Care Home: Tall Trees

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What the care home does well The service is run as a home, with service users being involved whenever possible in its day-to-day activities. Staff members and service users were observed to have a relaxed, friendly relationship and there is warm, homely atmosphere in the home. The home successfully offers a high level of personal support that is specific to the needs of each individual and all service users are encouraged to be as independent as possible and to develop their skills. The individual plans for service users are well written, regularly reviewed and give staff clear guidance as to how service users like and need to be supported. Service users are supported by the home to be a part of their local community and there is a good range of activities for them to take part in. The home has its own vehicle to enable service users to get to their activities. Service users are appear to be very happy with the service provided and were very proud to show their bedrooms and the home in general. The home supports and encourages service users to keep in contact with their friends and family. Service users are well supported by a small team of staff and it is clear that staff are dedicated to the needs of service users. Members of staff spoken with said that they are happy working at the home and some had worked there for a number of years. The home is effectively managed in an open way and it is clear that all aspects of the home are led by the wishes and needs of those living there. What has improved since the last inspection? As the service was meeting the needs of service users and the National Minimum Standards at the last inspection, no requirements were made. What the care home could do better: The service continues to effectively meet the service users` needs and meets the National Minimum Standards. No requirements have been made at this inspection site visit. CARE HOME ADULTS 18-65 Tall Trees Tall Trees Guildford Road Chertsey Surrey KT16 0PL Lead Inspector Sandra Holland Unannounced Inspection 23rd January 2007 10:45 Tall Trees DS0000013812.V324953.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 DS0000013812.V324953.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 DS0000013812.V324953.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tall Trees Address Tall Trees Guildford Road Chertsey Surrey KT16 0PL 01932 844044 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) Welmede Housing Association Ltd Mrs Jennifer McArthur Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (1) of places Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The age/age range of the persons to be accommodated will be 30-65 Years One service user can be accommodated who is over 65 years of age. Date of last inspection 1st December 2005 Brief Description of the Service: Tall Trees is a residential home for up to 3 adults who have learning disabilities. Welmede Housing Association manages the service and the staff are employed by the North Surrey Primary Care Trust (NSPCT). The service is a detached property and the facilities and accommodation are set on two floors. There is no mechanical means to access the upper floor and none is required for the existing service users. All service users have a single bedroom and access to a separate lounge, dining room and kitchen. There is a garden area to the rear and front of the house. The location of the home is near to a busy motorway and roundabout and is such, that transport is required for all activities and appointments. The service users living at the home require full support and supervision from staff for all their daily living activities, both inside and outside of the home. The fees at this service are £ 1951.00 per week. Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was the first to be carried out in the Commission for Social Care Inspection (CSCI) year, April2006 to June 2007 and was carried out under the CSCI “Inspecting for Better Lives” programme. Mrs Sandra Holland, Link Inspector for the service carried out the inspection over five hours. Mrs Jenny McArthur, Registered Manager was present representing the service. The inspector met with all three service users who live at the home and two members of staff. A number of records and documents were sampled including service user’s individual plans, staff files, medication administration records (MAR) and staff training records. A full review of the information held about the home was carried out prior to the visit to the home, and a pre-inspection questionnaire was supplied to the home which was completed and returned. A number of CSCI feedback cards were also supplied for distribution to service users, relatives or visitors and healthcare professionals. Three feedback cards were completed and returned by service users, who had been supported by staff to do this. Two feedback cards were completed and returned by service user’s relatives and one by a healthcare professional. All feedback was positive and one made an additional positive comment. The inspector would like to thank service users and staff for their time, hospitality and assistance. What the service does well: The service is run as a home, with service users being involved whenever possible in its day-to-day activities. Staff members and service users were observed to have a relaxed, friendly relationship and there is warm, homely atmosphere in the home. The home successfully offers a high level of personal support that is specific to the needs of each individual and all service users are encouraged to be as independent as possible and to develop their skills. The individual plans for service users are well written, regularly reviewed and give staff clear guidance as to how service users like and need to be supported. Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 6 Service users are supported by the home to be a part of their local community and there is a good range of activities for them to take part in. The home has its own vehicle to enable service users to get to their activities. Service users are appear to be very happy with the service provided and were very proud to show their bedrooms and the home in general. The home supports and encourages service users to keep in contact with their friends and family. Service users are well supported by a small team of staff and it is clear that staff are dedicated to the needs of service users. Members of staff spoken with said that they are happy working at the home and some had worked there for a number of years. The home is effectively managed in an open way and it is clear that all aspects of the home are led by the wishes and needs of those living there. 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 DS0000013812.V324953.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 DS0000013812.V324953.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): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of a prospective service user would be fully assessed before their admission to the home. EVIDENCE: The manager stated that the three service users have lived together at the home for almost ten years since the home was opened and no vacancies have arisen. The manager was able to provide detailed information about the assessment process which would be carried out to ensure the home could meet the needs of a prospective service user. As most prospective service users would be supported financially by a local authority, a care management assessment would be carried out and a copy would be obtained by the home. The home would also carry out their own assessment. Any prospective service user would be invited to visit the home on a number of occasions, usually of increasing length. The prospective service user would be invited to stay for a meal and possibly overnight, if it appeared that the home would be suited to the service user. A particular emphasis of the assessment would be to ensure that the prospective service user was compatible with the Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 9 existing service users and to minimise any effects a new service user may have on them. Tall Trees DS0000013812.V324953.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 and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Detailed and informative individual plans are available to guide staff to the support needs of service users and these include the support required to manage risks to service users. Service users are well supported to make decisions. EVIDENCE: Comprehensive individual plans have been drawn up for each service user to describe their support needs and the services and facilities the home needs to provide to meet these needs. The individual plans that were seen were in good order, contained the required information and had been regularly reviewed. Where necessary, behavioural guidelines have been drawn up to inform and guide staff to anticipate behaviours which may challenge, what to avoid to prevent these and how to manage them if they should occur. It was clear that staff had a good knowledge and understanding of the service users’ specific needs. Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 11 The manager stated that staff were in the process of developing a computerbased system of recording the information in the individual plans, as this makes it easier to read, to review and update. It was pleasing to see that the new care plans recorded service users’ wishes, needs, strengths and choices for each of the areas covered. Information had also been included to guide staff to specific conditions which affect service users. Assessments have been carried out of any risks to the service users, including risks involved in mobility, choking, scalding, wandering away, and lack of awareness of dangers. These were very detailed and included ways to prevent risks and how to manage them to minimise the risks to service users, whilst enabling them to be independent. It was clear that service users require assistance in all activities of daily living, including making decisions. Staff advised that to enable service users to make decisions, they offer service users choices, such as of food, clothes to wear, and things to buy when out shopping. Staff were observed to offer service users a choice of drinks, refreshments or activities and to respect the choices which were made. Staff advised that they take service users known preferences, likes and dislikes into account when supporting them to make decisions. Tall Trees DS0000013812.V324953.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, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are very effectively supported to take part in a range of activities and to be active members of their community. Service users are offered and supported to plan, a well balanced diet. EVIDENCE: It was pleasing to hear service users talk about the activities they take part in and enjoy and each service user’s preferred activities are recorded in their individual plan. The range of activities include horse riding, visits to pubs and restaurants, snoozelem sessions, visits to places of interest and bowling. The manager advised that service users are not able to hold jobs due to the limitations of their disabilities. Service users were observed to be coming and going to their planned or spontaneous activities throughout the inspection. Two service users went out to a bowling session with a member of staff and a “floating” support worker and returned with a light lunch. The floating support is provided by the Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 13 Welmede organisation which runs the home to enable service users to have one to one support and is in addition to staff at the home. The floating support staff assist service users with planned and spontaneous activities and two service users went out for a drive in the home’s vehicle during the afternoon. The manager stated that service users are actively supported and encouraged to maintain family contacts. Families are welcomed to visit service users and staff also support service users to go to visit