CARE HOMES FOR OLDER PEOPLE
Elders (The) The Elders Epsom Road Ewell Surrey KT17 1JT Lead Inspector
Mr Peter Benthom 15 & 20
th th Unannounced Inspection December 2005 10:00 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 Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 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. Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Elders (The) Address The Elders Epsom Road Ewell Surrey KT17 1JT 020 8393 9757 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) Golden Hours Fellowship Limited Mr R Taylor Care Home 27 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (27) of places Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Of the 27 residents accommodated up to 3 service users may be within the category DE(E), Older People with Dementia The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE 18th August 2005 Date of last inspection Brief Description of the Service: The Elders is a care home providing personal care and accommodation for up to 27 older people, of whom a maximum of 3 may suffer from dementia. The home is a large detached converted property, close to the village of Ewell and Epsom town centre. Good transport links are nearby. The home is operated by a charity, the Golden Hours Fellowship and benefits from a wellestablished management structure. The manager has worked at the home for many years and lives on site. He is actively involved in the day-to-day running of the home. There has been considerable improvement to the premises in recent years, in order to comply with the National Minimum Standards for Older People. Bedroom accommodation is currently provided at ground and first floor level, with some rooms having en suite facilities. All rooms are single. The home has a lift and a stair lift for use by service users. Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was the second of the year 2005/6 and was conducted by an inspector from CSCI. The inspection was carried out with the assistance of the senior care assistant owing to the sudden and unexpected absence of the manager through illness and it took place over two days. Adequate numbers of staff were on duty and several of the Service Users in the home were spoken with. A tour of the premises took place and care and medication records were inspected. Staff and service users were spoken with and observation of practice was made. The CSCI would like to thank staff and service users for their hospitality throughout the inspection process. What the service does well: What has improved since the last inspection?
Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 6 There is a genuine commitment to NVQ and other training opportunities for staff. Whilst this was in place at the last inspection, it was noted that even more members of the staff team have been afforded appropriate support and training. 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. Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 7 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 Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Service users are admitted only following a full assessment undertaken by people trained to do so. EVIDENCE: The home has produced a comprehensive Statement of Purpose and Service Users Guide. All service users have a written contract and care plan. The home is clear in the care it offers to service users. All potential service users are assessed prior to admission. It was reported that the service only admits new service users based on an assessment of needs, and appropriateness of placement The initial assessment was used to form the basis of the care and the support plan, which identified the actions that carers should follow to assist an individual living at the home. Service users and their families/representatives and relevant professionals are involved in the assessment process. Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Health, personal and social care needs are effectively met in this home. Service users’ health needs were well met and medication administration was accomplished satisfactorily. Health, personal and social care needs are effectively met in this home. Service users’ health needs were well met and medication administration was accomplished satisfactorily. EVIDENCE: Encouragement and support was given to service users to promote independence within the limitation of each individual’s capabilities During the inspection the staff cared for Service Users in a respectful manner. Those Service Users requiring any assistance were helped sensitively. All Service Users have their own bedroom, thus providing the opportunity for privacy when visitors arrive, whether family or professionals. The Homes’ policies and procedures placed particular emphasis on the core values of caring, such as independence, privacy and dignity. Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Links with the local community are good and serve to enrich Service Users lives. Food is appetising and well prepared with choices being offered at all times. EVIDENCE: Links with the local community are good and serve to enrich Service Users lives. Activity programmes were in place, and service users were able to maintain contact with friends and family. There are no restrictions in terms of visiting times. The service users were free to move around the home consistent with individual risk assessments in place. The menus viewed showed a good variety of meals offered. Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 The home has a satisfactory complaints system that is made available to all Service Users and staff. Arrangements were in place in respect of adult protection matters EVIDENCE: The home has had no complaints since the last inspection. All home staff have had some training in the protection of vulnerable adults. The subject of abuse was addressed within the staff induction programme. Up to date training in the Protection of Vulnerable Adults will be talking place on an ongoing basis. Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 2,0, 21, 22, 23, 24, 25 and 26 The standard of décor and equipment in this home is good with evidence of improvement through continual maintenance and refurbishment. EVIDENCE: Overall the home was in good condition; appropriately decorated, well maintained and furnished to a high standard. The secluded garden is particularly attractive and of a large size, stocked with garden furniture. Some bedrooms were seen during the inspection. These were each highly personalised and individual in style. Most of the bedrooms had photographs and other items linked to the Service Users family life outside the home. There were sufficient bathrooms and toilets to meet the national minimum standard. The communal areas in the home were considered safe and accessible for the Service Users.
Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The manager is supported well by the senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: Staff spoken to at the day of the inspection had a good understanding of their job descriptions and their responsibilities and they were able to identify the roles of other members of staff in the hierarchy. Communication between staff was good. Owing to the sudden and unexpected absence of the manager, staff have had to assume extra duties and provide additional cover to fill gaps ion the rota. The management committee have provided extra resources to make sure that service users are adequately cared for and that the home continues to provide a good standard of care. One of the committee members will be acting as management support until the committee appoint a deputy manager. CSCI have been extensively involved in the decision making processes since the departure of the manager. Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, 37 and 38 The home’s Committee is currently providing management support in the abrupt absence of the manager on account of his sudden illness. EVIDENCE: One of the Trust’s committee members who is experienced in home management has agreed to manage the home on a temporary basis until a permanent deputy manager can be found to assist the registered manager when he eventually returns to work following his recent illness. Relevant policies and procedures were in place. Systems existed to demonstrate these had been communicated to staff. Also those of relevance to service users had been shared with them. Records examined included; care plans and medication procedures.
Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 15 There were policies and procedures in place for the health, safety and welfare of service users and staff. Detailed policies and procedures were in place in relation to safe working practices. Staff were trained in First Aid, Food Hygiene and other aspects of Health and Safety. Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 16 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 18 3 3 3 3 3 3 3 3 3 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 3 3 X X 3 3 3 Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 17 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 OP31 Regulation 9(2)(b) Requirement It is required that the home’s Committee keep CSCI fully informed in all aspects of the day to day management of the home ion the light of recent sudden and unexpected circumstances relating to the absence of the manager Timescale for action 20/12/05 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 Elders (The) DS0000013633.V252632.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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