Care Home: Tall Trees

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What the care home does well Tall Trees is an established, well-managed and well maintained service that continues to provide good quality care and support for the people who live there. The comfortable, relaxed and welcoming environment has evolved over several years and reflects the stability and commitment within the staff team and the open and inclusive management style. Thorough policies and procedures are in place for the admission and ongoing care and support of residents. Effective communication and consultation systems enable residents to be directly involved in developing and reviewing their individual support plans as well as many decision making processes within the home. Residents are enabled and supported to take part in a variety of recreational and leisure activities, both within the home and in the wider local community. What has improved since the last inspection? No requirements were made as a result of the previous inspection. What the care home could do better: Information made available to prospective residents, including the Statement of Purpose, should be reviewed and amended to accurately reflect thee current situation within the home and the wider organisation. All areas of the premises including the grounds must be kept safe, accessible and well maintained. Currently there is a large area of the rear garden that is looking neglected with overgrown trees, broken fencing and mounds of garden waste. It is also completely inaccessible to residents. CARE HOME ADULTS 18-65 Tall Trees 148 De La Warr Road Bexhill-on-Sea East Sussex TN40 2JL Lead Inspector Nigel Thompson Unannounced Inspection 31st July 2008 09:00 Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 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 Tall Trees DS0000021236.V368994.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 Adults 18-65. 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. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tall Trees Address 148 De La Warr Road Bexhill-on-Sea East Sussex TN40 2JL 01424 211990 01424 819104 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) www.caremanagementgroup.com Care Management Group Ltd (trading as CMG Homes Ltd) Karen Billings Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is six (6) Service users must be aged between eighteen (18) and sixty-five (65) years on admission Service users with a learning disability only to be accommodated. Date of last inspection 13th March 2007 Brief Description of the Service: Tall Trees is a detached property in a residential area of Bexhill. It is located on the main road to St. Leonards-on-Sea and Hastings, within easy walking distance of shops and local amenities. A secluded rear garden is accessed via steps from a patio area. The home provides twenty-four hour residential and social care for six adults with learning disabilities; there are opportunities for service users to attend local day services and participate in community and social activities. It is one of around 80 homes owned by the Care Management Group, providing services for people with learning disabilities who may also present challenging needs. Service users private accommodation is on two floors. Each bedroom is provided with en suite facilities. There is no passenger lift and Tall Trees would not be suited to service users with restricted mobility. The home has a rented car used to transport service users. There is a parking area at the front of the building, sufficient for a small number of vehicles. The fee for the service ranges from £757.53 per week to £1,400.00 per week. Tall Trees DS0000021236.V368994.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 took place over four hours in July 2008. It found that all the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was satisfactory. The purpose of this inspection was to monitor care practices and the focus was on the quality of life for people who live at the home. On the day of the inspection there were six residents living at the home. Residents observed and spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. The inspection process involved a tour of the premises, observation of working practices, examination of records and documentation and discussion with three residents, two members of staff and the registered manager. The manager, who has been at Tall Trees for the last eight years, is due to leave at the end of August. It is evident that she has been very popular within the home and many people will be sorry to see her go. What the service does well: Tall Trees is an established, well-managed and well maintained service that continues to provide good quality care and support for the people who live there. The comfortable, relaxed and welcoming environment has evolved over several years and reflects the stability and commitment within the staff team and the open and inclusive management style. Thorough policies and procedures are in place for the admission and ongoing care and support of residents. Effective communication and consultation systems enable residents to be directly involved in developing and reviewing their individual support plans as well as many decision making processes within the home. Residents are enabled and supported to take part in a variety of recreational and leisure activities, both within the home and in the wider local community. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The improved admission policy and procedure ensures that residents are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents know that the home is able to meet their individual care and support needs. EVIDENCE: Comprehensive information relating to the service is made available to all prospective residents, their relatives and associated care managers. Relevant documentation including a ‘Statement of Purpose’ and ‘Service User Guide’ was examined and found to be satisfactory. However, as discussed with the manager, it is necessary for both documents to be reviewed and amended so as to accurately reflect the current situation, following the recent management restructuring. An ‘Initial Assessment of Need and Compatibility,’ is completed for each prospective service user by an Assessment and Referral Officer. As well as Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 9 personal details, reason for referral and background information, the comprehensive assessment includes sections relating to: ‘Care and support needs’; ‘Communication’; ‘Learning disability’; Physical/mental health needs’ and ‘Risk factors to self/others’. In accordance with the Referral and Assessment Procedure, ‘If the referral relates to a specific service the Home Manager or Regional Operations Manager will be asked to attend the initial assessment.’ The manager confirmed that she has been directly involved in the assessment of individuals referred to Tall Trees. She added that, prior to moving into the home, a prospective resident would be invited to visit the home to look around and get a feel for the place. During these visits the individual would also have the opportunity to meet with members of staff and existing residents. On moving in, a flexible trial period is provided to establish whether the individual’s assessed needs are able to be met and decide on their suitability for the home and their compatibility with existing residents. An admission policy made available for inspection contained details of the assessment procedure, undertaken to identify an individual’s care and support needs. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents’ care plans enable staff to meet assessed needs in a structured and consistent manner and individual plans, including risk assessments, reflect changing support needs. Systems for consultation and participation remain effective and residents are treated with respect and encouraged and enabled to make decisions about their day-to-day living. EVIDENCE: ‘Person centred’ care and support plans have been developed and implemented for each resident. Individual plans that were examined contained personal risk assessments and comprehensive details of their physical, psychological and emotional support needs and were found to be accurate, up to date and well maintained. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 11 Comprehensive guidelines for staff are in place, in respect of each resident, helping to ensure consistency of approach and continuity of care. The guidance relates to the delivery and provision of personal care and support, in accordance with the identified wishes of the individual. The manager confirmed that residents and, where appropriate, a relative or representative continue to be directly involved in annual care plan reviews. Such reviews are held to discuss and monitor an individual’s progress, review previous goals, as well as agreeing action points and setting goals for the future. An impressive report is produced for all residents, in preparation for their review. Each document contains personal details, guidelines, risk assessments and comprehensive information regarding their individual progress during the previous year. Independence and individuality continue to be encouraged and promoted within the home and are reflected in the personalising of residents’ rooms, the choice of bedclothes and colour schemes and individual preferences for occupational and leisure activities. Staff, spoken with during the inspection, confirmed that residents are encouraged and supported to make decisions regarding many aspects of their daily living, including menu planning, what clothes they wear and how they spend their day. The manager emphasised the importance of staff developing close working relationships with individual residents. Despite the variable and limited verbal communication of some residents, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of residents being supported in a professional, sensitive and respectful manner. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social and educational opportunities. Residents benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: The recreational and leisure interests of residents are identified and recorded in their individual care plan and the manger confirmed that they are supported to access activities and facilities, reflecting their individual needs, preferences and abilities. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 13 From examination of individual care plans and through discussions with staff, it is evident that since the previous inspection, the care and support needs and general dependency levels of certain residents have increased. Community participation evidently remains a focus in the home and staff confirmed that, where practicable residents are encouraged and supported to attend day services, as well as visiting local shops and other amenities. Each resident has an annual holiday supported by staff. Recent destinations have included the Isle of Wight and Butlins. A key worker system is in place, providing opportunity for occasional 1:1 support. Each resident also has one day a week when they are able to enjoy extended ‘quality time’ with their key worker to go out together or spend the day as they choose. On the day of the inspection one resident was celebrating her birthday and was looking forward to going into Brighton. Residents are encouraged and supported to maintain family links. The manager confirmed that visiting to the home is largely unrestricted and relatives and friends are made welcome at any reasonable time. From discussions with residents and staff and examination of menus it is evident that meals at the home are varied and balanced. They are based on identified likes and preferences and drawn up following individual consultation. An alternative to the main meal is always available. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff have developed close and positive relationships with residents and demonstrate an awareness and sound understanding of their individual care and support needs. Residents are protected by improved, clear and comprehensive policies and procedures in place for the control and safe administration of medication. EVIDENCE: The manager emphasised the importance of staff developing close working relationships with individual residents and being aware of changes in mood or behaviour. In accordance with their personal care plan, residents are supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 15 As previously documented, during the inspection residents were observed being supported in a sensitive, professional and respectful manner. Documentary evidence was in place to demonstrate that the health and emotional care needs of residents continue to be met within the home. All residents are registered with local GPs and have access to other health care professionals, including district nurses, speech and language therapists and dentists, as required. All medical appointments with, or visits by, health care professionals are recorded. Recently revised policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. All staff responsible for administering medication have received training, as part of their comprehensive induction programme, and are individually assessed and authorised to do so. The manager confirmed that, following risk assessments, no resident currently self-administers their own medication. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home’s complaints procedure ensures that residents, staff and visitors feel able to express any concerns, confident that they will be listened to and acted upon. Residents are protected, through updated policies and procedures relating to abuse and safeguarding vulnerable adults. EVIDENCE: A simple and accessible complaints procedure has been developed and implemented for the benefit of residents, staff and other visitors to the home. A copy of the procedure is displayed in the entrance hall. All complaints received are appropriately recorded, including details of any actions taken and outcomes achieved. Residents and members of staff confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. It was noted that there have been no concerns or complaints recorded by the home since the last inspection. