Inspection on 26/05/06 for Elingfield House

This inspection was carried out on 26th May 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

Elingfield House 20/02/09

Elingfield House 07/03/08

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Elingfield House 26 High Street Totton Hants SO40 9HN Lead Inspector Mrs Michelle Presdee Unannounced Inspection 26th May 2006 10:00 X10015.doc Version 1.40 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 Elingfield House DS0000011861.V289267.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elingfield House Address 26 High Street Totton Hants SO40 9HN 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) 023 8066 3363 Mrs Susan Hollingworth Mrs Susan Hollingworth Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14/11/05 Brief Description of the Service: Elingfield House is a care home providing personal care and accommodation for 14 older people. The home is not registered to take people with dementia or any other mental health diagnosis. 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, 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 fees for the home range from £321.65 to £420.00 per week. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this unannounced inspection the inspector was assisted by the care coordinator and later by the manager and owner Mrs Hollingworth. On the day of the inspection 13 service users were being accommodated, with one man and twelve women. During the inspection the majority of service users were spoken to, who all had praise for the home. Care staff spoken to on the day felt the home offered a good level of care and that they received adequate training. Two visitors were spoken to who felt the home was meeting their relatives’ needs very well. A tour of the building was undertaken and several bedrooms were looked in randomly. Assessments, care plans and other paperwork including some policies and procedures were looked at. What the service does well: What has improved since the last inspection? The home ensures adequate records and checks are made before care staff work in the home, ensuring the safety of service users. Staff are receiving adequate training and more staff are hoping to start N.V.Q Level 2 training. A quality assurance review has taken place seeking other views of how the home is run. Staff are receiving adequate sessions of supervision, ensuring they are aware of good practice. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 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. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process provides information for care staff to meet service users needs, although additional information would be of benefit. The home does not provide intermediate care. EVIDENCE: It was clear from the assessments seen and from discussion with service users and two visitors, the home has a clear assessment process. The inspector was informed where possible the manager or a senior member of staff would go and visit a service user before they came into the home. At this time information is gathered from all sources possible and a pre-admission assessment is completed. The inspector looked at three pre-admission assessments and found good information had been recorded and they had been signed and dated. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 9 When the service user comes into the home a preference questionnaire is completed. This records information on how a service user wishes to spend their day, for example, what time a service user gets up in the morning, if they would like a hot drink when they wakeup, if they would like breakfast in bed or would prefer to have breakfast in the dining room. An assessment is then completed, which includes details of needs including health needs and the reason for admission. Assessments and reviews seen gave adequate information on a service users needs. From three assessments viewed, one had completed a section on social background and stated how the service user liked to spend their day before moving into the home. One service user spoken to and a relative stated they thought the assessment process had worked very well. They both felt the transition period had worked well. A review had taken place after four weeks, which all those involved had been invited to. Service users are not currently formally involved in the assessment process. Discussions were held on including service users, recording their views on the assessment and getting them to sign the assessment The home does not provide intermediate care. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans give sufficient information to identify service users needs and show how the needs are to be met by care staff. Service users medication needs are being met, although the medication procedure needs to be followed regarding controlled medication ensuring service users safety. The core values are promoted in the home ensuring service users are treated with respect and their right to privacy is respected. EVIDENCE: The inspector looked at the care plans of three service users. Care plans included information on abilities, problems and needs, aim of the care and the method and recreation and leisure. Information was clear and gave care staff adequate information to be able to care for service users. Discussions were held on including the service users views and opinions in the care plans and where possible getting them to sign the documents. Care plans also need to record individual recreation and leisure activities and record how these are Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 11 being met. Care plans were reviewed on a regular basis. From discussions with two service users who had recently moved into the home, both felt the home met their needs and they were well cared for. Other information recorded included information on risk assessments, a handling assessment, a matrix (tick box) assessment and a skin and body chart for pressure sores. Separate sheets were maintained for all doctors’ visits and district nurses. It was noted recommendations suggested by the health professionals had been acted on. Charts were also maintained for weight and bathing. The home has a comprehensive medication procedure, which is attached to the wall with the drugs trolley. Only the senior members of