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Inspection on 03/08/05 for Elderwood Residential Home

Also see our care home review for Elderwood Residential Home for more information

This inspection was carried out on 3rd August 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Elderwood provides a very good standard of care to the people living there. Care is provided by a well trained, settled, committed and well lead staff team. The home is committed to putting residents first, in everything it does. Staff are encouraged to think about their actions and life in the home from the service users` perspective. Catering arrangements and food provided within in Elderwood is of a commendable standard. Meal choices are offered to service users whilst they are seated in the dining room. There is a commitment to obtaining feedback to ensure people`s preferences are catered for. The home was purpose built and is well maintained.

What has improved since the last inspection?

Since the last inspection the home`s entrance foyer has been re-designed and refurbished: there is a new entrance door and a new entrance / security surveillance system covering it. The floor in one of the dining rooms has been re-covered recently with an attractive non-slip, wood-effect vinyl. Plans have been made to update / upgrade the home`s bathroom facilities.The home has recently completed a `dining with dignity` training programme. The inspector was present when the main meal was being served. It was noted that every member of staff and management made themselves available to provide assistance. This resulted in the mealtime being an unhurried and dignified social occasion.

What the care home could do better:

The home`s assessment and care plans are prepared under various headings within `individual lifestyle agreements`. These reflect a range of needs, aspirations and lifestyle preferences and are generally appropriate for most service users. However, the headings are fairly prescriptive and the home / organisation should be mindful to consider any needs, aspirations or lifestyle preferences not covered under the various headings. For example, the mental health needs of older people require further consideration.

