Archived: Yew Tree House Residential Care Home for the Elderly

Updated 16 June 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014

This inspection took place on the 5 & 6 April 2018 and was conducted by one inspector and was unannounced.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Due to technical problems a PIR was not available and we took this into account when we inspected the service and made the judgements in this report. Before our inspection we reviewed information we held about the service, including previous inspection reports and notifications. A notification is information about important events which the service is required to tell us about by law.

During the inspection we met eleven of the people in the service. We observed interactions between staff and people and spoke with seven people. We also spoke with the registered provider, registered manager, three care staff and a member of the domestic staff team.

We inspected the environment, including the communal lounges and dining area, the laundry, bathrooms, medicines trolley and some people’s bedrooms.

We looked at a variety of documents including two support plans of people more recently admitted, their risk assessments, daily records of care and support, one staff recruitment file, training records, medicine administration records, and quality assurance information..

At inspection we met one relative and after the inspection we spoke with a further seven. We contacted and received feedback from two health professionals.

Updated 16 June 2018

This inspection took place on 4 & 5 April 2018 and was unannounced.

Yew Tree House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Yew Tree House Residential Care Home for the Elderly is registered to provide accommodation for up to 13 older people with nine single room’s one shared room and two independent living flats. The service caters primarily for older people some of whom may have age related physical and mild dementia type conditions.

Yew Tree house is located in a residential area of the main high street of the village of Headcorn and is within walking distance of village shops and other community facilities. The property is currently owned by a sole provider. At the time of this inspection the service was full with 12 people in residence and the shared room used for single occupancy. This inspection took place on the 4 and 5 April 2018 and was unannounced.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

People told us that they felt at home in the service were safe, well cared for and had their choices respected. At the last inspection in March 2017 we identified several breaches of regulations and requirement notices were issued, we asked the provider to tell us what actions they were taking to address these shortfalls which they did. At this inspection we checked that the improvements were in place and had been sustained.

At the last inspection on 15 and 16 March 2017 we had identified that recruitment files had not contained all the required information. We had also found that some people’s bedroom doors were propped open compromising fire safety across the building. At previous inspections there was a lack of audits and survey feedback from people and/or their relatives. Whilst enough improvement has been made to meet the breach of regulation this remains an area for ongoing development to ensure all aspects of care quality are monitored and sustained.

The registered manager undertook assessment of people referred to the service to ensure only those people whose needs could be met were admitted. Care plans were developed with the involvement of people and their families to guide and inform staff about how people preferred to be supported. Staff knew people well, they were able to describe the support people required on a daily basis and understood their characters and wishes, their feedback matched most of the information in care plans which would benefit from some improved detail. Staff helped people to retain their independence for as long as possible

People’s health needs were monitored and the registered manager and staff were proactive in seeking advice and guidance from health professionals to ensure people remained healthy. Staff spent time with people and got to know their characters and individual preferences; they delivered care and support in line with these.

Staff had a clear knowledge of how to protect people and understood their responsibilities for reporting any incidents, accidents or issues of concern. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff were aware of decision making processes for people who lacked capacity but how this was recorded was an area for improvement.

People and relatives who provided feedback during the inspection showed a positive appreciation for the quality of care and support people received in a homely environment.

Staff said they enjoyed working in the service and coming to work; they said they received the training they needed to fulfil their role competently. They said the registered manager was supportive and approachable and promotes an open culture but recording around staff supervision and appraisal was an area for improvement.

Medicines were managed safely and administering staff are trained to do so. People ate well and meals were nutritious and cooked from fresh.

People and relatives said they felt able to raise concerns if they had them. Due to the small intimate nature of the service people and staff were in each other’s company for much of the day, this made it easy for people to share their views at any time but occasional resident meetings were held and satisfaction surveys sent out to relatives.

Staffing levels were sufficient. The registered manager used a dependency tool to review staffing needs. There was flexibility to use additional staff when required should a person’s needs increase greatly.

There were systems in place to monitor service quality, some records viewed would benefit from additional detail but there was an emphasis and culture in the home that the needs of people were prioritised. The provider was a visible presence on an almost daily basis in the service and knew the people that lived there well. The provider had an overview of what happened in the service.

We have made one recommendation for specific guidance for staff in regard to pacemakers.