staff who are currently completing a long distance course on medication are responsible for the administration of medicine. The home uses blister packs, which are delivered into the home on a monthly basis. The inspector was advised all medication is checked when it enters the home and then stored in the new medication trolley. At the times of administration, the carer takes the medication to the service user and signs the record. The inspector checked the medical administration records in the home and found all records to be accurate. The records of controlled medication were checked and it was found these were not correct. The medication was being stored appropriately, but when being administered it was not being signed by two carers at all times. It was also noted a record was not being held of the amount of tablets remaining; for one service user there were three packs of medication dating back three months. It was agreed a running total would be maintained, two carers would sign when controlled medication is administered and all extra medication stored would be returned to the pharmacist. The inspector was advised no service users currently self medicate. Records are maintained of all medication returned to the pharmacist and the pharmacist signs the record. On the day of the visit the district nurse and auxiliary nurse visited the home. The district nurse had not visited the home before. The auxiliary nurse had been a few times and stated the home had a good atmosphere and the service users she saw were happy with the home. The nursing staff felt they had been called into the home appropriately. It was clear from observing staff interacting with service users they are aware of the core skills and work with service users in a way, which promotes their dignity and independence. When asking service users if they would like to go to the toilet before lunch, this was done in a quiet and private way for each service user. Service users spoken praised the staff and felt they worked very hard. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a variety of group social activities, giving service users the choice to join in when they wish. Visitors are made welcome to the home. A varied menu with a choice and good quality food is served to service users in a pleasant environment. EVIDENCE: Service users spoken to on the day felt the home had matched their expectation. One service user commented the home was much better than she had anticipated and was really enjoying herself. The home had a list of social activities for June, which included shopping trips, entertainers, reminiscence work, tea party, theatre company, exercise groups and a hairdresser. The home has an attractive garden with suitable furniture for the summer months, which service users enjoy. Activities are provided by both the staff and outside agencies. Holy Communion is provided in the home every six weeks, which the inspector was informed meets all service users religious needs. Visitors are always made welcome at the home and are asked to sign in and out of the home. Service users spoken to stated their visitors are always made Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 13 welcome and offered a cup of tea or coffee. A lot of service users spoken to spoke of their enjoyment of going out with their family. Two visitors spoken to stated they were always made welcome in the home and could see their relative in private. It was clear from observations and discussions with service users and staff, service users are offered choices in their daily living activities. All service users spoken to felt the staff worked hard and were always available to help. Choice was promoted by service users choosing what to wear on a daily basis, choosing from the tea–time menu and deciding where to sit and spend their day. Some service users preferred to spend most of their day in the lounge others preferred to spend time in their own rooms. The menu is displayed in the hallway. Meals are served in the dining room, or if a service user prefers they can have their meals in their own room. The dining room is bright and pleasantly decorated. All service users spoken to thought the meals were good and the food of good quality. A choice is available at breakfast and evening meal. At lunchtime only one meal is cooked, but if a service user does not like the main choice an alternative will be provided. At lunchtime service users had a choice of fish in sauce or fish in breadcrumbs. A list of service users likes and dislikes is in the kitchen. Meals are home cooked with fresh vegetables used. Only one special diet is prepared in the home, which meets all service users needs. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users felt confident their complaints would be listened to and acted upon. Service users are protected from abuse and staff have adequate knowledge on dealing with suspected abuse. EVIDENCE: The home has a complaints procedure, which details all the relevant information, including phone numbers, address and timescales. The commission has received no complaints since the last inspection. Service users and visitors on the day clearly felt their complaints would be listened to and acted on. Service users stated they would speak to the manager if they had a complaint. Details of the complaint procedure are included in the contract and the service user guide; which was displayed on the notice board in the home. Policies and procedures relating to the protection of older people and information on abuse are available in the dining room. Training on the adult protection has been provided. On discussion with staff members it was clear they had an awareness of the types of abuse and knew the agencies to contact if abuse was suspected. