Inspection on 20/02/09 for Elingfield House

This inspection was carried out on 20th February 2009.

CSCI found this care home to be providing an Good service.

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

Elingfield House 07/03/08

Elingfield House 26/05/06

Elingfield House 14/11/05

Elingfield House 03/06/05

Elingfield House 16/02/05

Elingfield House 20/08/04

Elingfield House 23/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elingfield House 26 High Street Totton Hampshire SO40 9HN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ian Craig     Date: 2 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Elingfield House 26 High Street Totton Hampshire SO40 9HN 02380663363 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): s_hollingworth@btconnect.com Mrs Susan Hollingworth Name of registered manager (if applicable) Mrs Susan Hollingworth Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 14 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia - DE Date of last inspection Brief description of the care home Elingfield House is a care home providing personal care and accommodation for 14 older people. The home is registered to take people 4 people with dementia over 65 years of age of both sexes. Elingfield is located in the centre of Totton, a small town, which is near the city of Southampton and the New Forest. The home was opened in 1992 and is an old building with character, which is a grade 2 Care Homes for Older People Page 4 of 27 care home 14 Over 65 0 14 14 0 Brief description of the care home listed house, extending over two floors. Accommodation is provided in a range of shared and single bedrooms. Shared space includes a lounge, a dining room and a terraced garden laid to lawn and flower beds, with a patio area. The current fee for the home ranges from 415.03 to 455.00 pounds per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection consisted of a site visit to the home which lasted approximately 4.5 hours. A tour of the premises took place. Discussions took place with the manager. Three staff were interviewed about their work at the home. Staff were observed working with residents. Three residents were asked about their views of the home. Records, documents, policies and procedures were looked at. Surveys forms were sent to professionals, residents and to the staff, asking for their views on the service provided by the home. These were returned by 8 residents, 4 staff and 2 health care professionals. Information contained in these surveys has been used for this report. Some of the residents were supported by the homes care staff to Care Homes for Older People Page 6 of 27 complete the surveys. A more objective approach would have been for this assistance to be provided by advocates or relatives. Care services are required to complete an Annual Quality Assurance Assessment (AQAA). This was completed and returned to the Commission. Information contained in the AQAA has been used for this inspection report. What the care home does well: What has improved since the last inspection? What they could do better: Not all staff are aware of the agreed procedures for the protection and safeguarding of vulnerable adults. Staff induction procedures need to be improved as these are currently not recorded. This is being addressed by the home. Care Homes for Older People Page 8 of 27 Staff supervision takes place but is not recorded. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Potential residents are able to make an informed choice about moving into the home. The home takes steps to ensure that it accommodates only those whose needs it can meet. Evidence: Each of the 8 residents who returned a survey state that they received enough information about the home before moving in, which helped them decided if it was the right place for them. Two residents spoken to on the day of the visit, and one survey, confirmed that their next of kin relative came to have look round the home on the their behalf before they moved in. The process of assessing the needs of those referred to the home for possible admission was looked at for two people admitted to the home since the last inspection Care Homes for Older People Page 11 of 27 Evidence: visit. In both cases the home assessed the needs of the person before they moved in. Records show that assessments are carried out when the person visits the home prior to moving in, and at a local hospital where the person was residing. The home completes an admission form and a client assessment form. Hospital discharge details are also obtained. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meets the health and personal care needs of the people living there. The privacy and dignity of the residents is promoted. Evidence: Care plans have been revised and are comprehensive. There is a Core Care Plan, which gives clear guidance for staff to follow in delivering care including instructions on numbers of staff required for lifting as well as the equipment and procedures to be followed. Records show that residents have agreed the content of the care plan by recording their signature. The care plans also cover the following needs: diet and weight, sight, hearing and communication, mobility and dexterity, promoting continence, mental state and cognition, special health needs, social interests and religious observance. Risk assessments are carrried out and recorded regarding mobility, the use of bed rails, falls and lifting. Daily records are maintianed, which show that personal care is provided to each person. Care plans are reviewed and updated. Care Homes for Older People Page 13 of 27 Evidence: There is a photograph of each person and care records are structured as follows: emergency evacuation plan, personal details, personal profile, health and medication, medical visits, district nurse visits, hospital visits, chiropody services, optician and dental appointments. Surveys were received from 2 health care professionals who state that individual health care needs are always met. One survey said, The staff seem to know the residents well and respect their privacy. I am quite happy with the care given by the Elligfield staff. Records show that the home works in conjunction with local community health services to obtain specialist equipment, and, for advice and input regarding continence needs and wound dressings. Three residents were spoken to about their life at the home. Each said that the staff are kind and helpful. One person said, The staff are marvellous. Nothing is too much for them. Another person said, I cannot fault anything. Your needs are attended to. The staff and manager are excellent. The staff should be congratulated. Each of the surveys returned by residents states that always receive the medical support they need. One person said, The staff notice if I am ill and have called the doctor on several occassions. 