Inspection on 11/12/06 for Elgin House

This inspection was carried out on 11th December 2006.

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 01/12/05

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 Denise Bate Key Unannounced Inspection 14th December 2006 09:30 Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 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.V320858.R01.S.doc Version 5.2 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.V320858.R01.S.doc Version 5.2 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 Helenor Renshaw-Harris Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Plus One (1) Day Care Place Date of last inspection 1st December 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. Charges are £340.20 per week, which includes the price of a week’s holiday. There are no ‘hidden extras’ that are charged for, although service users do contribute their mobility allowance to the running of the home’s minibus, which is accessed by everyone. Service users pay for services like hairdressing that are arranged outside the home, and towards some activities. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection which lasted just over 4 hours. Four service users were spoken with during the inspection to ascertain their views of the home. There was an opportunity to chat with other residents informally over tea. The manager, proprietor and one staff member were interviewed. Written information was provided by the manager prior to the inspection. Nine service user surveys were received prior to the inspection providing feedback on the service. An assessment was made of the progress by the registered persons to address the requirements made at previous inspections. Three service users were case tracked. A number of records were examined, including care planning documentation, minutes of meetings, regulation 26 visit records, staff files and medication records. A tour of the building took place. The service user guide and statement of purpose were provided. The inspector was welcomed by service users who were open, friendly and enthusiastic. What the service does well: Service Users at Elgin house continue to be encouraged and supported to participate in community activities such as leisure, arts and crafts, and educational and training facilities. There is also a choice of activities within the home, and regular contact with family and friends. Some service users spoken to were going to their families for Christmas. Elgin House provides a homely, family style life were choices and independence are maintained. Service Users spoke highly of the care given at Elgin House, and the positive and relaxed relationship between staff and service users was evident in their day to day interaction. There is a stable group of service users who have made this their home. One service user commented ‘this is the best home I have ever been in’. Another service user commented ‘ I couldn’t be happier’. Care planning documentation reflects the service user as an individual, and risk assessments are in place. There is a stable staff group, with all staff being offered excellent training opportunities. The home was clean, tidy and well maintained. Service users rooms are personalised and comfortable. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 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.V320858.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to ensure residents can make an informed choice about where they live. EVIDENCE: The home has a statement of purpose and service user guide that provides information about the home, including complaints. It is clear and well written, and includes photographs of the home. It includes a privacy and dignity statement and the home’s philosophy which includes ‘full integration of residents into community life’ The home’s policy is to invite prospective service users to the home for tea and overnight stays. The initial contract is for six weeks, and current service users and their needs are considered before a placement becomes long term. This is clearly explained in the service user guide. Some minor amendments are needed to the service user guide as the home is no longer providing a respite bed, and the information on the Commission’s complaints procedure needs updating. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 9 Copies of detailed assessments were seen on the care planning documentation of service users case tracked. Copies of contracts were seen on the care planning documentation of service users case tracked. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are suitably completed to demonstrate that service users personal and social care needs are being fully met. Service users within the home are encouraged and supported to make decisions and choices regarding their lives. EVIDENCE: Three service users were case tracked and their care planning documentation looked at in detail. Care plans were clear, detailed, and reflected the individual needs and strengths of individual service users. As well as daily routines and preferences, information included activities and leisure, medical information, finances, communication, and concept of death and dying. Awareness of the complaints procedure was also included on one care plan. Care plans had been signed by residents. There were regular reviews with care plan objectives set. In addition there were monthly updates written by key workers. Several Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 11 service users talked about their key worker. Service users have close relationships with their key worker who was a significant person in their lives. Various risk assessments were seen that were specific to individual service users, and aspects of choice and risk were discussed with the proprietor and manager. This indicated that individual’s rights to take some risks was accepted and supported by staff at the home. One care plan included a ‘friendship map’. Logs are kept up to date with three entries a day. There are thorough handover meetings and it is felt that communication within the home is good. Bedroom seen were decorated and personalised according to the individuals taste. 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. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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: Individual personal development and independence skills are encouraged. One service user commented that he gets support from the home to live the kind of life he wants to live. Several service users told the inspector about special friendships they have with people outside the home. Some service users are still in touch with their families, whom they see on a regular basis. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 13 All service users indicated that their rights were respected. The staff rota is flexible to support the service users in their activities. Service users enjoyed a variety of meals, including such dishes as Tai curry. The food on the day of inspection was excellent and enjoyed by everyone. 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. One service user showed the inspector the activities board. This included outings and carol services. One service user told the inspector ‘ we are free to go out when we like’. The proprietor said that the home enjoyed a good relationship with the community and service users were known in the local area and often went to local pubs and cafes. The home has its own transport of a mini people vehicle. However service users who are physically able also access the local bus service, with staff support as required. One service user told the inspector ‘people go on holiday’. The home have access to a caravan and a narrow boat. There were lots of pictures in the home of service users enjoying holidays, outings and celebrations. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate medication policies and procedures that are in place within the home,ensuring that service users needs are met and protected. EVIDENCE: Care planning documentation included information on medication and health issues, together with details of how individual needs were to be met. The proprietor and manager reported a good relationship with local health professionals and GPs. One matter was discussed on the day of inspection relating to a medication issue and it was confirmed that medication could be administered with the GP’s agreement to the home’s arrangements. Most service users have a shower every day and service users at risk from developing pressure sores are logged through the daily logging system. The home also plan to formally monitor through the Waterlow system. A record is kept of service users’ weight. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 15 Most service users have contact with learning difficulty professionals at Ash Green Hospital. Records are kept of all visits. The home uses 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 service user who self-administers does not use the NOMAD system, and dispenses their medication directly from the containers supplied from the pharmacy under staff supervision. The containers did not contain details of the individual medication as required by current guidelines as per Royal Pharmaceutical Society of Great Britain Guidance 2003. The home have a good relationship with the local pharmacist and there is a drug review every six months. There was a record of sample signatures. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22. 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clear and accessible complaints and safeguarding adults procedures are in place to ensure service users can be confident that any issues raised would be acted on effectively and promptly. EVIDENCE: The complaints policy was seen and included a timescale of 28 days for a response to complaints. The complaints procedure is included in the service user guide. The complaints book was seen but there had been no recent complaints, nor have any been received by the Commission. Service user meetings are 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. Service users indicated that any concerns could be discussed with the staff who were always very helpful and friendly. Staff spoken to were aware of adult protection issues and said they had had appropriate training. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean, comfortable, well equipped in general, and well maintained, providing a safe and pleasant environment for residents. EVIDENCE: Two residents took the inspector on a tour of the home. The home is comfortable, homely and well maintained. There is a choice of lounge/dining areas and the home was decorated with Christmas decorations and Christmas trees. Since the last inspection a number of improvements have taken place including a new bath and shower in the downstairs bathroom, a hoist track in one of the toilets and in a service users bedroom, a new 3 piece suite, a new cooker and Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 18 microwave in the kitchen, new stair carpets, a new washer and new dryer, three bedrooms have been refurbished and the drive area has been improved. Service users bedrooms reflected their individual choices, interests and lifestyles. Service users were proud of their bedrooms and enjoyed showing the inspector round. Bathrooms were homely, and service users can have a bath or shower every day if they like. Several service users have physical disabilities. Unfortunately despite assessments by social services specialist equipment has not been provided by them, but has been provided by the home. Service users needs for specialist equipment are now met. The inspector was informed that some service users have purchased their own wheelchairs. All areas of the home seen were clean and hygienic on the day of inspection. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A trained and competent workforce are in place which meet the dependency needs of service users currently accommodated within the home. EVIDENCE: Staff training was discussed and all mandatory training is up to date. Copies of certificates are available on staff files and were seen by the inspector, together with individual records of all training undertaken. A new member of staff is working towards NVQ2, but all other staff have undertaken NVQ training. There is a stable staff group and it is reported that staff work well as a team. Three staff files were seen and all contained evidence of Criminal Records and POVA first checks, two written references, and application forms. There are at least two members of staff on all shifts during the day, and there can be up to four members of staff on duty if they are supporting service users Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 20 in other activities. There is one waking night staff. The proprietors live nearby and are on call if there are any emergencies. The member of staff interviewed said she was ‘proud to work at the home’ and she felt well supported and trained. She felt that the home provided a good standard of care and that there was a family atmosphere with staff and service users getting to know each other very well. Regular supervision takes place, is recorded and was seen by the inspector on staff files. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are made for a suitably qualified and experienced manager to be in post and staff demonstrate an awareness of their roles and responsibilities, thus ensuring the home is run in the best interests of service users. EVIDENCE: The registered manager is suitably experienced and qualified. She is going on maternity leave in the near future. One of the proprietors, who was previously the registered manager, is taking management responsibility for the home during this period. The manager and deputy manager both have the registered manager award at NVQ level 4. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 22 The home’s quality assurance exercise found that all residents were happy with the way the home was run, felt they were treated with respect and were safe and comfortable. They felt they were supported in their relationships and were able to tell someone if they had any problems. A few people wanted more choice of food, and extra activities. There is a service user meeting every month, and minutes were seen. These indicated that service users felt able to comment on the service provide. One service user commented that the proprietors were ‘excellent people’ and felt that ‘good homes should get more money’. Matters relating to health and safety, as well as administrative tasks, are dealt with by one of the proprietors. The inspector was given information prior to inspection that indicated that all matters regarding health and safety are dealt with in a satisfactory manner. The accident records were seen and found to be appropriate. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 3 2 3 3 x 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 X 29 3 30 x STAFFING Standard No Score 31 4 32 X 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 24 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. Standard Regulation 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 2 Refer to Standard YA1 YA20 Good Practice Recommendations The statement of purpose should be amended as discussed on the day of inspection. The description of medication should be in accordance with current guidelines i.e. Royal Pharmaceutical Society of Great Britain Guidance 2003 and include a detailed description of each medication on the NOMAD box. Elgin House DS0000019978.V320858.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V320858.R01.S.doc Version 5.2 Page 26 - 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. 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