Care Home: Yew Tree Nursing Home

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What the care home does well The home is managed well and there is a clear sense of direction towards providing a good standard of care. Staff in the home communicate well with health and social care professionals and they promote and monitor residents health and social care needs. Staff are well trained, know the service users well and show a caring, friendly and respectful approach to service users and their relatives and friends. "My clients needs are extremely well met at Yew Tree. I cannot imagine a home elsewhere that would meet my clients needs better than Yew Tree has". "I find Yew Tree is a good place to live and all of the staff are helpful". "There is a high staff service users ratio, there is a homely atmosphere and a gentle caring team of staff especially the Matron". A variety of good home cooked meals are served. A good range of activities is provided both to individual service users and groups of service users, they are varied and tailored to meet the identified social needs of service users. The home is well maintained and has a homely and inclusive atmosphere. What has improved since the last inspection? The home has produced service user packs designed to be more user friendly for service users with learning disabilities. Advice has been sought from the community occupational therapy team resulting in further training being provided for the activity co-ordinators which has improved the activities offered. Care staff have had training in learning disabilities in order to meet the needs of service users accommodated who have a learning disability. Qualified nurses have attended training to update their skills and be able to meet all of the needs of service users i.e. Venepuncture. The exterior of the building has been re painted, a gardener has been employed and a sensory room for service users developed. In house English lessons are provided for staff from overseas to improve communication between staff and service users and an audit tool has been developed for use throughout the home to improve quality. CARE HOMES FOR OLDER PEOPLE Yew Tree Nursing Home Yew Tree Nursing Home North End Road Yapton Arundel West Sussex BN18 0DU Lead Inspector Ann Peace Unannounced Inspection 08:30 8th April 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 Nursing Home DS0000047860.V361672.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 Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Yew Tree Nursing Home Address Yew Tree Nursing Home North End Road Yapton Arundel West Sussex BN18 0DU 01243 552575 01243 554901 yewtree@fsbdial.co.uk 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) Yew Tree Care Ltd Mrs. Janette Mary McCorquodale Care Home 40 Category(ies) of Learning disability (15), Old age, not falling registration, with number within any other category (40), Physical of places disability (15) Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users in the PD and LD category must be over 40 years of age. One named service user who is under 40 years of age may be accommodated in the home. 14th June 2006 Date of last inspection Brief Description of the Service: Yew Tree Nursing Home is a care home registered to offer personal and nursing care for up to 40 residents in the categories of old age, or with a physical disability or with a Learning Disability. The home is situated in the village of Yapton, near Bognor Regis. Shops, a public house and links for public transport are within walking distance. Accommodation is provided in two buildings which are linked with a corridor on the ground floor. Both buildings have bedrooms on two floors. The upper floor is accessed by a passenger lift. Communal space consists of a large lounge/dining room and a smaller lounge on the each floor. There are gardens accessible and suitable for the residents. There are twenty-four single bedrooms and eight double bedrooms. Some have ensuite facilities. The fees start at £550.00 Yew Tree Nursing Home DS0000047860.V361672.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 stars. This means the people who use this service experience GOOD quality outcomes. Mrs Ann Peace, Regulatory Inspector, carried out the unannounced visit at 8.30 am on Tuesday 8th April 2008. To prepare for this inspection ‘Have Your Say’ surveys had been sent to people using the service, relatives and health and social care professionals prior to the inspection and the results from the surveys and the comments have been included in this report. An Annual Quality Assurance Assessment (AQAA) had been sent to the manager for completion, this was returned within the given timescales and informed this inspection. We met people in the communal areas of the home and in their bedrooms, we observed residents and staff interactions throughout the day and we spoke to as many residents as we could to gain an insight into life at the home. We observed that residents were relaxed and content in the home and had good relationships with the staff who care for residents in a caring, friendly and professional manner. We looked at a selection of records; both care records and records related to the general running of the home. We received sixteen ‘Have your Say’ surveys from service users, fourteen from relatives, ten from staff and five from Health and Social Care professionals. Some comments from the surveys included: Health professionals said that there is always staff available when they visit and that staff communicate well. The home does take advice and act on instructions the medication is managed well and the staff take appropriate decisions related to the health of residents. They all said they are satisfied with the overall care given at Yew Tree. Service users and their relatives said: “Staff always come when I ring the bell”. “I am always pleased with the way I am cared for”. “An excellent level of care and kindness is shown and the support of staff has been an enormous help”. “We have always seen such kindness to the people in care and the staff are lovely to us too”. “I find Yew Tree is a good place to live and all of the staff are helpful”. “There is a high staff service users ratio, the home has a homely atmosphere and a gentle caring team of staff especially the Matron”. “I visit Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 6 the home a lot and can see for myself that the Matron and staff give a lot of