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Inspection on 09/06/05 for Eliot House Nursing Home

Also see our care home review for Eliot House Nursing Home for more information

This inspection was carried out on 9th 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides good, quality care taking into account the choices and wishes of individual service users. An activity organiser ensures that stimulation is provided to each person staying within the care home. The staff work well as a team and are committed to stimulate and to improve the quality of life of people with dementia staying within the home. Staff enjoy working in the care home and feel supported by the management team.

What has improved since the last inspection?

This is a first inspection since the home was purchased in May 2005.

What the care home could do better:

At the initial assessment the needs of service users coming to stay in a home are identified. A care plan and risk assessment is written on individual files. There is a need to review the manner in which this information is recorded to ensure that it is recorded in a consistent manner on all care records. The home needs to review the supervisions and appraisals for staff to ensure that the Care Home Regulations are met.

CARE HOMES FOR OLDER PEOPLE Eliot House Nursing Home Crooked Billet Street Morton Gainsborough, Lincs DN21 3AH Lead Inspector Ken Hague Unannounced 9 June 2005 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. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Eliot House Nursing Home Address Crooked Billet Street Morton Gainsborough Lincs DN21 4AH 01476 617545 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) MPS Care Homes Ltd Manager application to be submitted Care Home with Nursing 29 Category(ies) of DE - Dementia - 29 registration, with number MD - Mental Disorder - 29 of places OP - Old Age - 29 Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The registered person will: a) provide external support from within the organisation to the home. b) review the current management arrangements within the home within three months of purchase to determine the employment of a manager for registration. The home is registered to provide personal and nursing care for service users of both sexes whose primary needs fall within the following categories: Dementia - over 55 years of age Mental Disorder, excluding learning disability or dementia - over 55 years of age Old age, not falling within any other category The maximum number of service users to be accommodated is 29. Date of last inspection 1st Inspection Brief Description of the Service: Eliott house is a care home providing personal care and nursing care for 29 people who are accommodated within the category of older people all within the category of dementia or mental disorder. The care home is set in the village of Morton which can be found on the outskirts of Gainsborough. The care home is a listed building, a new extension has been added to the rear of the property. It is surrounded by its own gardens which are totally fenced in providing security for service users staying at the care home. There are a number of patio areas outside the home where service users can sit in the summer months. There are public transport services to the care home and parking is provided at the front of the home. Additional on street parking is available. There are local shops and public houses within walking distance of the care home. The first floor of the care home can be accessed by staircase or a lift. The home has 25 single rooms and 2 double bedrooms. Fourteen of the rooms have toilet facilities. The home was purchased by new owners in May 2005. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a six-hour period. A tour of the building was made and care records were inspected. Two staff, four service users, the acting manager and a relative were interviewed. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 6 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 Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 7 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) 3&4 The admission process enables service users to make an informed decision about coming to live at the care home. The assessment carried out by the acting manager provides staff with information about the needs of new service users. EVIDENCE: The registered manager stated that each service user is given a copy of the service users guide and an individual copy of the terms and conditions for their stay at the care home. A service user interviewed confirmed this to be the case. A copy of the terms and conditions were found on individual service users files. The care records for four service users identified all the care and social needs of the individual service users. This included their choices and wishes in relation to the manner in which care should be provided. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 8 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) 7,8&10 A full assessment is carried out on all new service users before they are admitted to the care home. This identifies all the care and social needs of the individual service user. The home ensures that stimulation is provided to all service users. EVIDENCE: There were four individual files inspected on this visit. All contained an initial assessment which outlined the social and care needs for each person. The information was gathered from other professionals, relatives, GPs and consultants. There was evidence of service users contributing information to this assessment document. The care plan was written after the initial assessment and was signed by the individual person to whom it related. If a risk was identified the management of that risk was recorded on the service users file. There was evidence of this assessment being reviewed shortly after admission and at the frequencies set out in the National Minimum Standards. The care records include a medical history and family structure. The wishes and choices of each service user in relation to activities, menu and the manner in which personal care should be provided is also recorded. Each file contained a photograph of the service user, a pen picture which included their personality and details of their family and past employment. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 9 An activity organiser writes an individual activity plan for each service user to ensure that they asked given activities which they find enjoyable and stimulating within their own ability. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 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) 12.13.14&15 A wide range of activities is available for service. Service users who are diagnosed with dementia are provided with an individual detailed activity plan to ensure stimulation is provided and the quality of life maintained. Catering services reflect service users preferences and choices. EVIDENCE: Observations made during this inspection provided evidence of the activity organiser ensuring that stimulation was provided to all service users. The staff were observed to be actively seeking out individual service users to ensure that they were being stimulated. In the case of one service user 2 members of staff were working with this person playing dominoes. A second service user was being helped to reminisce by discussing a photograph album of his home and past hobbies. The third service user was being assisted to carry out some tiny tasks in the garden on the patio area. Care records contained details of the likes and dislikes of individual service users. One service user was said to like liquidised food. A second service user enjoyed plain home cooking especially sweet things and disliked porridge. It was noted in another service users file that they have a good appetite and would often ask for second helpings. A member of staff confirmed that all service users are spoken to in the evening to discuss their menu for the following day. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 11 The member of staff confirmed that there are two choices of meat and a vegetarian choice offered to service users and four different puddings are often provided. Service users interviewed confirmed their satisfaction with the menu stating that their own dietary needs were being met by the care home. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 12 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) This standard was not inspected EVIDENCE: Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 13 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) 19,20,21,23,24,25&26 Service users live in a clean, comfortable and homely environment. The garden area provides a safe environment in which activities can take place. There were no health and safety issues identified during this inspection. EVIDENCE: A tour was made of the care home. All areas of the home were found to be clean and free from any offensive older. There was evidence of new equipment and ongoing maintenance being carried out during this inspection. All of the rooms seen were decorated to a high standard. A sample number of bedrooms were viewed and they all met the National Minimum Standards in relation to the provision of facilities and equipment. The rooms viewed had been personalised by the individual service users. The service users confirmed their satisfaction with the environment of the care home and their own individual bedrooms. There has been extensive work carried out in the garden area to provide a safe environment for activities. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 14 It was observed during this visit that service users use the various patios for social meetings, discussions and activities. Staff was seen to be using all of these areas to provide one-to-one stimulation to individual service users. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 15 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) This standard was not inspected on this occasions. EVIDENCE: Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 16 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) 31,32,3337&38 The home has a clear management structure, staff are being provided with leadership and guidance from the acting manager. The individual care records meet the National Minimum Standards, but can be improved. The acting manager needs to review the supervision and appraisal of staff to ensure that the National Minimum Standards are being met. EVIDENCE: The acting manager was appointed in May 2005 when the care home was purchased by its present owners. In the formal discussions the acting manager agreed that there was a need for her to ensure supervision and appraisals were being provided in accordance with the National Minimum Standards. The inspection of care records provided evidence that needs were being identified, but this information was not being recorded consistently and in the same manner on all service users files. Care staff stated that they were not allowed to record information in individual service user files. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 17 The acting manager agreed to review this practice as the Inspector stated the importance of all information relating to the provision of care being recorded by all staff. The care staff stated that the files appeared to be divided into two sections. Nursing information is recorded in a different area to social care needs. Care Staff stated this practice could result in inconsistencies in recordings and made the files difficult to read and use as working care plans. Some risks identified had not been recorded on individual care plans. In the case of one service user discussed it stated that she smoked. There was no risk assessment in place to manage this. Staff stated staffing levels are good, an additional shift has been included since the new owners took over which has proved very beneficial to the provision of care to the service users. Staff stated teamwork is good, there are support links established within the carer group. There were no health and safety issues identified at this inspection. There were five service users spoken to and one relative during this inspection. All stated that they were happy with the services provided by the care home and that the management and staff were approachable. A visiting relative stated that they were made welcome on each occasion that they visited. The acting manager is to apply to the Commission for Social Care Inspection to become the registered manager for this care home. This application is currently being processed. Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 18 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 3 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 4 3 3 x 3 3 3 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 3 x x x 3 3 Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 19 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 Regulation none Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 3 Good Practice Recommendations The acting manager is recommended to review the method in which initial assessment information is transferred onto individual files. This is to ensure that information is recorded consistently across all files. The acting manager is recommended to review the homes policy and procedure for the supervision and appraisal are care staff to ensure that the national minimum standards are being met. 2. 36 Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN 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 Eliot House Nursing Home C53 C04 S63148 Eliot House V232196 Stage 4.doc Version 1.30 Page 21 - 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. 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