Inspection on 23/06/05 for Elgin House

This inspection was carried out on 23rd June 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 01/12/05

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 S42 5LJ Lead Inspector Rose Veale Unannounced Inspection on Thursday 23rd June 2005 at 1.00pm 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Elgin House, Address 89 St Lawrence Road, North Wingfield, Chesterfield, S42 5LJ 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) 01246 884486 Mrs Christine Renshaw Mrs Christine Renshaw CRH 12 Category(ies) of LD registration, with number of places Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21/01/2005 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 devleopment of individual care plans and activity programmes. One day care place is provided. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over three hours on one day. There were eleven residents accommodated in the home on the day of the inspection, six of these were at home. Two staff were spoken with, plus the owner / manager. A tour of the home was undertaken and documents relating to the care of residents and the running of the home were examined. What the service does well: What has improved since the last inspection? What they could do better: Although the administration of medication in the home was generally adequate, there were some potentially unsafe practices which needed to be addressed to ensure the safety and welfare of residents Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 6 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 C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 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 standard(s) 2, 4 and 5 The assessment and admission procedures in the home ensured that residents were able to make informed choices about living in the home. EVIDENCE: The care files for two residents were seen. These both contained assessment information including physical and mental health care needs, leisure and activities, and risk assessments. Each resident had an individual care plan. The home offered visits and overnight stays for prospective residents. Admission was on a trial basis and other residents were consulted during this period. There had been an emergency admission for short-term care in April 2005 and this resident had then decided to stay at the home permanently. The two care files seen did not contain a copy of the terms and conditions between the home and the resident. The terms and conditions for another resident was seen. This contained all the information required under Standard 5, except specifying the room to be occupied. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 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 standard(s) 6, 8 and 9 It was clear that residents were involved in planning care and were consulted about the day to day running of the home. EVIDENCE: The care plans seen were detailed and well-written with clear objectives for the planned care. The plans covered all areas of daily living, including personal care needs, communication, mobility, leisure and social activities. The plans were reviewed at least every two months. Plans and reviews were signed by residents where possible. Regular residents meetings were held in the home. Residents were involved and consulted in the selection of new staff. It was clear during the inspection that staff consulted with residents informally about the day to day running of the home. For example, on the day of the inspection residents were going out for tea to celebrate a birthday and there were discussions between residents and staff about the arrangements for this. Residents had their own money and managed this with support from staff as appropriate. The care plans seen contained detailed risk assessments covering areas such as self-medication, use of bed rails, and going out of the home. Risk Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 10 assessments had been further developed as a result of a requirement made at the last inspection. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12, 14, 15 and 16 The lifestyle at the home focused on choice and independence with appropriate support. EVIDENCE: Most of the residents at the home attended day centres and other educational / training activities outside the home. Residents were encouraged and supported to choose from appropriate leisure activities. For example, all residents had televisions and DVD players in their rooms, one resident was using a Playstation game machine, residents talked about recent trips out, and two residents with reduced vision had talking book machines. A group of six residents were planning to go away on holiday to Cleethorpes the week following the inspection and another group had already been earlier in the year. There was an open visiting policy at the home. Residents were supported to maintain links with family and friends. The manager said that one resident was regularly taken by staff at the home to visit a friend in Newark, and two residents regularly attended a local church. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 12 Daily routines were detailed on care plans with an emphasis on encouraging choice and independence. For example, during the inspection, one resident had chosen to prepare his own lunch. It was observed that staff did not enter residents’ bedrooms without knocking and waiting for permission. The manager said that all residents had keys for their rooms. Residents and staff were observed to relate well, with residents readily engaging staff in conversations. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 18, 19 and 20 Residents’ needs appeared well met with good liaison with local health care services and appropriate support from staff in the home. Generally, the administration of medication in the home was adequate. However, there were some potentially unsafe practices which required attention to ensure the safety and welfare of residents. EVIDENCE: The personal care needs of residents were detailed in the care plans. There were no residents who currently required nursing care. Care records seen indicated that residents had access to health care services as required, such as optician, District Nurse, GP, dentist. It was clear from the care records that residents’ health was monitored and any potential problems dealt with. For example, one resident had recently attended an optician when it was identified that his glasses were no longer suitable. The home used the Nomad system for medication. Medication supplies were ordered by a nominated member of staff and supplied weekly by a local pharmacist. Records were seen of regular audit visits by the pharmacist. The medication was stored securely in a locked cupboard and administered by senior care staff who have all undergone the relevant training. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 14 When administering medication, staff took the Nomad cassettes and any boxes / bottles of medication to the resident. The resident then took out the medication under supervision and signed the Medication Administration Record. One resident had chosen to have a different GP and so medication was dispensed by a different pharmacist who could not supply the medication in a Nomad cassette. The staff at the home were re-dispensing this medication from the boxes / bottles supplied into a weekly pill box for administration. This was a potentially unsafe practice and it was advised that it would be safer to administer medication directly from the supplied boxes / bottles. There were some gaps on the Medication Administration Records with no signature to say the drug had been given or a code or reason why it had not been given. Medication returned to the pharmacy for disposal was recorded and signed by staff at the home and the pharmacist. The disposal records seen were not dated. The home’s medication policy was seen. This did not contain reference to keeping medication in the home for 7 days following the death of a resident. The home did not have a copy of The Royal Pharmaceutical Society guidelines for the administration of medication in care homes. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 22 and 23 Residents were protected by the attitude and awareness of staff, and by the home’s procedures. EVIDENCE: The complaints procedure for the home was seen. This required amendments to refer to the Commission for Social Care Inspection and to include a timescale of 28 days for response to complaints. Residents were encouraged to raise any issues at residents meetings, or informally with staff. There had been no formal complaints about the home since the last inspection. The home had in place the Derbyshire County Council multi-agency procedures for the protection of vulnerable adults. The staff had all undergone adult protection training. Staff spoken with were aware of adult protection procedures and said they would be able to raise any concerns with the manager of the home. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 16 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 standard(s) 24, 26, 28 and 29 The home was clean, comfortable, well equipped and well maintained, providing a safe and pleasant environment for residents. EVIDENCE: On the day of the inspection, the home was clean, bright, airy and free from offensive odours. A portable ramp had been purchased since the last inspection to ensure the home was fully accessible to residents. Furniture and fittings appeared of good quality and were domestic in nature. The manager said there were plans to refurbish a bathroom and to replace the carpet in the ground floor corridor. The bedrooms seen were all clean, pleasant and well personalised with residents own possessions. One bedroom seen had a vinyl type floor covering rather than carpet. The manager explained this had been necessary due to the continence problems of a previous occupant of the room. The current occupant said he liked the floor and did not want a carpet. All residents had keys for their doors and a lockable cupboard in their room. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 17 There was a pleasant, mature garden to the rear of the house with a large, shady patio area with furniture for residents to use. The kitchen was modern and domestic in style. The shared lounges and dining room areas were spacious and comfortable. Residents were observed to move freely around the home. Specialist equipment was provided to meet the assessed needs of residents, such as an overhead tracking hoist, ‘talking’ microwave for residents with reduced vision, call system for assistance, grab rails in the toilets, and bed rails. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 36 Residents are protected and supported by the home’s recruitment procedures and ongoing staff supervision and training. EVIDENCE: Staff records were examined for two members of staff. Both contained two written references, copies of the CRB disclosure, terms and conditions of employment, job description, supervision records and training records. Residents were involved in the selection of staff. Staff supervision records were seen which showed that supervision was being carried out every two months. There were also records of annual staff appraisals. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 38 The home appeared well managed creating a good atmosphere for residents. EVIDENCE: The manager of the home had many years experience in the care of people with learning disabilities and of managing the home. She said she was planning to retire soon and intended that one of the senior care staff would take over as manager. This senior carer had already completed NVQ Level 4 in care. Staff spoken with were positive about the management of the home. They felt the manager was very involved and ‘hands on’. They felt they would be able to take any concerns to the manager. They were aware that the manager was planning to retire and felt that the senior carer taking over would provide continuity. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 20 The atmosphere in the home was calm and relaxed. Records were well organised and staff were able to find all the information needed for the inspection. Elgin House C52 C02 S19978 ElginHouse V229697 200605 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 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 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 3 x Standard No 11 12 13 14 15 16 17 x 3 x 3 3 3 x Standard No 31 32 33 34 35 36 Score x x x 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elgin House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x C52 C02 S19978 ElginHouse V229697 200605 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 20 Regulation 13 (2) Requirement Staff in the home must not remove prescribed medication from the original container supplied by the pharmacist, except immediately prior to the administration of each dose Gaps must not be left on the MAR charts of regularly prescribed medications. A signature to indicate administration or a coded reason for non-administration must be made. The policy in the home for the administration and control of medicines must include reference to keeping medication in the home for 7 days following the death of a service user The complaints policy in the home must contain a response timescale of 28 days Timescale for action 31/07/05 2. 20 13 (2) 31/07/05 3. 20 13 (2) 31/07/05 4. 5. 22 22 (4) 31/07/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 23 No. 1. Refer to Standard Good Practice Recommendations Elgin House C52 C02 S19978 ElginHouse V229697 200605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 C52 C02 S19978 ElginHouse V229697 200605 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!