their families. One service user is able to go to for weekend stays with their family and letters from service users families were seen in their individual plans. A link is maintained with an advocacy service, the manager advised, to enable service users to be supported if required, although this is not currently used. Service users are registered on the electoral roll, the manager stated, although service users have not taken part in elections due to the limitations of their disabilities. A leaflet advising on the right to vote was included in service users’ individual plans. From information supplied with the pre-inspection questionnaire, it was clear that service users are offered a well-balanced and varied selection of meals, which take their personal preferences into consideration. Staff stated that meals for the week ahead are usually discussed and planned, to enable shopping for the required items to take place and service users said that they take part. Staff advised that service users are offered pictures of meals from which to make their selections. Staff stated that service users make individual choices for their breakfast and lunch and this is taken at a time of their choosing to fit in with their activities. The main meal of the day is served in the evening and is taken family style as a group with staff. Tall Trees DS0000013812.V324953.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 and 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users receive support in the way that they prefer and their healthcare needs are well met. Medication is appropriately managed. EVIDENCE: Staff were observed to provide personal support very discreetly and in a manner that actively promoted service users’ independence, privacy and dignity. Service users were encouraged to be independent and staff offered support only if it was needed. When support was required it was provided in the privacy of the service user’s own room and was offered in a sensitive manner. From speaking to staff and from records seen, it is clear that service users are supported by a number of healthcare professionals and that their healthcare needs are well met. Service users have received support from healthcare professionals including dentists, general practitioners (GP) and hospital specialists. The manager stated that the service users’ GP is very understanding and supportive. As the service users often become agitated if they have to visit Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 15 the surgery, the GP is very willing to visit the home when required. If a service user is unwilling to be examined or is agitated by the doctor’s visit, the doctor calls again when the service user has had time to settle. Records showed that in response to changes in service users’ needs or health, staff have taken appropriate action and promptly requested referrals to specialists if needed. Medication is supplied by a local pharmacy the manager advised, and is stored appropriately in a central, locked cupboard. All staff who have received training in this administer medication. The amounts of medication held were checked with the medication administration record (MAR) and were correct with no gaps in the MAR noted. Sample signatures of staff authorised to administer medication were held, along with a signed authorisation by the service users’ GP, for the administration of homely remedies that can be purchased and do not need to be prescribed. The manager stated that homely remedies are rarely given, as service users are usually seen by the GP in the event of any change in their health. Tall Trees DS0000013812.V324953.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 and 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 has been drawn up in a way that is more suited to the needs of service users and staff are aware of their responsibilities in the safeguarding of service users. EVIDENCE: It was clear that service users would have to rely on staff to understand that they were unhappy or dissatisfied in any way, as the service users may not be able to explain this to staff. Although a complaints procedure is available in written or easy read forms, the service users are not able to use this the manager stated, due to the limitations of their disabilities. It is pleasing to see that the “Service user’s guide to complaints” has been developed in a more service user friendly style, and states it was produced with service users. Staff stated that service users are able to communicate their unhappiness in specific individual ways, which are known to staff. This would usually be shown by a change in behaviour, which staff would monitor to establish the reason it has developed. Staff would report any changes to the manager to ensure that appropriate support was provided and that any relevant procedures were followed. The complaints record was seen and no complaints had been recorded. Relatives who had completed and returned CSCI feedback cards indicated that they are aware of the home’s complaints procedure. Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 17 From speaking to staff it was clear that they are aware of their responsibilities in safeguarding service users. Staff stated that they would report any concerns or suspicions of abuse to the manager or person in charge. If needed, staff knew that they could also refer any concerns to an on-call manager or to other agencies outside the home. In the event of an allegation of abuse, the manager stated the home would follow the Surrey Multi-Agency Procedure for the Protection of Vulnerable Adults. An up to date copy of the procedure is kept in the home and the procedure has been implemented in the past. Service users’ monies for day-to-day use are securely held for safekeeping and individual records of these are maintained. Staff advised that these are checked by two staff at the change of each staff shift and to further safeguard service users, the manager advised that she also reviews service users’ spending. The amounts of monies held were checked with the records held and these accurately matched. Tall Trees DS0000013812.V324953.