6 of the 8 surveys returned by residents state that they always receive the care and support they need. One person answered usually to this and another sometimes. Staff spoken to on the day of the visit said that the residents individual care needs are met. The four surveys returned by staff each state that the care needs of the residents are met and that residents are treated as individuals. Staff confirmed that they receive training in working with people with dementia and that they are given support in their work. Staff were observed working with the residents in a polite and courteous way. Staff responded promptly when residents called for assistance by using the call point system. Screens are provided in shared bedrooms. Residents are able to have a key to their bedroom door. This is recorded. Two residents have a key to their bedroom door for privacy. The homes medication provedures were looked at. Staff receive training in medication, which was confirmed from training records and discussions with the staff. Staff were observed handling medication, and recording signatures and other data as advised by pharmaceutical guidelines. Staff record a signature when medication is administered. It was noted that where a controlled drug register is used, that the records for two residents are both recorded on the same page. Pharmaceutical guidlelines state that there sould be a separate page for each person so that staff can follow the records more easily. The manager agreed to address this. Care Homes for Older People Page 14 of 27 Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have a range of activities to choose from and the home provides nutritious meals. Evidence: The home employs staff specifically for engaging residents in activities for 3 hours on Mondays, Wednesday and Fridays. At the time of the visit a staff member was spending time talking to a resident and playing cards with him/her. A noticeboard in the hall gives details of activities for February 2009 and includes 16 activity sessions including times with a social carer, manicures, input from a motivational therapist, quizzes, exercises and a valentines lunch. There were photograph displays of the valentines lunch. Specialist providers are used for some activities. Residents confirmed that activities are provided and include slide shows and entainment from a musician. Two people said that they go out to a local day centre. The staff providing and arranging the activities also maintain a record of activities provided for the residents as well as a record of what each person has been involved in. These were seen for the 4 people whose care records were looked at. There is also documentary evidence that the home ascertains the social interests of each person. Care Homes for Older People Page 16 of 27 Evidence: From the 8 surveys returned by residents, 1 said activities are always provided, 5 said usually provided and 1 sometimes provided. Two people said that the activities could be improved and one person said that he/she finds some of the activities, a bit childish. Residents were observed using the garden which was sunny and warm. One person said how much he/she enjoys the garden. The provision of meals was looked at. The cook gave details of meal preparations. Residents were asked about the food and also commented in the surveys. The menu plan and food records were looked at. The midday meal was seen. The staff and manager were asked about the food provision. The home has a 4 week menu plan showing varied and nutritiuous meals. As well as the main meals, there are light snack meals at 3pm and in the evening. Staff have completed training in nutritional assessments of the residents and these assessments are recorded. Residents are asked in advance what they would like to eat for the midday and early evening meal; a record of this is made. The midday meal on the day of the visit was breaded plaice with mashed potatoes and green beans. Dessert was home made bread and butter pudding. Residents were able to have an omelette if they didnt like fish. From the 8 surveys completed by residents 2 said that they always like the meals, 1 usually and 5 sometimes. Residents spoken to on the day of the visit said they generally liked the food but that imprivements could be made to the variety and choice of meals available plus the provision of more green vegetables. One of the staff also expressed the view that the meals could be more varied. This was discussed with the manager who said that the home tries to incorporate the views and choices of the residents who are consulted about the menu. Fresh fruit is available to the residents. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an effective complaints procedure. The home has copies of agreed procedures for dealing with suspected abuse, but staff training needs to be provided so that staff are aware of the steps that should be taken to protect vulnerable people. Evidence: Each of the residents who returned a survey states that they know how to make a complaint. Residents also said that they know who to speak to if they are not happy, and that the staff listen and act on what they say. According to the AQAA the home has received 2 complaints in the last year. One of these was upheld. Records were available to show how the home dealt with the complaints and the outcome. The home has a copy of the local authority adult protection procedures. The home is still making arrangements for staff training in adult protection/safeguarding procedures. One staff member was aware that training in adult protection is being planned for and one staff member acknowledged that he/she is not aware of the procedures for dealing with allegations of abuse. The provision of the planned training in adult protection procedures will be checked at the next inspection. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a clean, well maintained and attractive environment that promotes their dignity. Evidence: A tour of the home took place, which included a number of bedrooms, the lounge, dining room and kitchen. The home was found to be clean and decor was appropriate to the age range of the residents, intact and looked to be recently refurbished. There is an absence of any unpleasant odours. Each resident who returned a survey states that the home is always fresh and clean. One person said, Everything here is spotless. Health care professionals made the following comments: Respectful and caring environment, and, Very caring environment. Residents names are labelled on their bedroom door. There are 4 single and 5 double bedrooms. Privacy screens are provided in shared rooms. There is lockable storage in each bedroom, but in double rooms these are shared between the two residents. The home should consider the provision of a lockable storage space for each person for privacy and security. Residents are able to have a key to the lock on their bedroom door. Bedrooms contain items of personal possession such as plants, photographs and Care Homes for Older People Page 19 of 27 Evidence: books. Residents said that they like the environment. The lounge and dining rooms are located on the ground floor. Residents were seen using both of these areas as well as the garden patio. One person said how much he/she likes to sit in the garden. A communal bathroom with a toilet is located on the ground and first floor. These are both clean and tiled. The ground floor bathroom offers a walk-in shower. A bath hoist is provided in the first floor bathroom. Access to the first floor is aided by a stair lift. Residents commented that the provision of just one communal toilet on the ground floor means that the residents sometimes have to wait to use the toilet. This was discussed with the manager. Presently, there is little that can be done to improve this, but this may improve as there are tentative plans to redesign and extend the home. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a well trained staff team supplied in sufficient numbers to meet residents needs, although some improvements are needed to the system of staff induction and supervision. Evidence: The home aims to provide the following staffing levels: 7.30am to 9.30am, 3 care staff; 9.30am to 8.30pm a minimum of 2 care staff, and, 8.30pm to 7.30am the next day, 1 waking and 1 sleep in staff members. In addition to this are the hours worked by the manager, the cook and the cleaner. Observation and the staff rota shows that these staffing levels are being maintained. Staff spoken to said that there are sufficient numbers of staff to meet the residents needs. The staff surveys also said that there are enough staff on duty. Residents spoken to on the day of the visit, and those who returned a survey described the staff as kind and helpful. 6 of the 8 surveys returned by residents state that staff are always available and 2 responded by saying they are usually available. Staff confirmed that they received an induction when they started work. One person said the induction was for 1 day and the other person said it lasted 2 days. Both confirmed that this involved shadowing a more experienced member of staff as well as Care Homes for Older People Page 21 of 27 Evidence: instruction and training, and, that the induction was sufficient to prepare them for working in the home. The 4 staff who returned a survey also said that the induction covered everything to prepare for the job. A record of staff induction is not maintained. The manager explained that there are plans to introduce this. Staff confirmed that they receive training, which is relevant to their job. Six of the 12 care staff are qualified to National Vocational Qualification (NVQ) level 2, or above, in care. One staff member spoken to has NVQ levels 2 and 3. Records and discussions with the staff and the manager show that staff are also trained in moving and handling, nutrition, menu planning, key working, first aid and dementia care. The homes manager has training links with the Hampshire County Council Partnership in Care Training (PaCT). Staff described a team ethos for working and there is frequent discussion of work issues. Staff surveys report that staff meet with the manager on a regular basis to discuss their work. Two staff said that one to one supervision is not provided, although they have had an appraisal of their work. It was clear from discussions with a senior carer and the manager that formal supervision is to be introduced following the completion of a supervision and appraisal course by the senior carer. Recruitment procedures were looked at for two staff who have started work at the home in the last year. Records show that these staff started work following the completion of the required checks, including obtaining 2 written references plus a criminal record bureau (CRB) and protection of vulnerable adults (POVA) check. A record of an assessment at interview was seen. Staff confirmed that the above procedures were followed. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and it is clear that the homes management makes continual improvements for the benefit of those who live there. Evidence: The manager is a National Vocational Qualification assessor. She has been involved in the management of Elingfield for more than 10 years. A number of training courses related to the management of residential care have been completed including the Common Induction Standards, employee behaviour, medication, dementia, health and safety and risk assessment. Staff report the manager to be supportive and approachable. Surveys are used to obtain the views of residents and visitors. A number of these were seen and these include a total of 28 questions asking for a rating of poor, fair, good or excellent regarding the food, environment, care and activities. The results of the Care Homes for Older People Page 23 of 27 Evidence: surveys are collated to give a picture of improvements that can be worked on. The home looks after the valuables and money for some of the residents. A record is made of any deposits or withdrawls plus a corresponding balance. A check was made of the amounts held which tallied with the record of the balance. The AQAA confirms that the homes equipment is serviced and tested by suitably qualified persons. Staff receive training in first aid, food hygiene and moving and handling. Residents are protected from possible scalds from hot water by temperature controls on hot water taps. Bath water temperature is also tested and a record made in the residents care records. Radiator covers protect residents from possible burns. Window restrictors are installed to prevent possible falls from first floor windows. There is a fire evacuation plan for each residents. The home has a contractual arrangement for checking fire safety. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Where records of controlled medication are maintained there should be a separate page for each person. This is advised by the Royal Pharmaceutical Society guidleines. Care Homes for Older People Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!