Inspection on 21/07/05 for Eleanor Palmer Trust Home

This inspection was carried out on 21st July 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.

Other inspections for this house

Eleanor Palmer Trust Home 10/01/07

Eleanor Palmer Trust Home 13/02/06

Eleanor Palmer Trust Home 16/02/05

Eleanor Palmer Trust Home 24/09/04

Eleanor Palmer Trust Home 16/02/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Eleanor Palmer Trust Home 27 Cantelowes House Spring Close Barnet, Hertfordshire EN5 2UR Lead Inspector Tola Akinde-Hummel Unannounced 21 July 2005 @ 10.00 am 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. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Eleanor Palmer Trust Home Address 27, Cantelowes House, Spring Close, Barnet, Hertfordshire EN5 2UR 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) 020 8364 8003 020 8449 7215 Anthony Grimwade of Eleanor Palmer Trust Vacant Post PC - Care Home only 32 beds Category(ies) of OP - Old Age registration, with number of places Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16 February 2005 Brief Description of the Service: The Eleanor Palmer Trust is a care home registered to provide care for 32 older people. The home is owned by a registered charity called The Eleanor Palmer Trust. It is managed by a board of Trustees. The homes aims and objectives state that it provides acommodation where sensitive and skillful care is available and it aims to enable service users to live as normal a life as possible within an environment where they are respected. Eleanor Palmer is a purpose built care home on two floors. A lift shaft connects the two floors. There are thirty single bedrooms and one double bedroom. On the ground floor are interconnected lounge areas, a dining room, a reception area, the main office, kitchen and laundry room. On the first floor, in addition to bedrooms, there is a large meeting room a kitchenette and the managers office. There is a communal assisted bathroom on each floor. There are gardens to the side and the rear of the home as well as the patio area. The gardens are pertly paved and are accessible to service users. The Eleanor Palmer Trust Home is in a pleasant residential area of Barnet close to local shops and amenities. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 6 This unannounced inspection took six hours to complete. The new manager Ms Diane Burgess was present throughout the inspection. The inspector had a tour of the building, spoke to four service users, four staff, and a visiting health professional. The inspector examined care plans, Health and Safety records, staff files, medication administration, complaints and the recording of accidents and incidents. The inspector also looked at some of the policies and procedures in the home. The inspector would like to thank the service users , the staff and the Manager for their participation in the inspection. What the service does well: What has improved since the last inspection? What they could do better: This inspection has generated eight requirements. As the home has a new manger there is a shift in the way business is conducted. The manager has identified many changes that need to be made and these are also reflected in this report. The manager must ensure that staff pay attention to the signing of assessments by staff and signing of care plans by service users and /or their representatives. Staff must standardise the care plans to ensure that information is consistent throughout. This will benefit service users who will know that all their care needs are considered and that staff will make every attempt to meet these. The complaint procedure requires minor amendment to demonstrate that all action taken is clearly recorded. This includes who needs to be responded to and when. This allows easy tracking of the progress of any complaint. The EASTSIDE HOUSE REST HOME Version 1.10 Page 7 area of most concern is the appointment of staff who have not completed their Criminal records bureau check. This must not occur without the permission of the CSCI, and only after a satisfactory POVA check has been completed. The home must also take care to ensure that two different written references are obtained for all staff offered employment in the home. This process is designed to help safeguard service users from being exposed to unsuitable potential carers. The home must label sauces that are used by service users where they are useful only up to six weeks after the date of opening. Service users are then at a minimal risk of food poisoning from these products. 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. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 8 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 Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 9 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) 3,5 Service users have detailed assessments prior to entering the home. The home must standardise their files to ensure that all service users benefit from the same level of understanding of their needs. Staff in the home must sign their completed assessments. EVIDENCE: Six service users files were inspected. All files had assessments completed by the agency referring the service user to the home for admission. These were detailed. Barnet Social services, and hospital medical staff completed the assessments. Staff at Eleanor Palmer also completed assessments of service users care needs. One care plan did not have the signature of the assessor, this is a requirement of the report. The care plan information contained detailed risk assessments. The inspector found that service users files who receive respite have a checklist that ensures all relevant information is on the file. The other plans require standardisation. Some files do not contain a record of activities, not all files have pictures of service users and not all files contain medical appointment sheets. This is a requirement of the report. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 10 All services users spoken to advised the inspector that they or their relatives had visited the home prior to admission and continue to be welcomed there. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 11 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) 7,8,9,10 Service user care plans contain adequate information. Service user involvement in their agreed plans of care is not documented. The health needs of service users are well met by the home and visiting professionals. Service users dignity is well maintained. EVIDENCE: The service users care plans contain details of service users present and past medical history. These are kept at the front of the file and some include a medical appointments list. Service users have their health needs monitored appropriately. On the day of inspection the inspector met the Community Psychiatric nurse (CPN) who sees service users in the home. The CPN said that she has a good relationship with staff and gives support with monitoring medication. And managing behaviour. The CPN visits every two weeks and is available at other times if there is a problem. The CPN has known the home since 1997 and believes that staff are very caring and work hard for service users and said, “ I would put my relative here, and I have asked them to keep a bed for me” The care plans are reviewed on a monthly basis. The plans are updated where there have been changes to the care. The home has day care plans and night care plans. However, service users or their representatives do not sign the Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 12 care plans. This is a requirement of this report. The inspector looked at the storage and administration of medication. The medication folder does not contain pictures of service users. It is recommended that recent photographs of service users are placed on their medication charts. The manager advised that she in the process of putting this in place. The medication is kept securely in a large cupboard in the main office. The MAR sheets are signed at the time medication is administered. Service users said they get their medication promptly and to date there have been no issues for service users in relation to administration. The inspector spoke to four service users who all said that they receive good care from staff who attend quickly if called. One service user said that he receives personal care and staff treat him with respect. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 13 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) 12,13,15 Service users have a range of activities to choose from and staff ensure they are stimulated inside and outside of the home. Visitors are welcomed into the home. Meals are judged to be appetising and plentiful. EVIDENCE: During the inspection staff in the home read the daily newspapers to those service users who were unable to read the papers themselves. The inspector spoke to three service users who all said that there is a programme of activities service users can get involved in. The activities on offer are displayed on a board outside the dining room. One service users said that there are parties and barbecues organised in the home by staff. There are also day trips and there have been tea dances that service users were able to attend. At the time of inspection service users had participated in a light exercise class and were listening to music from the past, which some service users were singing along to. Service users also have the opportunity to go on holiday assisted by staff in the home. Two service users advised that they see their relatives regularly in private if they wish and they are welcomed in the home. There is a small kitchen off the main lounge where visitors can make themselves drinks during their visit. There are no restrictions on visiting times. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 14 Service users told the inspector that they are able to choose how they spend their time and they chose their times to go to bed and wake up in the mornings. The service users gave positive feedback about the food provided in the home. The menus are printed and displayed in the dining area, which is bright and welcoming. Three courses are served at lunchtime by staff who then sit and eat with service users, sitting next to those who need assistance. Service users are also given menus on the table just before meals are served. The chef is aware of service users on special diets and caters for those who do not like particular food. The tables have table clothes are well laid prior to lunch being served. The inspection of the kitchen found it to be well managed with all paperwork in order. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 15 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) 16,17,18 The policy and procedure for dealing with complaints is robust and staff are aware of the procedures ensuring the protection of vulnerable adults. The home must record clearly the actions taken of all complaints. EVIDENCE: Then home has dealt with two complaints since the last inspection. One was a serious complaint, which resulted in the dismissal of a member of staff. The home followed it’s own and Barnet’s Adult Protection procedures adequately and it is clear that from the complaint that staff are aware of the procedures relating to the protection of vulnerable adults and whistle blowing. There are four members of staff in the home who will attend Protection of vulnerable adults training shortly. The second complaint is outstanding but within timescale and is currently being dealt with. Social services have been informed and are completing their own investigation. The home must ensure that they clearly record the actions taken of all complaints. One service user informed the inspector that she completed a postal vote in the last general election. All service users have their own front door with post boxes therefore all mail is delivered to them unopened. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 16 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) 19,20,21,26 The standard of cleanliness and maintenance in the home is of a high standard. Service users personal toiletries should not be left in the bathrooms and toilets. EVIDENCE: Eleanor Palmer Trust Home is attractive and pleasant throughout. There is sufficient space provided which includes interconnected lounge areas and the dining room on the ground floor, as well as a first floor room used for activities. There is a large entrance hall with comfortable chairs where service users can relax. There is a range of bathing facilities for service users including a wheelchair accessible shower room, assisted bathrooms and conventional bathrooms. There are also adequate toilet facilities in the home. Some staff have been leaving service users personal items in the bathrooms and toilets which have been used when assisting service users. This is not appropriate and the manager had discussed this the day previous to the inspection with staff. A recommendation is made that all service users personal items are returned to their rooms after any personal care is given. On the day of inspection, the home was clean and hygienic throughout. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 17 Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 18 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) 27,29 The recruitment procedure is not robust enough to provide the safeguards required to protect people living in the home. EVIDENCE: The level of staffing was discussed with the manager and the senior carer. There are four members of staff to twelve service users. There are five staff members available on each shift. At night there are two waking night staff and a senior member of staff providing weekend cover. Domestic, administrative, maintainence and catering staff also support the home. The inspector looked at the staffing files of the two most recently recruited staff. The inspector found that one domestic assistant and one new care staff have not yet received clearance from the criminal records bureau (CRB). These members must not have unsupervised access to service users until their CRB checks have been received and are satisfactory. The member of the domestic staff had only one written reference. All other documentation was up to date including a written test that included protection of vulnerable adults and ensuring the dignity of service users. A requirement in respect of the reference and CRB checks is made I this report. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 19 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) 31,32,33,38 The manager has begun to implement positive changes in the management of the home. Health and safety requirements in the home are kept up to date. The policies and procedures in the home require review. The home must ensure that all foodstuffs are labelled and not used past expiry. EVIDENCE: The manager has recently been appointed to the home. The manager has had previous experience of managing care homes. In the three months since her arrival, Ms Burgess has got to know the service users and has implemented some changes to the way the home is managed. The manager has appointed senior carers to enable staff to develop in their role and take on more responsibility. The manager has put tablecloths on the tables to make service users experience in the dining room more pleasant and is consulting openly with staff. One staff member told the inspector that they often did not know what was going on in the home before and were unclear about how decisions Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 20 were being made. “Now we feel more included in the decision making process.” Despite the previous management style, staff have remained employed in the home for a number of years as they enjoy the relationships they have built with service users and other staff. All service users and staff spoken to are pleased with the new manager who is enthusiastic and engaging. One staff member said “The new manager is great”. One service user said, “The manager Diane is really nice”. The inspector found that a number of policies and procedures had not been reviewed for a number of years. The medication policy requires review as a priority. The review of policies and procedures is a requirement of this report. The manager produced evidence of weekly fire alarm tests. The emergency lighting, hoists, lift servicing, Portable appliance testing and nurse alarm call system have all been serviced. The wheelchairs have also been serviced. At the time of inspection, the home was due to be visited for a fire risk assessment to be completed on 27/7/05. The manager assures the inspector that all actions arising from this assessment will be undertaken. During a tour of the kitchens, the inspector noticed that sauces are not labelled at the time of opening. This means they may not be discarded within the correct timescale. A requirement is made in respect of this. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 21 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 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 2 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 3 3 3 2 x x x x 2 Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 22 No 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. 1. Standard 3 Regulation 12(1) (b) Requirement The registered person must ensure that care plans for service users are standardised and incorporate all aspects of physical, health and social care needs. The registered person must ensure that those staff members carrying out asessments sign the assessment when it is complete. The registered person must ensure that all service users sign their care plans. The complaints procedure must record clearly all action that has been taken. The registered person must ensure that two members of staff do not work unsupervised with service users until their CRB check has been returned satisfactorily. The registered person must ensure that an additional reference is requested for one member of staff. The registered person must not employ any staff in future without a satisfactory criminal records bureau check. The registered person must Timescale for action 30/10/05 2. 3 14,(1) (a) 30/08/05 3. 4. 5. 7 16 29 15 (1) 22 (4) 19 (1) (b)(i), schedule 2 19 (1) (b)(i) schedule 2 19, (1)(a)(b), schedule 2 24(1)(a) 30/09/05 30/08/05 15/08/05 6. 29 15/08/05 7. 29 10/08/05 8. 33 30/12/05 Page 23 Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 9. 38 16 (g) review all policies and procedures relevant to the effective running of the home. The registered person must ensure that opened sauces are labelled and dated when opened to mimimise the risk of food poisoning. 15/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 7 25 Good Practice Recommendations The registered person should ensure that all service users up to date photographs apear on the medication administration record. The registered person should consider removing all personal items from the bathrooms. Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Solar House, 1st Floor, 282 Chase Road, Southgate, London, N14 6HA 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 Eleanor Palmer Trust Home G59 S10427 Eleanor Palmer V231507 21.07.05 Stage 4.doc Version 1.30 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!