love and affection”. We are so pleased with out relative’s progress and good health while living at Yew tree. One Social Care professional said: “My clients needs are extremely well met at Yew Tree. I cannot imagine a home elsewhere that would meet my clients needs better than Yew Tree has”. Staff said they are given up to date information to enable them to care for the service users and meet their needs and that training and support is given. Three requirements were made at the last key inspection and we could confirm that these have been complied with. One requirement has been made following this inspection. What the service does well: What has improved since the last inspection? The home has produced service user packs designed to be more user friendly for service users with learning disabilities. Advice has been sought from the community occupational therapy team resulting in further training being provided for the activity co-ordinators which has improved the activities Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 7 offered. Care staff have had training in learning disabilities in order to meet the needs of service users accommodated who have a learning disability. Qualified nurses have attended training to update their skills and be able to meet all of the needs of service users i.e. Venepuncture. The exterior of the building has been re painted, a gardener has been employed and a sensory room for service users developed. In house English lessons are provided for staff from overseas to improve communication between staff and service users and an audit tool has been developed for use throughout the home to improve quality. 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 Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 8 be made available in other formats on request. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 9 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 Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 10 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): 1,2,3,4,5,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are given the information they need to make an informed decision about the home. Each service user has a written contract/statement of terms and conditions with the home. New service users are only admitted following a pre assessment to ensure the home can meet their needs. All service users have an up to date assessment and plan of care for daily living. Prospective service users are able to visit the home prior to admission. Yew Tree does not provide Intermediate Care; therefore Standard Six does not apply. EVIDENCE: Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 11 There is an up to date statement of purpose for the home and a visiting social care professional, one visitor and one service user on the day of the visit said they had been given enough information about the home to be able to make a choice. The Social worker said that the transition into the home had been excellent for the service user due to the good communication between homes and that staff from a service user’s previous home have been welcomed into Yew Tree. Surveys returned to CSCI also indicated that people are given good information about the home. Prospective service users are able to visit or have a trial stay in the home before making a decision. All service users have contracts/terms and conditions and where they have been admitted through the local authority a copy of the authorities care plan is with the records. Pre assessment records of service users in the case tracking exercise indicated that all service users have their needs assessed by the manager or a qualified nurse before they are admitted into the home to ensure the home will be the right place for them. One survey commented that the manager had visited the service user at home and had been very helpful and informative. Since the last inspection the manager and a number of staff have undertaken training in Learning Disabilities to ensure they are up to date with the latest information about treatment and care to optimise the care given to those with a learning disability residing in the home. Since the last inspection the home has been registered with different categories i.e. for learning disabilities below the age of 65 years and older people, however even with the mix of ages and disabilities the atmosphere in the home is really good and inclusive for all service users and the mix of categories seems to enhance the atmosphere in the home. Intermediate care is not provided at the home. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are basic plans of care in place that set out individual personal, health and social needs. Service users’s benefit from a well trained and caring team of staff and have access to health services to meet their assessed needs. Medication policies are in place and staff follow safe administration practices. Service users say they feel that they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of death staff will treat them and their families with care sensitivity and respect. EVIDENCE: The care records for five service users were examined in detail and tracked to see if care plans were being followed, medication administered as prescribed and that specialised equipment where needed was being provided. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 13 All of the information needed for the staff to care for the service users is in the care records, these are updated regularly. When admitted risks to service users are identified and individual risk assessments are completed for example: falls, pressure sore risk, manual handling and nutrition those seen are up to date. The nutritional risk assessments used are the same as is used in hospital and are basic and do meet the standard but Mrs Mc Corquodale was advised to see if there was a more detailed one which would be more suitable for service users in care homes. A record of the service users usual day and night routines are in their files so staff can be aware of how they like to be cared for. We are told and could see that personal and health care support is responsive to the varied and individual needs and preferences. Service users are supported to be as independent as possible, information from the surveys told us that staff do listen to service users and act on what they say. They have access to healthcare and remedial services and these visits are