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Inspection on 05/12/05 for Elderwood Residential Home

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

This inspection was carried out on 5th December 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

What has improved since the last inspection?

What the care home could do better:

2 requirements have been made as a result of this inspection and these are shown on page 20 of this report. To make medicine administration safer, the home`s system of receiving medication upon service users` admission must be reviewed to prevent the secondary dispensing of medication. To ensure the manager has the necessary qualifications required to run a care home, the home`s manager must complete the Registered Managers Award she has commenced. 2 recommendations have also been made and these are shown on page 20 of this report. As highlighted in the previous inspection report, 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. Although it is acknowledged that staff training needs are identified, and individual staff training records are kept, benefit would be obtained from collating individual training needs into a document setting out the overall collective training needs of the whole staff team.

CARE HOMES FOR OLDER PEOPLE Elderwood Residential Home Westmoreland Street Darlington Durham DL3 0FB Lead Inspector Mr Paul Emmerson Unannounced Inspection 5 December 2005 10:15 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 Elderwood Residential Home DS0000000816.V259656.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. Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elderwood Residential Home Address Westmoreland Street Darlington Durham DL3 0FB 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) 01325 368256 jill.burt@anchor.org.uk Anchor Trust Eileen Elizabeth Jill Burt Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3 August 2005 Brief Description of the Service: Elderwood is a care home providing personal care and accommodation for up to 40 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 Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. By law we have 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 7 hours, on the morning and afternoon of Monday 5 December 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 were assessed during the last inspection of the home. The inspector looked around the building and a number of records were examined. 16 service users, 6 visitors, a GP, a consultant psychiatrist, a physiotherapist, the manager, deputy manager and 9 members of staff were spoken to. What the service does well: Elderwood was purpose built and has been well maintained and upgraded where necessary. It provides a very good standard of care to the people living there. Care is provided by a well-trained, settled, committed and well-led staff team. Care planning arrangements are to a good standard. Care plans are well written and document: assessed needs; actions required and being taken to meet them; ongoing evaluation; and reviews. 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. For example, in providing additional support at mealtimes to ensure people dine with dignity. Catering arrangements and food provided is of a commendable standard. Meals choices are offered to people whilst they are seated in the dining room. There is a commitment to obtaining feedback to ensure people’s preferences are catered for. One service user said, “It’s very good, they are very helpful – if you want anything they try to help”. Another person said, “I can’t fault it”. A relative said, “The care is first rate and I think the home is very good – as good as a 3 or 4 star hotel”. Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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 Residential Home DS0000000816.V259656.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 Elderwood Residential Home DS0000000816.V259656.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): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. EVIDENCE: NA Elderwood Residential Home DS0000000816.V259656.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 & 10. Personal and healthcare needs are adequately met. Appropriate care plans are prepared. Any medicines required are dealt with correctly. EVIDENCE: The inspector spent time in the company of service users and saw that they are well cared for and comfortable in their home. Management and staff ensure that service users’ health care needs are met. Experienced and well-qualified staff are employed to provide care where it is required. Where more specialist intervention is required it is sought. Records checked confirm that contact with GPs and other health professionals is maintained. A GP, a consultant psychiatrist and a physiotherapist visiting the home provided positive feedback. The inspector observed, through their actions and responses, that staff respect service users’ privacy and dignity. Service users spoken to expressed their satisfaction with the manner and attitude of the staff. One person said, “The staff are very nice, first rate”, another person said, “They’re very kind I’ll give you that”. Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 10 The inspector looked at 4 care plans - ‘Lifestyle Agreements’. These detail the action to be taken to ensure assessed needs are appropriately met. Risk assessments are undertaken. Staff review care plans on a monthly basis. Any changes in need and care required are documented and actioned. Care plans are drawn up with service users’ involvement and agreement. Formal review meetings are held every 6 months, prior to which a ‘Check List for Resident Review’ document is completed. However, as highlighted in the previous inspection report, 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. The home’s systems relating to medication were checked. Generally medication was found to be in order. The home now uses a monitored dosage system and care staff who administer medicines have received training in its use. The home has adequate policies, procedures and systems in place relating to the receipt, recording, storage, handling, administration and disposal of medicines. However, where people are admitted into the home for respite care and they come with monitored dosage cassettes that have been prepared other than by a pharmacist, such secondary dispensing is open to mistakes occurring. The home’s system of receiving medication on service users’ admission must be reviewed to prevent the secondary dispensing of medication. Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 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 the following standard(s): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. EVIDENCE: NA Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 12 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 & 18. Complaints and adult protection systems in the home serve to safeguard service users. EVIDENCE: Information about complaints, how and who to make them to, is made available to service users and their families through information displayed on the home’s notice boards and in the home’s ‘Service Users Guide’. Service users’ and families’ views are obtained through regular contact and an ‘open door policy’. Residents / Family Meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. One person spoken to said, “I’ve no complaints, they listen to me to see if I’m happy”. Another person said, “If I needed to I’d speak to the manager or whoever I felt I had to”. The home, through its parent organisation, has detailed complaints and adult protection procedures. Copies of these were seen to be available for staff use. Staff interviewed voiced a commitment to the service users they work with and to upholding service users’ rights. The parent organisations policy and procedure documents relating to adult protection provide information and guidance to staff. Staff training in this area is also provided. A copy of ‘Durham & Darlington Adult Protection Committee’s Inter-Agency Adult Protection Policy & Procedures’ on abuse and the protection of vulnerable adults is available in the home. Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 13 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): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. EVIDENCE: NA Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 14 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 & 30. Sufficient staff are employed. The home has a settled, well-trained and wellled staff team. EVIDENCE: There is a settled staff team. Many of the staff spoken to have worked at Elderwood for a number of years and they know the service users well. Excluding the manager and ancillary staff, current staffing levels for Elderwood are: a senior carer and 4 care assistants between 7:45 am – 10:00 pm, and a senior carer and 2 care assistants throughout the night. In addition, one of the morning carers starts ¾ hour earlier at 7:00 am and the manager states that an extra member of staff is to be rostered between 8:00 am – 11:00 am & 6:00 pm – 9:00 pm. From discussions with management and staff, and from an examination of duty rosters, sufficient staff are generally employed and rostered to work within the home. Although these staffing levels should be kept under review, they are considered adequate to meet the needs and numbers of the people currently accommodated. From staff files checked and people spoken to, recruitment procedures within the home, and through the parent organisation are safe. Records confirm that CRB (Criminal Records Bureau) disclosure checks are carried out for all staff. Applicants for employment complete an application form and 2 references are obtained. A reference from the last employer is requested, plus another; any Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 15 gaps in employment are explored at interview. Each member of staff receives a contract of employment and a job description. All new staff undertake a TOPPS based induction programme. Staff training is given a high priority. 63 of care staff have an NVQ (National Vocational Qualification) at level 2 or above. Auxiliary staff, for example the head cook (NVQ3), have also completed NVQ training. Core training such as in First Aid and Moving and Handling is arranged, along with other courses such as continence and catheter care. However, although it is acknowledged that staff training needs are identified, and individual staff training records are kept, benefit would be obtained from collating individual training needs into a document setting out the overall collective training needs of the whole staff team. Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 16 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, 33, 35 & 38. Elderwood is a well-run care home. Appropriate quality assurance systems are in place to identify and rectify any concerns. EVIDENCE: The registered manager is well-qualified and experienced. She has almost completed a ‘Registered Managers Award’ training course. Nevertheless, this course must be completed by September 2007. Service users’ and families’ views are obtained through regular contact and an ‘open door policy’. Residents Meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. The home has a recognisable quality assurance system, which serves to ensure that Elderwood is run in the best interests of the people who live there. Senior managers visit regularly and reports required under Regulation 26 of the Care Homes Regulations 2001 are completed and forwarded to CSCI. Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 17 Records in the home are to a good standard. The home has a range of appropriate policies and procedures, and systems are in place to ensure service users’ health and safety is protected. For example, risk assessments are carried out within care planning arrangements and are regularly reviewed. Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X 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 2 X 3 X 3 X X 3 Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 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 OP9 Regulation 13(2) Requirement The home’s system of receiving medication upon service users’ admission must be reviewed to prevent the secondary dispensing of medication. The home’s manager must complete the ‘Registered Managers Award’. Timescale for action 01/02/06 2. OP31 9 30/09/07 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 OP7 Good Practice Recommendations As highlighted in the previous inspection report, 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. Although it is acknowledged that staff training needs are identified, and individual staff training records are kept, benefit would be obtained from collating individual training needs into a document setting out the overall collective training needs of the whole staff team. 2. OP30 Elderwood Residential Home DS0000000816.V259656.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Darlington Area Office 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. 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