Inspection on 01/12/05 for Elgin House

This inspection was carried out on 1st 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.

Other inspections for this house

Elgin House 11/12/06

Elgin House 23/06/05

Elgin House 21/01/05

Elgin House 25/05/04

Elgin House 11/12/03

Elgin House 05/08/02

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Elgin House 89 St Lawrence Road North Wingfield Chesterfield Derbyshire S42 5LJ Lead Inspector Angela Kennedy Unannounced Inspection 1st December 2005 01:00 Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 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 Elgin House DS0000019978.V270483.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elgin House Address 89 St Lawrence Road North Wingfield Chesterfield Derbyshire S42 5LJ (01246) 854486 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) Mrs Christine Mary Renshaw Mr John Renshaw Mrs Christine Mary Renshaw Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Plus One (1) Day Care Place Date of last inspection 23rd June 2005 Brief Description of the Service: Elgin House is a converted detached house situated in North Wingfield, between Chesterfield and Clay Cross. The home is on a main bus route and close to local amenities. Accommodation is provided for 12 adults with learning disabilities requiring personal care and support. All the bedrooms are single and the home has several lounge areas. There are accessible gardens and sitting areas to the rear of the house. The home looks to enhance independence and develop learning skills. The use of community facilities is encouraged through the development of individual care plans and activity programmes. One day care place is provided. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over two and a half hours. There were twelve service users accommodated in the home on the day of inspection, six of the service users were at home and were spoken with. Two care staff were spoken with, plus the deputy and manager/owner. Documents relating to the running of the home and the care of residents were examined and a tour of the home took place. What the service does well: What has improved since the last inspection? All requirements from last inspection have been met. These included actions to ensure safe practice are maintained with the administration and documentation of service users prescribed medication, and a sufficiently detailed medication and complaints policy. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 6 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. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards 1 – 5 were not inspected at this visit. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 Service users within the home are encouraged and supported to make decisions and choices regarding their lives. EVIDENCE: Individual service users choices were demonstrated, each bedroom seen was decorated and personalised according to the individuals taste. One service user was keen to show their bedroom and its contents, in particular their personal computer of which they stated they spent much time on. Within each service users bedroom was a lockable safe style cupboard, which was used for resident personal allowance, all service users managed their own monies with staff support as required. There are staff employed within the home to launder service users clothes, however the service users spoken with were happy with this arrangement. One service spoken with said that he was able to choose what he wanted to do and felt that nothing was too much trouble for the staff. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,17 Service users are part of local community and play an active role within it. A variety of meals are offered within the home and appear to be enjoyed by service users. EVIDENCE: Service users regularly access community activities; the activity list was seen and included music therapy, pottery and crafts, which were undertaken within the nearby town. Visits to the town centre for shopping, including food shopping, ten-pin bowling and church services within the local area. All activities were subject to service users wishes. The home has its own transport of a mini people vehicle, and three cars. However service users who are physically able also access the local bus service, with staff support as required. The manager stated that all of the service users vote, if they wish to and are escorted to the local polling station as required. On the day of inspection the service users were practicing for a Christmas pantomime they were due to perform at home, all the service users and some of the staff were participating in the pantomime, service users spoken to said they were looking forward to the pantomime. The manager of the home was busy making all the costumes and said that family and friends of the residents Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 11 were coming to watch the performance. The staff were flexibly rostered on shift to support the service users in these activities. Service users enjoyed a variety of meals, including such dishes as Tai curry, which after speaking with some of the service users appeared to be a popular dish. Service users were able to choose on a daily basis their preferred choice of meal. One service user stated that he loved living at the home as the staff were very nice and the food was very good. The service users had no special or cultural dietary requirements. Service users were able to choose where and when to eat, the home offered breakfast, lunch, evening meal and supper. A small domestic style kitchen was available for service users to access to prepare drinks and snacks as required, with staff support if needed. On Tuesdays some of the service users participated in independent living skills within the home, this involved planning a meal followed by shopping for the food, preparing and cooking the meal, with staff support and assistance as required. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Service users are protected by the medication policies and procedures that are in place within the home. EVIDENCE: The home used the NOMAD (monitored dosage) system for medication, which is stored securely in a locked cupboard. Senior care staff, who have undergone the relevant training to administer medication then take the NOMAD cassettes to the service user who self administers the correct medication under staff supervision and then signs the medication administration chart. One resident who self-administers does not use the NOMAD system, and dispenses their medication directly from the containers supplied from the pharmacy under staff supervision. This was a requirement from the previous inspection that has now been met. Of the medication administration charts seen, all of the prescribed medication times had signatures and codes were available on the charts, which were used to identify reasons when medicines had not been administered. This was a requirement from the previous inspection that has now been met. The policy for the administration and control of medicines included reference to keeping the medication in the home for 7 days following the death of a service user; this was a requirement from the last inspection that has now been met. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The relationship between the staff and service users and the homes policies promotes service users protection. EVIDENCE: The complaints policy was seen and included a timescale of 28 days for a response to complaints; this was a requirement from the last inspection, which has now been met. Service user meetings were held, some of the minutes of these meetings were seen and demonstrated that service users were able to raise issues, which were then dealt with promptly and appropriately. One service user spoken with stated that if he had any concerns he could discuss this with the staff that were always very helpful and friendly and would sort it out the concern out for him. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29,30 The home was clean, comfortable, well equipped in general, and well maintained, providing a safe and pleasant environment for residents. EVIDENCE: Specialist equipment was provided to meet the assessed needs of the service users, such as overhead-tracking hoist in some of the bedrooms and bathrooms. However one service user who had been admitted to the home the day before inspection, was found on assessment to require a hoisting facility within their bedroom, which was not in place. The manager stated that the nursing assessment sent prior to admission had not fully reflected this service users needs. Discussions took place with the manager as to the provision of alternative moving and handling equipment such as a mobile hoist, which should be used whilst awaiting the fitment of overhead hoist tracking. A tour of the home was undertaken; this included the laundry area, which housed a washing machine with a built in sluicing facility, hand washing facilities were also provided within this area. Staff were employed within the home to undertake the laundering of service users clothes and linen. Policies regarding the control of infection were seen and appeared robust in detail. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 15 Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Staff receive the appropriate training to ensure that the service users needs are met. EVIDENCE: The training and development plan were seen and demonstrated that an annual budget was in place to provide staff training that met the service users needs; this included fire safety training, first aid and moving and handling procedures training, all training certificates seen were up to date. Fire training was planned within the home for the following day, one service user stated that the fireman were coming the next day and appeared to be looking forward to this. The induction programme was seen and demonstrated that this commenced on the day of appointment and included all the relevant training. Staff were allocated a mentor on induction, this person would continue to mentor them until the manager, mentor and new member of staff felt this was no longer required. All staff employed at the home have a successfully completed their National Vocational Qualification (NVQ) 2 in care, four of the staff have an NVQ 3 in care and two of the staff have an NVQ 4 in care, one of these being the deputy manager who is intending to take over as manager within the near future. The manager, who has many years of experience within learning disabilities, was planning to retire soon from her position as manager. One member of care staff spoken with stated that she had worked at the home for many years and loved working there, as there was a good atmosphere and Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 17 a homely, family like environment. She stated that staff training and supervision were very good. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 42 Service users views and opinions are reviewed and underpin the homes development. The homes safe working practices promotes Service users safety and welfare. EVIDENCE: The homes Quality Assurance policy was seen, this was reinforced by the quality control systems that were in place, which included a quality control book that looked at issues that service users had raised within their bi-monthly meetings, and documented the outcomes of these discussions, this demonstrates the home has a self monitoring programme in place which is underpinned by the views and opinions of the service users. However these systems could be improved with a published feedback made available to service users, prospective service users, and the commission for social care inspection (and other interested parties), this would demonstrate how the views of service users shape the delivery of service, and may be of interest to a person considering the home as a place to reside. The safe working practices regarding moving and handling were in place within the home, the fire safety equipment, i.e. fire extinguishers and fire blankets Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 19 were seen to be in good working order and the fire escape routes, fire procedure in the event of a fire and assembly point were clearly marked. Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X 2 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elgin House Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 3 X DS0000019978.V270483.R01.S.doc Version 5.0 Page 21 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 29 Regulation 23 (2) Requirement Overhead hoist tracking or suitable moving and handling equipment must be in place within a service users’ bedroom to ensure their physical needs are met The results /actions taken by the quality control systems in place, must be published and made available to current and prospective service users, their representatives and other interested parties, including CSCI Timescale for action 16/12/05 2. 39 24 (2) 31/03/06 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 Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Elgin House DS0000019978.V270483.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!