recorded. Staff were noted to be friendly but respectful when talking to and caring for service users. All staff spoken with said they enjoyed working in the home. Where pressure-relieving mattresses are needed they are provided, however Mrs Mc Corquodale was reminded to ensure that the mattresses are inflated to the correct pressure for the weight of the service users. We are told verbally and through surveys that the home does promote the health of the service users and were given the examples of the home pushing for a service user to have an operation on their eyes to improve their sight, one service user who had not spoken for a long while but who is now verbally making themselves understood and another service user who before admission was going to have to be fed via a tube into their stomach but since admission to Yew Tree with the help of staff they are eating normally. A Social worker who was visiting the home during our visit said that she had admitted two new service users into the home recently and could see improvements in the health and well being of both. She was extremely pleased with the home and the way staff care for service users. One visitor who comes to the home frequently told us that the staff are wonderful and she is always made welcome. She thought the care given to her mother could not be better. Qualified nurses administer medication and part of the medication round was observed and was seen to be safe. Policies and procedures are in place and training records indicated that staff have had recent updates/training. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 14 At the last inspection a note was made that as the medication administration charts (MAR) were handwritten which could be a potential risk, at present the same system is operation, however Mrs Mc Corquodale is in the process of changing to another supplier who operates a safer system. All surveys told us that service users feel they are treated with respect and their privacy is upheld. This was confirmed by observation during our visit by watching staff when caring for service users in the communal areas and noting that when in service user’s rooms the doors were closed and privacy upheld when they were using the toilets and bathrooms. Where possible service users remain at the home at the end of their lives. Policies and procedures are in place and we are told additional staff are allocated to sit with service users if there are no relatives/friend with them. Mrs Mc Corquodale has been on the training and is at present looking into starting the Liverpool Pathway for Palliative Care in the home which will enhance the end of life care given. Through observation on the day of the visit, from talking to people and evidence from the surveys we concluded that the staff would treat service users and their families with care, sensitivity and respect at the time of death. The home has a good relationship with the local General Practitioners who visit the home on a regular basis. Four GP’s completed surveys and told us that staff at the home communicate well with them, staff have a clear understanding of service users health needs and they take advice. The staff take appropriate decisions when necessary and the GP’s are satisfied with the overall care provided by the home. Other comments made were” My client’s needs are extremely well met at Yew trees. “Staff always come when I ring the bell”. “I am always pleased with the way I am cared for”. “An excellent level of care and kindness is shown and the support of staff has been an enormous help”. “We have always seen such kindness to the people in care and the staff are lovely to us too”. “I find Yew Tree is a good place to live and all of the staff are helpful”. “There is a high staff service users ratio, the home has a homely atmosphere and a gentle caring team of staff especially the matron”. “I visit the home a lot and can see for myself that the Matron and staff give a lot of love and affection”. We are so pleased with our relative’s progress and good health while living at Yew tree. “I cannot imagine a home elsewhere that would meet my clients needs better than Yew Tree has”. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users find that the lifestyle they experience in the home matches their expectations and meets their needs. There is a very good activity programme in the home and service users are supported in maintaining contacts with family, friends and the local community and are able to exercise choice and control over their lives. They enjoy the food provided at the home and special diets, likes and dislikes are catered for. EVIDENCE: We are told and surveys indicated that the home promotes the service users right to live the life they want within their capabilities. We could see this on the day we visited by staff encouraging service users who were able to make choices about their day. We could see that the home revolves around the service users and not the staff or the daily routines of the home. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 16 Person centred activities are provided 6 days a week and although there are group activities and get togethers, service users do also have individualised activities as and when needed. The home employs two activity co-ordinators who are very committed to providing a good range of activities and social support to service users. Both activity co-ordinators have NVQ level 2, one in activities and another in care. We could see that the activities are regularly reviewed and the activity coordinators responsive to changing needs. They maintain a profile with a photograph of individual service users and their past and current interests and they try to ensure that they provide activities that service users will enjoy. A lively horse racing game was underway in the main lounge and an exercise class in another lounge. There was an all denomination communion service held in the afternoon. Clergy from various denominations will visit the home when requested. We are told that the home used to operate a timetable of planned activities but due to the varying attention span and the diverse needs and capabilities on a daily basis of service users they often had to change their plan, so now the activity co-ordinators vary from day to day depending on the service users. However, overall they do include: Horse racing game, beetle game, bingo, exercises, gardening club and planting