Archived: Yew Tree Care Centre

Updated 4 August 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.

Two adult social care inspectors started the inspection on 16 June and completed this 4 July 2018.

During our inspection we spoke with 16 people who used the service and eight family members. We used SOFI to observe four people and they looked relaxed and happy. We also spoke with the registered manager, area manager, two nurses, two senior carers, seven care assistants, the cook, a domestic staff member, the activities coordinator and two visiting healthcare professionals. We observed staff practices, looked at the care records of seven people who used the service and three staff files plus records associated with the management of the service.

Before we visited the service we checked the information we held about this location and the service provider, for example, inspection history, statutory notifications and complaints. A notification is record about important events which the service is required to send to the Commission by law. We contacted professionals involved in caring for people who used the service, including commissioners and safeguarding staff. Information provided by these professionals was used to inform the inspection.

Due to technical difficulties the registered manager was unable to submit a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

Updated 4 August 2018

This inspection took place on 26 June and was completed on 4 July 2018. The inspection was unannounced, which meant staff and registered provider did not know that we would be visiting.

This was the first inspection since the new provider registered to operate this service.

Yew Tree is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Yew Tree can accommodate up to 76 older people and people living with dementia. At the time of the inspection, there were 69 people using the service.

The registered manager had recently left the service and a new manager was in the process of becoming registered with CQC. A registered manager is a person who has registered with CQC to manage the service. Like 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 were happy and told us they felt safe. The staff had a clear understanding of safeguarding and ensured that action was taken if concerns arose about the way people were supported. Staff ensured any risks were closely managed. Following the purchase of the service we found that the registered manager and provider had consistently worked to drive improvements within the service.

People who used the service and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. The management team closely considered people’s needs and ensured sufficient staff were on duty each day and night.

Effective recruitment and selection procedures were in place and we saw that appropriate vetting checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

We reviewed the systems for the management of medicines and found that people received their medicines safely. Medicines were closely managed and this ensured people received their medication exactly as prescribed.

The service was being totally refurbished and action was taken to ensure the building and equipment was maintained to a satisfactory standard. When issues were raised with the maintenance person these were dealt with straight away.

People’s care plans were tailored for them as individuals. But the assessment tool provided limited space and this led staff to detail the assessment information in the care plans. The area manager and manager recognised this difficulty and were working with the provider to review the tool. People were cared for by staff who knew them really well and understood how to support them.

Where people had difficulty making decisions we saw that staff gently supported them to work out what they felt was best. Staff understood the requirements of the Mental Capacity Act 2005 and had appropriately requested Deprivation of Liberty Safeguard (DoLS) authorisations. DoLS authorisations are used for people who need to be deprived of their liberty lawfully in their best interests to maintain their health and safety.

We observed that staff had developed very positive relationships with the people who used the service. The interactions between people and staff were jovial and supportive. Staff were kind and respectful and we saw that they were aware of how to respect people’s privacy and dignity. People felt they would receive support from staff when needed.

We found that a range of stimulating and engaging activities were provided at the service.

Sufficient staff were on duty to meet people’s needs. The manager had recently reviewed staffing levels and was in the process of increasing them. A training programme was in place that enabled staff to provide the care and support people needed. Staff were all clear that they worked as a team and for the benefit of the people living at Yew Tree Care Centre.

The manager had introduced systems for reviewing incidents and accidents. This was used to consider how lessons could be learnt and positive outcomes were achieved. Staff told us that since starting work at the service the manager had made a range of improvements to the service. People told us they were confident that the manager would thoroughly investigate any concerns but had not needed to raise any and were happy with care provided.

People told us they were offered plenty to eat and we observed staff assisted individuals to have sufficient healthy food and drinks to ensure their nutritional needs were met. The cook also provided a range of fortified meals for people who needed extra calories to maintain their weight.

People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff or relatives to hospital appointments.

The manager had a clear vision about the direction of the service. They were committed and passionate about the people they supported and were constantly looking for ways to improve. Quality assurance processes and audits were in place and the manager was ensuring these were used to check that the care and support was delivered in the safest and most effective way possible.

The registered manager actively sought feedback from people who used the service, relatives, staff and external agencies to measure the effectiveness of the service delivered and satisfaction levels.