CARE HOMES FOR OLDER PEOPLE Elderwood Care Home Westmoreland Street Darlington County Durham DL3 0FB Lead Inspector Paul Emmerson Unannounced Inspection 3rd August 2005 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 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. Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Elderwood Care Home Address Westmoreland Street Darlington County Durham DL3 6DS 01325 368256 01325 350801 Jill.Burt@anchor.org.uk Anchor Trust Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs. Jill Burt CRH 40 Category(ies) of OP Old age (40) registration, with number of places Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26 Jan 2005 Brief Description of the Service: Elderwood is a care home providing personal care and accommodation for up to forty older people. The home is one of a number of homes throughout the country run by the Anchor Trust. Elderwood is situated off North Road in Darlington. It is a two-storey building and was purpose built in 1991. The home is accessible throughout and there is a passenger lift between floors. All bedrooms are for single occupancy and have en-suite facilities. There is a dining room and a lounge on each floor. The home also has a garden room. Bath / shower rooms and separate WCs are also provided throughout the home. Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. CSCI has a statutory obligation to inspect all care homes at least twice a year. This unannounced inspection was carried out in accordance with this obligation. The inspection took place over 6½ hours, on the morning and afternoon of Wednesday 3rd August 2005. In line with current CSCI policy on ‘Proportionality’, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion will be assessed during the next inspection of Elderwood. The inspection also looked at any issues raised in the last inspection of the home. The inspector looked around the building and a number of records were examined. 7 service users, 8 visitors, a district nurse, the manager, area manager and 8 members of staff were spoken to. What the service does well: What has improved since the last inspection? Since the last inspection the home’s entrance foyer has been re-designed and refurbished: there is a new entrance door and a new entrance / security surveillance system covering it. The floor in one of the dining rooms has been re-covered recently with an attractive non-slip, wood-effect vinyl. Plans have been made to update / upgrade the home’s bathroom facilities. Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 6 The home has recently completed a ‘dining with dignity’ training programme. The inspector was present when the main meal was being served. It was noted that every member of staff and management made themselves available to provide assistance. This resulted in the mealtime being an unhurried and dignified social occasion. 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. Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 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 standard(s) 3 Admissions to the home are appropriately managed. EVIDENCE: Elderwood is registered to accommodate up to 40 service users. There are currently no vacancies. More recently admitted service users and some of their relatives were spoken to. One service user said, “It’s wonderful, I should have come here sooner”. A relative said, “It’s a lovely place, I’ve nothing bad to say. He’s well looked after, everything he needs they are there for him”. Elderwood has standard initial assessment and care plan documents. Recently admitted service users’ care plans were examined. These showed initial assessments had been conducted, which were informing the delivery of the people’s care. These documents are being appropriately developed in to longer-term records of the care required and being provided by the home. Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 9 Where service users are admitted through care management arrangements, assessment / care plan information is also obtained from the Local Authority Social Services Department and / or via Hospital discharge arrangements. Subsequent to admission, reviews are arranged appropriately. The home’s assessment and care plans are prepared under various headings within individual lifestyle agreements. These reflect a range of needs, aspirations and lifestyle preferences and are generally appropriate for most service users. However, the headings are fairly prescriptive and the home / organisation should be mindful to consider any needs, aspirations or lifestyle preferences not covered under the various headings. For example, the mental health needs of older people require further consideration. To ensure that care planning arrangements meet service users’ needs, assessment and care plan documentation should be amended to better consider the mental health needs of older people. Any issues relating to challenging behaviour should also be explored. Service users considering a move into Elderwood would be welcome to visit with their relatives, have a meal and stay overnight if necessary. In this way, service users can get to know the home before moving in. Any move into Elderwood is on an initial trial basis. Approximately six-weeks after admission a formal review meeting is held to consider permanency. Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 10 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 standard(s) None of these outcomes / standards were assessed on this occasion. They will be examined during the next inspection of the home. However, as highlighted above, to ensure that care planning arrangements meet service users’ needs, assessment and care plan documentation should be amended to better consider the mental health needs of older people. Issues relating to challenging behaviour should also be explored. EVIDENCE: N/A Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12, 13, 14 & 15 Social needs are recognised and provided for. The home has open visiting arrangements. Service users’ rights are respected and choice is provided. Meals and catering arrangements are of a commendable standard. EVIDENCE: Throughout the inspection, staff were seen to engage with service users in social interaction. An activities co-ordinator is also employed, who arranges social events and activities. One service user said, “The girl who does the activities is very good, I like the quizzes and the organist who comes”. On the morning of the inspection, service users were seen to enjoy an exercise / mobility class. Elderwood has open visiting arrangements. One service user said, “My family can come in when they want you know”. The inspector spoke to 8 visitors who also provided positive feedback. Communication in the home is good. One visitor said, “It’s very good, everyone is very friendly, the meals are very good, I’ve no complaints at all”. One service user spoke about the friendliness of the staff and said, “I feel I couldn’t have found anywhere nicer”. Observations made by the inspector Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 12 confirmed that people are treated with respect. From discussions with staff and management, there is a shared goal in the home to promote improvement. Catering arrangements and food provided within in Elderwood is of a good quality. Activity in this area is commended. Staff have completed ‘focus on food’ training courses. For the last 3 years running, the home has received a ‘Heartbeat Award’ for its commitment to healthy food, food standards generally and food hygiene. Food is served in adequate quantity and meets service users’ nutritional needs. One service user said, “The food’s good, always hot, nice choices”. When the inspector asked another service user if they had enjoyed their dinner the person replied, “Yes it was smashing”. Where necessary, specialist diets are provided and if a soft diet is required, food is pureed and reformed in appropriately shaped moulds for serving. Meals are served in the ground and first floor dining rooms or in service users’ rooms if they choose. Assistance is provided where it is required. The home has recently completed a ‘dining with dignity’ training programme. The inspector was present when the main meal was being served. It was noted that every member of staff and management made themselves available to provide assistance. This resulted in the mealtime being an unhurried and dignified social occasion. A choice of meals is provided from a four week rotating / seasonal menu. These menus include recipes provided by service users. Service users are provided with a choice of main meals whilst they are seated at the table and where vegetables are served from tureens. Service users’ meal choices are recorded and form a ‘record of food provided’ within the home. These records are used as an additional safeguard to monitor service users’ nutritional needs and, through close work between care and kitchen staff, link into the home’s nutritional needs assessments. The home has 2 sets of chair scales to record and monitor service users’ weight. Kitchen staff obtain feedback by visiting service users - any comments are recorded and are responded to accordingly. Feedback is also obtained from residents’ meetings. Circulated notes, from a residents’ meeting held on 28 July 2005, record that during the meeting, “Residents were reminded that the chef manager would really appreciate any suggestions residents may have for the menus”. The notes also record that, “Residents said they were satisfied with the meals and had no complaints”. Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 13 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 standard(s) None of these outcomes / standards were assessed on this occasion. They will be examined during the next inspection of the home. EVIDENCE: N/A Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 14 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 standard(s) 19 & 26 Elderwood is safe and well maintained. The home is clean, tidy and free from offensive odours. EVIDENCE: Elderwood was purpose built as a care home. Since the last inspection the home’s entrance foyer has been re-designed and refurbished: there is a new entrance door and a new entrance / security surveillance system covering it. The floor in one of the dining rooms has been re-covered recently with an attractive non-slip, wood-effect vinyl. Plans have been made to update / upgrade the home’s bathroom facilities. There is a lounge and separate dining room on each floor of the home. There is also a pleasant garden room on the ground floor and a seating area on the first floor landing area. Service users can thus spend time alone or in the company of others. Service users’ needs are met in comfort and safety. The furnishings and lighting throughout the home are domestic in nature and create a homely Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 15 atmosphere. The home and grounds are well maintained, wheelchair accessible. The garden has seating provided. All bedrooms have en-suite facilities. Additional WCs are also appropriately located throughout the home. Bath / shower rooms within the home are suitably adapted, with additional equipment available, to meet the needs of the service users accommodated. The inspector had a good look around the building and saw that most people have personalised their rooms with their own furniture and personal belongings. The inspector saw that the home was clean, tidy and odour free. The premises are safe and well maintained. There are sluice facilities on both floors of the home. Although paper towel dispensers should be installed, there are appropriate hand-washing facilities available throughout the home. The home has a well-equipped laundry room, for which a number of new appliances have been purchased and within which each of the home’s service user’s laundry is washed separately. Activity in this area is commended. Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these outcomes / standards were assessed on this occasion. They will be examined during the next inspection of the home. EVIDENCE: Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these outcomes / standards were assessed on this occasion. They will be examined during the next inspection of the home. However, as highlighted in previous inspection reports, the registered manager should complete a management-training course at NVQ level 4 or equivalent by 2005. EVIDENCE: N/A Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 4 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 19 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 Regulation None 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. Refer to Standard 3&7 Good Practice Recommendations Assessment and care plan documentation should be amended to better consider the mental health needs of older people. Issues relating to challenging behaviour should also be explored. As highlighted in previous inspection reports, the registered manager should complete a managementtraining course at NVQ level 4 or equivalent by 2005. 2. 31 Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection No 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Elderwood Care Home B54 S816 Elderwood V227153 030805 Stage 4.doc Version 1.30 Page 21 - 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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