CARE HOMES FOR OLDER PEOPLE
Elingfield House 26 High Street Totton Hampshire SO40 9HN Lead Inspector
Beverley Rand Announced 03 June 2005 13:40 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 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 H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Elingfield House Address 26 High Street Totton Hampshire SO40 9HN 02380 663363 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) Mrs Susan Hollingworth Mrs Susan Hollingworth Care Home 14 Category(ies) of Old Age - OP -14 registration, with number of places Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16.02.05 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. Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was the first unannounced inspection of the year. The manager was unable to be present for the inspection, and the staff and later, the senior carer, assisted the inspector. The inspector spoke to two residents about the relevant standards looked at in this report, and spent time sitting in the lounge with other residents. The inspector also looked at three careplans, and other records such as policies and procedures. What the service does well: What has improved since the last inspection?
Residents have now been given their own copy of the Service User Guide, which gives information such as the staffing arrangements, how to complain, etc. The activities programme has increased, and now includes cookery, hand massage and art and craft sessions. Residents said they enjoy activities like cooking, and one person said they join in more now that the activities have increased. The necessary checks and references are now gained before new staff start work, in order that residents can be protected. The hot water in the downstairs bathroom basin is now running at a cooler temperature, which means it is less likely to scald anyone. Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 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 H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 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 standard(s) These standards were not assessed. EVIDENCE: These standards were not assessed, however, a requirement was previously raised with regard to providing service users with their own copy of the Service User Guide. Although one service user did not recall having been given one, another did, and the senior carer was sure that everyone had been given. This requirement is therefore considered to have been met. Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7 The home’s care planning system ensures that service users needs are set out in an individual plan of care. EVIDENCE: The inspector sampled three service user plans based on conversations with staff regarding individual needs. The careplans referred to the individual needs discussed and clearly detailed the necessary care. The plans were reviewed every month as required by the standard. Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 14 The home ensures that service users are helped to exercise choice and control over their lives. EVIDENCE: The residents could manage their own financial affairs if they wished and were able: the home does not currently manage any resident’s money. The inspector saw that some people had their own furniture in their bedrooms, as well as ornaments, pictures etc. Standard 12 was not assessed, but a requirement had been raised before, with regard to increasing activities. The inspector spoke with residents and staff who confirmed that there was a more varied activity programme. Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 16 & 18 The home’s complaints procedure means that service users feel confident that their complaints would be listened to. There are procedures in place to protect service users from abuse. EVIDENCE: There have been no complaints made to the home since the last inspection, but the Commission received one in March 2005. The complaint was partially upheld. Allegations that the provider did not complete an application form for new staff and that staff had too much work to do at night and were not allowed to eat were not upheld. An allegation was also made that checks and references were not undertaken prior to new staff beginning work. This part was substantiated and a requirement was raised. The inspector spoke with two residents about whether they would know how to complain. One resident said that they ‘can’t complain’, (because the staff and food were good), but that if necessary, they would feel able to speak with the provider, who was also, ‘very good’. This view was confirmed by the second service user. Staff advised the inspector as to how people could complain, and service users have a copy of the complaints procedure in the Service User Guide. The inspector saw the Adult Protection policy and spoke with staff who confirmed that they knew what to do if there was an allegation or suspicion of abuse. Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 19 & 26 The manager ensures that residents live in a safe, well-maintained, clean and hygienic environment. EVIDENCE: One of the single bedrooms has been re-decorated with new furniture, a mirrored cabinet, curtains and carpet. New duvet covers and towels have been provided for the entire home. The back garden was looking attractive and well kept. The home was clean, protective gloves are provided in bedrooms, and aprons are available, for dealing with laundry. Dirty washing has to be taken through the dining room to the laundry, but is taken in a drawstring bag. The manager has recently purchased a new washing machine. Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 Staff and service users would benefit from staff receiving more training. EVIDENCE: Information received prior to the inspection showed that staff have only undertaken training in Fire Safety and Abuse Awareness in the last year. Staff confirmed that the training lasted a total of about four hours. Other training is planned for the coming year, but in order to meet this standard, staff should have a minimum of three paid days training per year. A new staff member is undertaking a formal induction programme. Standard 29 was not assessed but following a requirement made at an unannounced complaint investigation, a requirement was raised regarding the need for the necessary checks and references to be in place before new staff began work. Whilst the inspector was unable to view the records in the manager’s absence, the senior carer remembered various checks and references being returned. Therefore, the inspector regards this requirement as having been met. Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The home ensures that service users live in a safe environment. EVIDENCE: Standard 36 was not assessed, however, a requirement made at the previous two inspections regarding staff supervision sessions has not been met, and is therefore raised again. Standard 38 was assessed, and the inspector found that equipment such as the emergency call system, fire equipment, central heating system, etc. have been checked and found to be working properly. Certificates were available for inspection. A requirement was raised at the last inspection regarding the need for risk assessment on basin hot water taps. It was not possible for the inspector to see whether the risk assessments had been done or not, but the basin particularly referred to at the last inspection was running at an acceptable temperature. Therefore, this requirement is viewed as being met. Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 x
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 3 Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 16 yes 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 OP36 Regulation 18 (2) Requirement Care staff must receive six supervisions sessions a year. Timescale for action 31/07/05 2. OP8 16(1,a,i) The previous timescale of 30/4/05 was not met. This requirement has also been raised on 17/11/03 The provider must provide 30/09/05 appropriate telephone facilities for the day to day running of the home, ie. a phone which can be used by all staff at all times to ensure effective communication methods. 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. Refer to Standard 30 Good Practice Recommendations Staff should receive a minimum of three days paid training per year. Elingfield House H54 S11861 Elingfield House V230569 030605 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection 4th Floor, Overline House Blechyden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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