Care Home: Yew Tree Lodge

Similar services:

• Springfield House
• The Shelley
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well What has improved since the last inspection? From observation on the day of this key inspection, staff do respect the privacy and dignity of the residents. Where residents need help with feeding this is carried out in a discreet and understanding way. Staff ensure that personal hygiene is carried out privately, and there was no evidence of external medications being applied in communal areas. The results of the quality assurance surveys sent by the home to residents, relatives and external professionals who visit the home, have now been published and show many positive outcomes, and some areas for improvement. What the care home could do better: Care plans need to be tidied up and truly reflect the assessed needs of the residents, whilst at the same time giving good guidance to staff as to how they will meet these needs. Levels of risk while recognised at the present time through risk assessments again do not give clear steps that staff must take to keep the level of risk to a minimum The registered manager must ensure that administration of medication is carried out according the `The Royal Pharmaceutical Care Home Guidelines`, to ensure that residents are not placed at risk, and that residents` are given the opportunity to take their prescribed painkilling medication. There are three areas in the home where offensive odours are present and this detracts from the homely environment that the registered manager and registered provider are trying to achieve. The senior management in the home must ensure that a complete employment history is sort from all prospective employees and that there is written evidence for any gaps in employment. All staff must receive mandatory training in health and safety issues together with work related training. All new staff must complete the `Skills for Care Induction.` The registered manager must develop a monitoring system so that systems used in the home are checked on a monthly basis; this should include care plans, reviews, medication, cleaning, food presentation, policies and procedures. CARE HOMES FOR OLDER PEOPLE Yew Tree Lodge Stoke Road Hoo Rochester Kent ME3 9BJ Lead Inspector June Davies Key Unannounced Inspection 10:00 13th February 2008 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 Yew Tree Lodge DS0000029005.V359551.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. Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Yew Tree Lodge Address Stoke Road Hoo Rochester Kent ME3 9BJ 01634 251312 01634 254941 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) Mrs Abida Ali Mr Syed Ikram Ali Sharon Edmunds Care Home 29 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia over 65 years (DE(E)) maximum number of places 28. Old Age, not falling within any other category (OP) maximum number of places 1 - to be accommodated in the annexe. The maximum number of service users to be accommodated is 29. 2. Date of last inspection Brief Description of the Service: Yew Tree Lodge is a large detached property. The Proprietors live next door and have day-to-day contact with the home; they employ a number of care staff, domestic staff, and two cooks. The home is situated in a rural setting on the outskirts of Hoo village. There are transport links with Rochester and Strood. There is car parking to the rear of the building. Fees are from £425.11 to £458.75 Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 10:00 a.m. and was in the Service for five hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Service’s general manager and registered manager and any information that CSCI has received about the Service since the last inspection. There are four Required Developments at the end of this Report. What the service does well: What has improved since the last inspection? Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 6 From observation on the day of this key inspection, staff do respect the privacy and dignity of the residents. Where residents need help with feeding this is carried out in a discreet and understanding way. Staff ensure that personal hygiene is carried out privately, and there was no evidence of external medications being applied in communal areas. The results of the quality assurance surveys sent by the home to residents, relatives and external professionals who visit the home, have now been published and show many positive outcomes, and some areas for improvement. What they could do better: Care plans need to be tidied up and truly reflect the assessed needs of the residents, whilst at the same time giving good guidance to staff as to how they will meet these needs. Levels of risk while recognised at the present time through risk assessments again do not give clear steps that staff must take to keep the level of risk to a minimum The registered manager must ensure that administration of medication is carried out according the ‘The Royal Pharmaceutical Care Home Guidelines’, to ensure that residents are not placed at risk, and that residents’ are given the opportunity to take their prescribed painkilling medication. There are three areas in the home where offensive odours are present and this detracts from the homely environment that the registered manager and registered provider are trying to achieve. The senior management in the home must ensure that a complete employment history is sort from all prospective employees and that there is written evidence for any gaps in employment. All staff must receive mandatory training in health and safety issues together with work related training. All new staff must complete the ‘Skills for Care Induction.’ The registered manager must develop a monitoring system so that systems used in the home are checked on a monthly basis; this should include care plans, reviews, medication, cleaning, food presentation, policies and procedures. Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 7 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. Yew Tree Lodge DS0000029005.V359551.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 Yew Tree Lodge DS0000029005.V359551.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): Standards 1, 3 and 6 People who use this service experience good quality outcomes in this area. The homes Statement of Purpose and Service User Guide has been reviewed and contains sufficient information for prospective people wishing to use the service to make a decisions about moving into the home. People move into the home knowing that their needs can be met and that their independence will be maximised and promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service user guide has been reviewed this year and contains all information required under the National Minimum Standards. Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 10 The general manager agreed that the Fire policy and procedure would also be included in these revised documents as it was omitted at review. The registered manager carries out pre-admission assessments for any prospective person wishing to use the service. Two pre-inspection assessments were viewed and found to be informative in regard to the level of care needed. Where a local authority funds the prospective resident, there is also an assessment profile by the Care Manager. The home does not offer intermediate care. Yew Tree Lodge DS0000029005.V359551.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): Standards 7, 8, 9 and 10 People who use this service experience good quality outcomes in this area. There is no clear or consistent care planning system in place to adequately provide staff with the information they need to meet residents’ needs. The health needs of the residents are well met with evidence of good multi disciplinary working taking place on a regular basis. The system for the administration of medication needs some improvement to ensure that residents are not placed at risk. Staff respect the privacy and dignity of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 12 Care plans contain duplicated information and are not clear as to the needs of the residents. Information contained within the pre-admission assessment is not always carried through into the care plan. There is not sufficient information to guide staff as to how they should be caring for each individual resident. Risk assessments recognise the degree of the risk, but there is no guidance to staff as to what steps they need to take in reducing the level of risk. From the two care plans seen there is no evidence that care plans are reviewed on a monthly basis. Daily report sheets are kept separately from the care plans. This practice does not promote the care plan as a working tool for care staff. There is no evidence that the residents’ or their relatives are involved in the drawing up of these care plans. Care plans did contain charts in regard to external visits from health care professionals but these had not been completed, although mention to these visits had been made on the daily report sheets. Each care plan has a personal hygiene chart, but this is not completed on a regular basis, so there is no evidence that residents in the home have oral care, hair care, nail care or tissue viability checked on a regular basis. Daily reports referred to personal hygiene as ‘all care given’. None of the residents have pressure areas and from observation several of the residents have pressure-relieving cushions. The registered manager confirmed that the home can call on the service of the continence nurse, and that she will visit the home to carry out an assessment for continence aids. One care plan viewed shows that the resident has access to a consultant psychiatrist. The registered manager confirmed that any concerns regarding physical or mental health will be referred to the general practitioner in the first instance he/she in turn will refer to the appropriate consultant. On the day of the visit the community psychiatric nurse was visiting the home. She confirms that she calls on the home regularly to visit residents. Nutritional screening takes place on a regular basis and this is recorded in the care plan. There was some evidence in the daily reports that residents have regular access to the chiropodist, optician and dentist. Discussion took place with the registered manager in regard to care planning, and the manager recognises that there is a need for improvement and will work towards making the care plans more user friendly, and ensuring that they are used as a working tool by the care staff. The inspector carried out an audit and observation of the administration of medication. The observation showed that medication is not being administered to the residents in accordance with Royal Pharmaceutical Guidelines in that a senior carer places blister packed medication into a pot and then hands it to another carer to take to the resident. Residents are not always offered PRN painkilling medication, the senior carer uses her own judgement to assess if the residents were in pain or not. Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 13 From the audit the inspector found that all staff administering medication had received medication training. There is a list of staff trained in the administration of medication with their signatures and initials. All MAR sheets have been initialled correctly and medication in blister packs correlated with the MAR sheets. Controlled drugs were kept in the controlled drugs cupboard, and there are no discrepancies with the controlled drugs register. Eye drops and liquid medications do not have the date of opening written onto the bottle. The date of opening of some eye drops is written onto the box. Medication policies and procedures have been reviewed and are clearly written. Regular daily temperatures are taken for the medication room and the medication fridge. The medication room, medication fridge and medication trolley are all in a clean condition. Any unused medication is returned to the pharmacist on a monthly basis. Through observation on the day of this inspection the inspector found that staff respect the privacy and dignity of the residents. Staff sit with residents and feed discreetly, and doors are kept shut when carrying out personal hygiene tasks. Staff were calling residents by their preferred term of address. The home has seven shared bedrooms all are provided with privacy screens. Yew Tree Lodge DS0000029005.V359551.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): Standards 12, 13, 14 and 15. People who use this service experience good quality outcomes in this area. The home offers both group and one to one activities to meet the differing needs and interests of the residents. The manager works hard at promoting links with the community to ensure that residents have a varied social life. The meals in the home are good offering both choice and variety and catering for special diets. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home offers both group and one to one activities to the residents. Group activities on offer are ball games, reminiscence box, board games, and videos. Recently one resident has been involved in planting up seeds for the garden. Staff do have time to sit with the residents for a chat or to discuss news topics. Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 15 The registered manager said that she is working towards providing more one to one activity for the residents. One member of care staff has now taken over the role of activities co-ordinator, and told the inspector how she is hoping to meet more of the residents’ interests. Those residents who wish to have access to the local community visit the local farm shop regularly and are able to have a cup of coffee there. The registered manager has arranged for outside entertainers to come into the home to provide entertainment for the residents. The home also has good relationships with local primary schools and the children come into the home on festive occasions to entertain the residents. The local Church of England vicar used to visit the home on a regular basis, but this has lapsed recently. The homes general manager stated that he would make contact with the Vicar to try and arrange more regular visiting. The home has an open visiting policy, and visitors are welcome into the home at any time. Residents can choose where they wish to entertain their visitors, either in one of the communal lounges or in their bedrooms. All the residents in the home have advanced dementia and arrangements have been made for their relatives or solicitor to manage their financial affairs for them. At the present time the manager is not aware of an advocacy service locally that could offer advocacy to residents who do not have relatives. From observation during a tour of the premises the inspector noted that all bedrooms had been personalised with items from the residents own homes. Time was spent observing lunchtime in the dinging room. Residents are offered choices and meals are served according to the residents needs. Some residents need part of their meal liquidised to ease swallowing. These are served in an appetising manner. Some residents need help with feeding and staff did this discreetly sitting with the residents and talking to them. All staff when presenting the plate to the resident’s described what food was on the plate. The inspector also noted that plate guards were provided where needed. Where a resident had chosen to eat in their own bedroom or one of the communal lounges lunch was delivered by care staff on a tray and covered up. Residents are offered a fruit drink with their lunch, but it was evident from observation that a glass of squash was not sufficient for some residents and it would be more appropriate to see a jug of squash placed on each dining table so that residents could help themselves. Menus show that residents are offered a choice of wholesome and nutritious food. Any need for specialised diet is catered for as and when required. Comments from residents – “The food here is very nice.” “I always enjoy my food.” “The staff do the food very well.” Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 16 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): Standards 16 and 18 People who use this service experience good quality outcomes in this area. Residents and visitors know their complaints will be listened to and acted on. Staff have excellent knowledge and understanding of safeguarding vulnerable adults issues which helps to protect the residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a reviewed complaint policy and procedure and this is displayed in the home and contained within the service user guide and statement of purpose. There is a complaints file, and there have been no complaints since the last key inspection. The registered manager is aware that she needs to record in writing any complaint, the investigation into the complaint and the response to the complainant. There has been one safeguarding adults issue in the home since the last inspection, this was reported to all the appropriate authorities and has now been closed. All staff have received ‘protection of vulnerable adults’ training. Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 17 The home has clear policies and procedures in place for the safeguarding of vulnerable adults and whistle blowing Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 18 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): Standards 19 and 26. People who use this service experience good quality outcomes in this area. The standard of the environment is within the home is good providing residents with an attractive and homely place to live this is only marred by offensive odours in some parts of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was carried out. Yew Tree Lodge offers a comfortable and homely environment to the residents living there. The whole home is kept in excellently maintained condition. There is continuous decoration taking place in the home, and at the time of the inspection, arrangements have been made to decorate the kitchen at night so that is causes the least Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 19 disruption to staff. The ground floor communal dining room has recently been decorated and this too was carried out at night to prevent disruption to residents’ mealtimes. There has been a great deal of investment in the home recently with a new wireless controlled nurse call system, wireless controlled central heating, a complete overhaul of the central heating system, a new Arjo shower room on the ground floor, a newly refurbished bathroom with Medi bath on the first floor, and a new kitchen due to be fitted within the next few weeks. All bedrooms were nicely furnished and decorated. Two bedrooms have an offensive odour, despite carpets being replaced at regular intervals. There is an offensive odour in the main reception lounge. Discussion took place with the registered manager and general manager, regarding the possibility of fitting laminate flooring or non-slip vinyl flooring to help to eliminate odours and there would be no problem with this, providing all parties are consulted and agree to these changes. The registered manager stated that carpets in the reception lounge are shampooed on a regular basis, but the odour remains Space has been made for a new communal dining/lounge on the first floor, and this room also incorporates sensory lighting. The attention to infection control in the home is good and is only marred by the offensive odours in some parts of the home. All staff are provided with disposable gloves and plastic aprons, when dealing with personal hygiene and blue plastic aprons and blue disposable gloves when serving food. 46 of the care staff have received infection control training, with further courses due to be booked. All communal toilet washbasins are provided with liquid soap and paper hand towels. The laundry room is situated away from the kitchen area. The washing machines are industrial and provide a sluicing facility. Red alginate bags are used for fouled laundry. A sluice room is situated on the first floor with a sluicing machine. There is a current contract with a waste disposal company for the collection of clinical waste. Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 20 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): Standards 27, 28, 29 and 30 People who use this service experience good quality outcomes in this area. Staff are employed in sufficient numbers on all shifts to meet the needs of the residents. Through the positive attitude of the manager many of the staff have achieved a care qualification. Recruitment practices are good within the home ensuring that the residents are cared for by appropriately vetted staff. Further improvements need to be made in ensuring that all staff receive mandatory training and have the skills to meet the residents needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rotas and discussion with members of care staff showed that there are sufficient staff on duty at all times to meet the needs of the residents. Staff said that although the morning shift was busy, they were able to spend one to one time with the residents; afternoons were not so busy and they were then Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 21 able to provide more group or one to one activities. There is a good skill mix of staff on duty throughout the three shifts to ensure that the assessed needs of the residents are met. The registered manager also employs 9 ancillary staff to cover cooking, laundry, cleaning and maintenance in the home. 66 of care staff have NVQ level two or three, with four care staff working towards NVQ level two, providing the home with well over the minimum requirement of 50 . Two staff personnel files were viewed on the day of this key inspection. The home operates a stringent recruitment policy and the only exception to this was that the application form does not require a full employment history. All personnel files contain two references, POVA check, current CRB check, at least two forms of identification and medical questionnaire. All staff have a copy of terms and conditions of employment, and a copy of their job description. Staff are issued with General Social Care Council Code of Conduct at the start of their employment in the home. The staff training matrix shows there are some staff who have not completed their mandatory training and this needs to be addressed to ensure that the staff have the skills and knowledge to meet the assessed needs of the residents. All staff receive initial orientation induction training and the registered manager stated that she is in the process of starting ‘Skills for Care Induction’ that she had accessed this information via the web site, and is in the process of introducing this for all new staff. Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 22 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): Standards 31, 33, 35, 36 and 38 People who use this service experience good quality outcomes in this area. The registered manager has a good understanding of what needs to improve in the home and is well supported by senior management and staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has a NVQ level 4 and Registered Managers Award and has many years experience of management in differing residential settings. She has been a registered manager at Yew Tree Lodge for nearly one year, and is clearly aware of further improvements she needs to make to Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 23 ensure that all the residents’ needs are met and that the home complies with the National Minimum Standards. Staff speak highly of the manager, saying that she is approachable and has made many good improvements in the home. The registered manager is also well supported by the general manager. There are clear lines of accountability in the home, and these are outlined in the statement of purpose and service user guide. One Care Manager visiting the home during the key inspection spoke highly of the home, and praised the home for meeting the needs of a new resident. The home has a quality assurance system in place and this includes sending out surveys to residents, relatives, and professional visitors to the home. A health and safety and fire risk assessment is carried out annually of the home both internally and externally. The registered manager still has to develop monthly monitoring of systems used in the home. A report has been published relating to the quality monitoring surveys carried out in August 2007. The home manages the personal finances for all the residents living in the home. The General Manager keeps a ledger with a separate page for each resident. Monies paid into the home by cheque are paid into a residents’ account at the bank. The General Manager also publishes an account sheet for all residents’ relatives and funding authorities to show what money has been paid to the home and how the home has spent the residents’ personal allowances. Receipts are kept of all expenditures made on the residents’ behalf. Actual cash held on the residents’ behalf is kept safely under lock and key in the home. Staff receive regular one to one supervision together with regular staff and team meetings. As mentioned previously in this report not all staff have attended training for health and safety related training. The registered manager did state that she is in the process of booking further training for this year. The home has good policies and procedures relating to health and safety issues in place. The fire points in the home are checked weekly and there are regular checks of hot water temperatures. All hot water outlets have been fitted with thermostatic control valves and deliver hot at 43ºC. Radiators throughout the home have been fitted with covers. All windows have opening restrictors fitted. The rear garden of the home is safe and secure for use by the residents. All appliances used in the home have up to date maintenance certificates. All accidents are properly recorded in the homes Health and Safety Executives accident book. Yew Tree Lodge DS0000029005.V359551.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 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 3 X 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 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 3 X 3 Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 Requirement Timescale for action 07/04/08 2. OP9 13 The registered manager must ensure there is a written care plan in place for all service users that has been developed with the person or their representatives that reflects their personality, strengths and needs and gives clear guidance to staff. This requirement was made at the previous inspection on 20/03/07 and timescales have not been met. The registered manager must 07/04/08 ensure that medication is administered in accordance with the Royal Pharmaceutical Guidelines. Medication must only be administered and signed off by one member of staff. Residents prescribed pain relieving medication PRN must be given the opportunity to decide if they wish to have this medication. Eye drops/ointment and liquid medication must be dated on the bottle/tube on the day of opening. DS0000029005.V359551.R01.S.doc Version 5.2 Yew Tree Lodge Page 26 3. OP26 12(1)(a) 16(2) (k) Schedule 2(6) The registered manager must ensure that the home is kept free of any offensive odours. The registered manager must ensure she obtains a full employment history with a satisfactory written explanation of any gaps in employment prior to a new member of staff being deployed in the home. 07/04/08 4. OP29 07/04/08 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 OP7 Good Practice Recommendations Care plans and risk assessments must be clear in the information they give to the care staff as to the level of care to be received by residents. All external healthcare visits should be clearly recorded. All personal hygiene tasks should be recorded to include oral health care, hair care, nail care and checking of tissue viability. The registered manager must ensure that all staff receive mandatory training and that this training is ongoing to include updating knowledge and for all new staff deployed in the home. All new care staff employed in the home must undertake ‘Skills for Care’ induction training. The registered manager develops a monthly monitoring audit of systems used in the home. 2. OP29 3. OP33 Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South East 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 Yew Tree Lodge DS0000029005.V359551.R01.S.doc Version 5.2 Page 28 - 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!