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean, safe, pleasant and well-maintained environment for the enjoyment of service users. EVIDENCE: The home provides a clean, well presented, safe and homely environment for all service users. No unpleasant odours were detected, whilst walking around the home. The home is decorated to a good standard. The lounge has recently been decorated with new paper, lighting and new chairs, which service users were proud of. The hallway and stairs have recently been re-painted. New bath hoists and two new stair lifts have been purchased. One bedroom has recently had the en-suite refurbished, and one bedroom has been re-decorated. The bedrooms seen were clean and had been personalised by the service users. It was noted in two bedrooms the vanity units were in need of repair or needed Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 16 to be replaced. Plastic gloves are available in all bedrooms. It was noted dirty washing has to be taken through the lounge to the laundry; the inspector was advised this is always taken through in a drawstring bag. It was also noted the linen cupboard is kept inside a double bedroom. The inspector advised this should be recorded in the service user guide and on the contracts of the service users involved. The inspector was advised the two service users who currently occupy this room, do not spend any time in their room, so are not affected by the current situation. In the future it may compromise the privacy of service users and an alternative for storage may have to be found. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good recruitment and training procedures, which ensures that service users needs are met by sufficient numbers of competent staff. EVIDENCE: From records seen and from discussion with service users and staff members, the home has adequate staff on duty. The home employs 13 members of care staff. The rota is arranged to ensure the manager, deputy or care co-ordinator are on duty during the day. At night the home has one waking staff member and one sleep-in staff member. Service user felt the staff worked very hard and were very good at their jobs. One service user stated, “There is always someone to help” another stated, “the girls work very hard”. Staff members spoken to felt there were adequate staff on duty at all times to meet the needs of service users. They felt service users were well cared for and had their needs met. A cleaner works in the home every weekday and a cook every day. The staffing records of the latest two care staff to join the home were checked. It was found all had completed all necessary paperwork, appropriate checks had been undertaken and references obtained. The inspector spoke to all staff on duty. Two members of staff had recently started work in the home. Both confirmed they had undertaken an induction, Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 18 which they felt had helped them carry out their job. A training plan is maintained for all staff, which is well organised. All staff have recently undertaken moving and handling training. Eight members of staff have recently undertaken training in first aid; other staff members already had indate training. Three members of staff currently have National Vocational Qualification (N.V.Q) Level 2, two more care staff are hoping to start this and two members of staff have N.V.Q. Level 3. All care staff have received one session on fire training and the inspector was advised another session has been booked. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the manager has a clear direction for the future. Service users views contribute in the development of the home. Service users finances are protected and the health and safety procedures in the home ensure service users are protected. EVIDENCE: The manager has many years and has lots of experience at running and owning the home. She is hoping to share some of her paperwork responsibilities with the deputy and care co-ordinator. Records and training are areas where there have been improvements. From discussions with service Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 20 users it was clear they were felt they could approach her if there was a problem. From observations and from discussions with service users and visitors it is evident that the home is run in the best interests of the service users. The majority of service users are independent and able to make their views known. The home had recently carried out a service users and visitors quality audit form. The results had not been collated, but the forms were shown to the inspector. It was noted the majority had positive comments recorded. All staff now receive bi-monthly supervision sessions. A written record is maintained, which both members sign. The inspector was advised the home does not manage any of the service users finances including their personal allowance. The kitchen was well organised and clean. All food in the main fridge was covered and dated. Menus are organised on a monthly basis and the food ordered as required, the butcher could deliver daily. The cook felt the food in the home was of a good quality with no restrictions to the budget. Service users spoken to also felt the meals were good in the home. The temperature of the fridge and freezers were being recorded daily. A probe thermometer was being used to test the temperature of the protein in the meal and this was being recorded. Service users choices at meal times were being recorded. The accident book was seen, which had been appropriately completed and the information had been stored in a relevant place. From records sent to the Commission and from records seen on the day it was clear the health and safety of service users is promoted within the home. All necessary tests are carried out on fire equipment within the agreed timescales and all equipment is serviced on a regular basis. Service records were seen for the stair lifts, gas boiler, bath hoists and portable electrical appliances. The home has purchased an industrial washing machine and an industrial dryer. The laundry appeared well organised in the home with each service user having their own laundry basket. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13 (2 ) Requirement The records of controlled medication must be completed accurately. All excess medication must be returned to the pharmacist. Timescale for action 01/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP24 Good Practice Recommendations Individual social activities must be recorded on the care plan with details of how these are met recorded. Vanity units identified must be repaired or replaced. Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Elingfield House DS0000011861.V289267.R01.S.doc Version 5.2 Page 24 - 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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