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 17 The home has produced detailed policies and procedures, relating to adult protection and abuse, including a whistle blowing policy. These documents have evidently been reviewed and updated, in accordance with the recently implemented multi agency guidelines for safeguarding vulnerable adults. The manager confirmed that all care staff have undertaken appropriate training regarding abuse awareness and procedures relating to ‘Safeguarding Vulnerable Adults.’ This was confirmed through discussions with members of staff and supported by training records examined. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. With the exception of the rear garden, the service is generally accessible, safe and clean and remains clearly suitable for it’s stated purpose. Residents benefit from pleasant accommodation that is comfortable, reasonably well maintained and decorated to a satisfactory standard. EVIDENCE: During my ‘guided tour’ of the premises it was clear that the generally well maintained décor and adequate furniture and furnishings continue to provide a comfortable, safe and pleasant environment for residents. It is evident that an ongoing decorating and maintenance programme is in place and new carpets and furniture have recently been provided in certain rooms. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 19 The manager confirmed that individuality continues to be promoted within the home and this is evident from the personalising of residents’ rooms, reflecting individual taste, preference and interests. As previously documented, the manager is due to leave Tall Trees shortly and it is hoped that the proposed and much needed garden clearance will still go ahead and be completed after her departure. At present a large area of the rear garden is looking neglected and with the overgrown trees, broken fencing and mounds of garden waste is completely inaccessible to residents. In view of the age and limited mobility of some of the residents in the home, consideration should also be given to improving access to the lower section of the garden. Residents, with key worker support as necessary, are evidently responsible for keeping bedrooms clean and tidy and on the day of the inspection, levels of cleanliness and hygiene throughout the home were found to be satisfactory. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents benefit from there always being sufficient trained and competent staff on duty to meet their assessed needs. Robust staff recruitment policies, procedures and documentation help to ensure the protection of residents. EVIDENCE: It is evident from examination of the rota and through discussions during the inspection that sufficient trained and competent staff are on duty at all times to meet the current care and support needs of residents. Two staff are on duty each morning and evening with a third ‘mid’ shift person allowing for more flexibility and 1:1 support, as necessary. One ‘waking night’ person is on duty each night. The manager confirmed that staffing levels, within the home, are closely monitored, to ensure that they reflect the changing needs and increasing dependency of certain residents. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 21 In addition to the comprehensive induction programme undertaken by all newly appointed staff, the manager confirmed that appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with staff and supported by training records examined: ‘There is always plenty of opportunity for training here!’ It is evident, from discussions with members of staff that the manager also operates an ‘open door’ policy, with staff feeling confident and able to discuss any issues at anytime. In accordance with company policy, the manager confirmed that formal supervision is provided for all care staff on a regular basis and is appropriately recorded. This was evidenced by supervision records examined and through discussions with staff, spoken with during the inspection, who acknowledged the benefits of effective supervision and confirmed feeling valued and supported by the manager: ‘She is a brilliant manager – very helpful and supportive.’ ‘She makes time for everyone and is always ready to listen.’ The manager is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of residents. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents benefit from a competent management structure. They are protected by satisfactory health and safety procedures and their best interests are safeguarded by effective quality monitoring systems. EVIDENCE: The experienced manager is clearly competent to run the home. She has worked at Tall Trees for the past eight years and has been in her current post for four years. Since the previous inspection she has successfully completed the Registered Manager’s Award (RMA). Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 23 From direct observation and through discussions with residents and members of staff, it is evident that the manager continues to demonstrate a clear sense of leadership and direction. She is clearly motivated, positive and approachable and continues to create an open and inclusive atmosphere within the home. It is also evident from discussions with residents and staff that the manager is very popular. She will clearly be missed by many people when she leaves and will certainly be ‘a hard act to follow.’ The home continues to operate effective quality monitoring systems, including annual satisfaction questionnaires for residents, their relatives and Care Managers. Responses from the most recent survey indicate a high level of satisfaction with the home and the care and support provided. The manager confirmed that the health, safety and welfare of residents and staff remain of paramount importance within the home. As previously documented, staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to residents. All accidents, incidents and injuries are recorded and reported, as required. Residents’ monies are held securely and improved policies and procedures are in place, ensuring that all financial transactions are recorded. Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 25 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 YA24 Regulation 23 (2) (o) Requirement It is required, for the benefit and welfare of the residents, that all areas of the premises, including the garden be well maintained, safe and accessible. Timescale for action 31/10/08 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 YA1 Good Practice Recommendations It is recommended that the Statement of Purpose be reviewed and amended so as to accurately reflect the current situation, following the recent management restructuring. It is strongly recommended that the home keep under review arrangements for the situation of the laundry and should any considerable rebuilding of the premises take place relocation be part of the planning. 2. YA30 Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 26 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 Tall Trees DS0000021236.V368994.R01.S.doc Version 5.2 Page 27 - 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. 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