Inspection on 01/03/06 for Eldermere

This inspection was carried out on 1st March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Eldermere 08/01/08

Eldermere 23/01/07

Eldermere 19/07/05

Eldermere 31/01/05

Eldermere 17/06/04

Eldermere 24/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Eldermere Knowle Lane Shepton Mallet Somerset BA4 4PF Lead Inspector Justine Button Unannounced Inspection 1st March 2006 09:30 Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 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 Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Eldermere Address Knowle Lane Shepton Mallet Somerset BA4 4PF 01823 423126 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) Somerset County Council (LD Services) Mr Michal John Porter Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may be admitted who have concurrent sensory impairment 19th July 2005 Date of last inspection Brief Description of the Service: Eldermere is a home providing care and support for six adults who have severe learning difficulties, multi-sensory and physical impairments. In addition, a high level of support is required in communication needs. Eldermere is a large detached property, with secure gardens at the rear. It is set in a rural location 2 miles from Shepton Mallet. The accommodation is arranged on two floors and includes single rooms for all. Some alterations have been made to the property to meet the needs of the service user group. Service users have access to the homes shared transport. A team of staff throughout a twentyfour hour period supports the people who live at Eldemere. Staff also provide support in maintaining links with families and the wider community. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted on the 01/03/06 by one inspector. Mr Porter the home manager was available on the day of inspection. As this inspection was unannounced not all the standards were assessed on this occasion. Six people were living at the service on the day of the inspection. The inspector would like to thank the residents and staff for their time and hospitality shown to the inspector during her visit. The inspector’s aim on this inspection visit was to seek views on the quality of the service from as many service users as possible and to speak to staff. Records examined were care plans, medication records, staff recruitment files, duty rotas, and some health and safety records. Other records will be examined at subsequent inspection visits. A tour of the building was carried out on this visit. What the service does well: What has improved since the last inspection? What they could do better: Feedback was given to the manager at the end of the inspection. Although it is recognised by the inspector that the people who live at the service are becoming older the range of activities on offer needs to be Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 6 developed. The current activities consist of individual or group outings with other people from the house. The people who live at the service should have the opportunity to develop friendships with peers from other services. Staff should develop the range of activities e.g. swimming, horse riding. There is an ongoing culture within the home of locking some of the doors. It is stated by the management team that this practise is in place to ensure the health and safety of service users. At previous inspections the management team were asked to review the policy of locking the doors to some communal areas. Staffing levels at the home are adequate during the day. The staffing levels in the evenings and at weekends should be reviewed to ensure that social activities are not compromised at these times. Staff training is of a good standard however not all staff have received recent moving and handling. First aid training is due in April. 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. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): There have been no recent admissions to the service. These standards were not inspected on this occasion. EVIDENCE: Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10. All individuals have a care and support plan. People are supported to make choices although this needs to be developed further. EVIDENCE: There have been no significant changes to the care and support plans since the last inspection. Somerset County Council have recognised that the current system is not ideal and is currently looking to change the format. These changes are yet to be implemented. The current care and support plans do not give clear guidance to staff on the current needs of the individual living at the home. There was no evidence to demonstrate that the people who live at the service are involved in the development or review of the plans, although it is appreciated that this may be difficult in all cases. Staff were observed to support individuals to make some choices. Communication systems are being continuing to be developed. These include the use of Total Communication. Increased staff ability to communicate with people will enable choices and decisions to be made more readily. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 10 People who live at the home are involved in the day-to-day running of the house. This is of course dependent on individual ability. Staff were observed supporting people to unload the dishwasher, do laundry and make drinks. Appropriate risk assessments are completed for all activities. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. There are some opportunities for social and recreational activities. The range of opportunities available needs to be developed. EVIDENCE: On the day of the inspection two people went out for lunch with one staff member. This is a regular for of activity. In addition people living at the home go for walks and shopping for personal items. A number of people living at the home went on holiday last year. Staff are currently supporting people to choose a holiday for next year. Despite this, few of the activities appear to involve meeting with peers. Consideration should be given to supporting people to increase the variety and range of social opportunities. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 12 The service has it’s own transport which is accessible to all the service users who currently reside at Eldermere. The transport provided is one larger style minibus. The garden provides a secure area, which provides area and is freely accessible to the service user group when the weather allows. Staff support individuals to maintain links with family. This includes phone calls and visits. Staff were observed talking to people who live at the service in a respectful and appropriate manner. It was clear from the discussions/ conversations between staff and individuals that there are positive relationships between all parties with banter and humour being demonstrated. The kitchen was viewed on the day of inspection. This area was clean and tidy. There was a range of fresh fruit and vegetables available. The fridge and cupboards were also well stocked. Staff support people to make healthy choices and options and to ensure a balanced diet. On the day of inspection staff did the house shop. Consideration should be given to including people who live at the house in this activity. People spoken on the day of the inspection stated that the food was of a good standard and quality. It could not be confirmed how people living at the home are informed what meal they are going to have as no menu is available. Again the continued development of communication methods will ensure that people at the house have an active choice of meals. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19. People who live at the service are support to meet personal care needs in a dignified manner. The health care needs of individuals are recognised and specialist advise sought if necessary. EVIDENCE: People visit the GP as and when required, staff give support when needed. Specialist support with regard to various support needs is sought on a regular basis e.g. psychology, speech and language and dietician. Service users key worker arrange visit to the dentist and other appointments when needed. All visits to all services are well documented in the service user plan. The service users at Eldermere have complex needs and staff appear to be well informed of all aspects of service users support needs. People on the day of inspection were well kempt. Staff support indivduals to maintain a high standard of personal hygiene and take pride in their appearance. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. People who live at the service are protected by a clear complaints procedure and robust prevention of abuse policies. EVIDENCE: The manager stated that there had been no complaints made since the last inspection. The home’s complaints procedure was included in all service users’ care plans and management confirmed that parents or guardians were issued a copy of the Council’s complaints procedure. The information on how to complain is also available in pictorial form, or a video is available. This is commendable. Staff are aware of the vulnerable adults and whistle blowing policies. In addition to this training there is in place a policy for the two areas. The policies complied with the Public Disclosure Act and the DOH Guidance No Secrets. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30. Eldermere is clean and tidy. The home is suitable for it’s stated purpose. EVIDENCE: A tour of the building was completed during the inspection. All service users are accommodated in single bedrooms. The bedrooms are safe, comfortable and clean. The furniture and fittings in the bedrooms also meet the needs of the individual. Each bedroom has sufficient storage space. All bedding, curtains and floor covering showed individuals tastes and were of a good standard. Individuals are able to individualise their rooms and all contained personal possessions and belongings including pictures, music systems etc. Wheelchair users would not find the accommodation at Eldermere suitable. All bedrooms have views of the surrounding countryside. All windows are fitted with restrictors. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 16 The bathrooms were again clean, tidy and accessible to all the people living at the home. The communal spaces are well furnished and the décor is of a good standard. The communal areas consist of a large sitting room, dining room and kitchen. All except the kitchen are accessible. As previously stated consideration should be given to having safeguards in place to allow accessibility to this area. Infection control measures are in place including hand washing facilities. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 & 36. A competent and enthusiastic staff group supports the people who live at the service. Staffing levels need to be reviewed. Some training needs have been identified. Staff have regular supervision and are well supported. EVIDENCE: Staff spoken to during the inspection spoke with clarity about their job roles. Staff stated that they felt that they have received adequate training in order to support the people who live at the service effectively. Staff training records were viewed. A number of staff are completing an NVQ qualification. It could not be confirmed however when staff have received refresher training in moving and handling. First aid training is due for renewal in April. Staffing levels during the day appear to be satisfactory. There are however two staff on duty during the evening and some weekends. This may compromise the ability of people to access social and recreational activities at Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 18 these times. It is recommended that staff levels are reviewed to ensure choice and inclusion. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 43. The service is well managed and run. EVIDENCE: The service is well managed and run. Staff spoken to confirmed that they received regular supervision and would have no hesitation in approaching the manager with any concerns they had. Some health and safety records were viewed these were satisfactory. It is recommended that the manager consider introducing a quality assurance system. This will ensure that the service delivered is in line with service users and stakeholders expectations. Somerset County Council also have a clear management system. The area manager visits the home regularly and conducts regular audits of the home in line with regulation 26 of the Care Home Regulations. Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 X 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 3 3 X X X 3 Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6 YA7 Good Practice Recommendations That service users are involved in the development and review of the service user plan It is recommended that communication methods continue to be developed in order that service users can make informed choices and be involved in decision making. These need to be used consistently by all staff. It is recommended that the range and diversity of activities be extended It is recommended that a quality assurance system is introduced. It is recommended that staffing numbers are reviewed at weekends and evenings to ensure inclusion and choice. It is recommended that staff receive refresher training in moving and handling. 3. 4. 5. 6. YA11 YA39 YA33 YA35 Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 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 Eldermere DS0000029566.V285155.R01.S.doc Version 5.1 Page 23 - 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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