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 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, safe environment, which is suited to the needs of those living there, and is very clean and hygienic. EVIDENCE: The home is attractively decorated in cheerful colours and is bright and airy. It is well furnished and equipped in a homely style to meet service users’ needs. Each service user has their own bedroom and two service users were very willing and happy to show their rooms, which have been made individual with their own belongings. It was pleasing to see a number of photographs of service users and staff displayed in the home, which help service users to remember holidays, days out and other events such as birthdays, the manager advised. All areas of the home were seen to be very clean and well presented and appeared hygienic. Liquid hand cleanser and paper towels were provided in all appropriate places and the laundry was positioned away from food storage and preparation areas. Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 19 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, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are effectively supported by a small team of staff who are appropriately recruited and trained. EVIDENCE: From the information supplied in the pre-inspection questionnaire it was clear that service users are supported by a very small team of staff. The manager stated that bank staff are supplied by the North Surrey Primary Care Trust if required, to cover any sickness or holiday absences that cannot be covered by the home’s staff. Wherever possible, staff known to the service users are supplied to ensure continuity and consistency of support. Staff advised that they provide support to service users in all aspects of running the home, including shopping, cooking, domestic and laundry tasks. Staff also provide support with transport and a variety of activities. A small number of staff have undertaken and achieved National Vocational Qualifications (NVQ) to level 2 or above, although the home has yet to meet the recommended target of fifty percent of trained staff. Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 20 Staff were observed to interact well with service users, listening to what they said and giving time for service users to respond. Staff were open, cheerful and welcoming. Recruitment records for staff were seen to contain the required records and documents. To safeguard service users all staff are required to undertake a Criminal Record Bureau (CRB) disclosure and these had been carried out. Staff training records were seen and covered training required by law and training to develop knowledge and skills. These included medication training, food hygiene training, first aid, fire training and the safeguarding of vulnerable adults. Half of the staff group have undertaken equality and diversity training and others are to undertake this, this manager advised. The staff team is made up of male and female staff although the service user group is male. The staff group is of mixed cultural and racial backgrounds and the service users describe themselves as British. Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 21 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 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Services users’ benefit from a well run home and the health, safety and welfare of service users is promoted and protected. EVIDENCE: It was evident that the manager is very experienced in the support and care of service users with learning disabilities, is well qualified and experienced for her role and is ably supported by a deputy manager. The management team have created an open and inclusive atmosphere and provide clear direction and leadership. From the outcomes for service users and the standard of the records maintained, it is clear that the service is effectively managed. Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 22 To review the quality of the service provided, a service users’ satisfaction questionnaire was supplied to service users in December 2005 and service users were supported by their key-workers to complete these, the manager stated. The manager advised that the Welmede organisation are in the process of developing a new system of assessing the quality of the services provided. Monthly, unannounced visits to the home are carried out under Regulation 26 of The Care Home Regulations and these had been recorded in the visitors’ book. A person nominated by the Welmede organisation to monitor the quality of the service offered undertakes these visits. During the visit the person speaks to residents and staff, looks around the premises and writes a short report of their findings, which is left at the home. As previously mentioned, CSCI feedback cards were supplied to the home to obtain independent views of the quality of the service. Three service users, two relatives and a healthcare professional completed these and returned them. All indicated satisfaction with the support and care provided and one relative made an additional complimentary comment. From information supplied, it is clear that the required maintenance and checks on systems and equipment in the home are carried out appropriately, and to the required frequency to promote the safety and welfare of all who live and work there. During the tour of the home no hazards to the health or safety of residents were observed. The home’s insurance certificate and health and safety at work poster are displayed as required. Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 23 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 X 2 3 3 X 4 X 5 X 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 4 25 3 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 3 3 X X 3 X Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 Tall Trees DS0000013812.V324953.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 DS0000013812.V324953.R01.S.doc Version 5.2 Page 26 - 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!