were being met and that the home had met the requirements of the previous inspection. The home is not yet fully open. There are twenty four residents living in rooms on the ground floor at present. There is a specialist dementia care unit which is spacious and has good access to a safe garden area which residents were enjoying. A new manager has been appointed recently and we were told that she would be registering with us in due course. What the care home does well: The home has developed better relationships with the local general practice and a general practitioner visits weekly. There was evidence in peoples records that they saw other health care professionals regularly, including a chiropodist and optician. Everyone had a care plan which described their main care needs and which had been updated regularly. Residents told us that they were happy in the home and that the food was good. The menus are varied and meals are presented in an appetising way. Medication is managed safely and the initial difficulties which were identified in the last inspection report have been resolved. Records were up to date and people were receiving their medication reliably and as prescribed. Two people were reluctant to take their medication and lacked the capacity to understand the implications of this. A multi disciplinary team decision had been made, and recorded, to disguise the medication which was essential for these residents. We were told that this was an unusual occurrence. The atmosphere in the dementia care unit was calm and purposeful. Carers were observed to be interacting with residents in a kind and understanding manner. Carers were able to diffuse difficult incidents well and could clearly anticipate peoples needs, when the resident could not articulate them well themselves. People were free to move around the unit and to sit where they wished. On the day of the unannounced visit a small group of residents was sitting in the garden with a carer and clearly enjoying tea in the sunshine. A copy of the complaints procedures is displayed in the entrance hall, although not in easily found location. Residents told us that their concerns were listened to. Records of written and verbal complaints are kept. Most staff have had training in safeguarding procedures and there is a plan in place to ensure that all staff are updated on the protection of vulnerable people regularly. We are not aware of any complaints or safeguarding referrals made to the local authority which is the lead agency in these matters. The manager and team are also undertaking training to ensure that they understand the implications of the Deprivation of Liberty Safeguards which are now in place under the Mental Capacity Act. The organisations quality monitoring processes have been implemented and the new manager said she was planning a residents and family meeting in the near future and said that she wished to develop the services in line with their views and wishes. Care Homes for Older People Page 4 of 8 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 2. Care Homes for Older People Page 5 of 8 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 8 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, 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 Care Homes for Older People Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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