weeds, reminiscence, music, art, massage, aromatherapy and sing songs and records are kept of who takes part in the activities. The home has purchased some games for the garden that will be used in the better weather. When the weather is nice we were told that they do take activities outside in the fresh air. There is also a sensory room available for service users. Records were seen that the home has taken outside professional advice about the sort of activities that would be suitable for the conditions/disabilities of service users presently accommodated and also how they can improve communication with service users through signing. The home has a committee of “Friends of Yew Tree” who organise fundraising events and involve the local community where possible. Visitors said they are always made welcome; they could visit at any time and are always offered refreshments. Meals are well balanced and cater for the cultural and dietary needs of service users. Staff sat and gave sensitive and patient assistance to those service users who needed help with eating. The mealtimes are at set times and the majority of service user had their meals at the set time however we were told by service users that if they wanted to wait and have their meal at a different time they could. Also we could see that is service users wanted a different Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 17 meal to what was on the menu they could. All surveys indicated service users were satisfied with the meals served. Service users are able to have their meals in their rooms or in the dining room. We sampled the main meal of shepherds pies and mixed vegetables and it was delicious, this was followed by bread and butter pudding or soft fruit and yogurt. Service users told us that they also enjoyed the meal; some residents who did not want shepherd pie were having alternatives such as Quiche. We sat in the lounge/diner for 45 minutes and observed part of the mealtime and how staff went about their work. We concluded that the staff are responsive and attentive to service users needs, moved them to comfortable positions for their meals using hoists for safety and explained all procedures they were carrying out. A visitor to the home who is a regular told us that the staff were acting the same way as when we (CSCI) were not there so we concluded that staff usually follow good practice. At present no service users at the home go out to vote but some do take part in elections with postal votes. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives are confident that their complaints will be listened to, taken seriously and acted upon. Regular training sessions for staff, a complaints book, plus policies and procedures regarding safeguarding adults and whistle blowing, ensure that, as far as is possible, the service users who live at Yew Tree are protected from bad practice EVIDENCE: The home has an open culture that allows service users to express their views and concerns in a safe and understanding environment. Service users told us and surveys indicated that they knew how to complain and who to and would feel able to make a complaint. There is a complaint procedure on display in the home and a copy is also in the Statement of Purpose, and records are kept of any complaints. Mrs Mc Corquodale did say they tend to deal with minor issues as and when they arise, she was advised to make a note of these and the action taken for the quality assurance system review. The Commission for Social care Inspection have not received any complaints about the home. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 19 The home understands the procedures for safeguarding vulnerable people and there have been not been any referrals made to Social Services or CSCI since the last inspection. Training for staff is regularly arranged by the home and records confirmed this. Wheelchair belts are only used short term when moving service users around the home and if a service user needs bed rails this is documented. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, well-maintained, clean and homely environment, they have access to safe and comfortable indoor and outdoor communal facilities. There is sufficient toilet and bathing facilities and they have specialist equipment to meet their needs. There is an ongoing programme of decoration and refurbishment EVIDENCE: The home provides a physical environment that is appropriate to the specific needs of the service users who live there. While touring the home we noted that it is clean, tidy, fresh and well maintained, since the last inspection the outside of the home has been re painted and a gardener employed. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 21 There is a large lounge/dining room with a large screen television and comfortable seating for service users. Two large fish tanks partitioned off part of this lounge/dining room and there were a number of service users sitting in this quieter area away from the television. There is another smaller lounge which was being used for an exercise class in the morning but was available for service users in the afternoon. There are well-kept, safe and attractive gardens and since the last inspection a new gazebo has been erected with the aid of a grant. Service users are encouraged to personalise their rooms with small pieces of furniture, pictures, photographs and other items to make them more homely. Some bedrooms are shared but there are screens available to protect privacy. Not all rooms have locks but all service users have access to lockable cupboards in their rooms. We were told that should a service user wish to have a lock on their door they could. Mrs Mc Corquodale was advised to pre-empt this by asking service users during admission what their wishes are regarding lockable cupboards. There are a number of rooms that can only be used by service users who are mobile as there is no lift access. However Mrs Mc Corquodale is looking at ways to get chair lift access for the future. There are adequate toilets, bathrooms and shower rooms with specialised equipment for the service users. Staff are aware of the procedures to control the spread of infection and do have training in this area. Hand washing facilities and alcohol hand gel is readily available. A recent inspection by the Environmental Health Department has been undertaken there were no requirements made just three good practice recommendations and we were told that these would be addressed. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service user’s needs are met by the number of care staff at Yew Tree but not ancillary staff in relation to the laundry. There is a thorough recruitment process in place and new staff receive induction training recognised by Skills for Care. Staff at Yew Tree have undertaken a number of training courses to enable them to understand and meet the needs of service users as well as provide a safe environment for them to live in. EVIDENCE: Service users told us and surveys recorded that people have the confidence in the staff who care for them and that there is enough care staff available to meet their needs. Rotas show that the home is staffed efficiently with well-trained nursing and care staff, but not ancillary staff in the laundry. It was noted at the last inspection that some overseas staff did not speak English very well so following that in house English lessons were provided for staff. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 23 Staff members undertake external qualifications and at present nine care staff are about to start NVQ level 2. Many of the care staff are qualified nurses from overseas and one is undertaking adaptation training in the home which when qualified will allow them to practice as a qualified nurse. Due to this the home has not yet met the standard for 50 of care staff to be qualified to NVQ level 2 but is well on the way. The training records were seen and so far in 2008 training has been provided in; health and safety, safeguarding, medicines, fire safety, manual handling, continence, personal hygiene and pressure sores. Training in first aid and food hygiene were provided in November 2007. Staff said they are supported and encouraged to undertake training and the training records of nine members of staff were examined and showed staff are up to date with training. There is a good recruitment procedure in the home which undertakes all of the relevant checks and gathers information to ensure that potential staff are safe to work with vulnerable people. The records of the latest members of staff to be employed were seen and we could confirm the procedure is followed. Some surveys sent to us indicated that people were not happy with the laundry service in the home, this may be because at present there are no designated laundry staff so care staff have to carry out laundry duties while rostered onto the rota for caring duties. The Providers and Mrs Mc Corquodale were told that sufficient ancillary staff should be employed, a requirement has been made. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, there is a quality assurance system in place to ensure the home is run in the best interests of service users. Service user’s financial interests and health and safety are safeguarded by the homes policies, procedures and record keeping. EVIDENCE: The Registered Manager Mrs Mc Corquodale has the required qualifications and experience, she is highly competent to run the home and meet its stated aims and objectives. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 25 Mrs Mc Corquodale communicates a clear sense of direction and implements best practice operational systems to the benefit of service users. She understands the importance of having a quality assurance system and carries out regular audits. Mrs Mc Corquodale is presently compiling the results form the latest round of surveys and plans to exhibit the results. Mrs Mc Corquodale provides an excellent role model for staff and service users, staff, professionals, and visitors on the day of our visit were very complimentary about her and the way she manages the home. Mrs Mc Corquodale ensures that staff follow the policies and procedures of the home which they are told about during induction and supervision and there is a staff appraisal and supervision system in operation. We noted that policies and procedures had recently been updated accordingly with new information. Through looking at surveys and speaking to service users and other involved in the home there is strong evidence that the ethos of the home is open and transparent and that the views of the people who use the service and the staff are listening to and valued. The AQAA contains excellent information that is supported by evidence found on the day of the visit. There is a good level of understanding about the importance of equality and diversity and a range of evidence showing how they have listened to service users. The AQAA did also indicate that the home recognises the areas that it still needs to improve and some of these are recorded earlier in the report. The home has effective and regular support from the Providers who visit the home on a regular basis. Informative Regulation 26 reports on the conduct of the care home are completed on a monthly basis and these were available for us to see. The home has efficient systems to ensure safeguarding and management of service user’s money and valuables, people are supported to manage their own money where possible. Following a requirement being made since the last inspection service user’s accounts have been separated so all have accounts in their own names. There is full and clear recording of all safety checks and accidents including analysis to identify any trends. The home monitors its health and safety performance and records showed that they do consult with other agencies about health and safety issues as required. By talking to staff we could confirm that staff have a good understanding of the risk assessment process at different levels. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 26 Mrs Mc Corquodale ensures that all staff are trained in health and safety matters and individual training records reflect this. Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 27 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 3 3 3 3 Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 28 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 OP27 Regulation 18 1 (a) Requirement Ensure that at all times an adequate number of ancillary staff are employed. Timescale for action 31/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 29 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 Yew Tree Nursing Home DS0000047860.V361672.R01.S.doc Version 5.2 Page 30 - 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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