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Inspection on 26/07/05 for Elisabeth House

Also see our care home review for Elisabeth House for more information

This inspection was carried out on 26th July 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

This is a home for adults with learning difficulties where the residents are looked after well. The staff respect the individuals in their care and follow detailed individual care plans encouraging each to maintain current skill levels and take part in a wide variety of activities that they evidently enjoy and benefit from. All necessary records and policies are professionally maintained. The home provides a very pleasant and personalised environment to live in. It was evident through discussions with the staff that there are clear lines of accountability within the homes management structure and through discussions and observations it was considered that the management approach created an open and positive atmosphere from which the service users benefit.

What has improved since the last inspection?

The home has continued to improve the programme of daily living skills and methods of communication. It was evident that the Proprietor is continually improving, upgrading and individualising the service users bedrooms and all communal rooms, including the garden area. The kitchen has been totally refurbished, continual maintenance is high on the agenda and many areas, inside and out, have been redecorated. It has to be noted that at this home that the proprietor and staff are constantly reviewing all aspects of the service to achieve best practice and maintain a high quality service.

What the care home could do better:

No shortfalls were identified at the time of this inspection.

CARE HOME ADULTS 18-65 Elisabeth House Rhosweil Weston Rhyn Oswestry Shropshire SY10 7TE Lead Inspector Janet Oxley Unannounced 26 July 2005 10.00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Elisabeth House Address Rhosweil Weston Rhyn Oswestry Shropshire SY10 7TE 01691 680983 01691 680983 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 Sonja Eckert-Hopkins Care Home only 9 Category(ies) of Learning Disability - 9 registration, with number of places Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13 January 2005 Brief Description of the Service: Elisabeth House is a privately owned care home registered to provide care and accommodation for up to 9 people with a learning disability, 2 of whom are over 65 years old. The home is owned and managed by Mrs S EckertHopkins.It is located in the hamlet of Rhosweil, some 8 miles north of Oswestry in North Shropshire, in a quiet area next to a canal but within easy reach of main roads and the local towns. The home has the use of 3 vehicles for ease of access.Elisabeth House was originally converted from a row of 4 cottages and provides homely accommodation on 2 floors in 2 double and 5 single bedrooms. Bathroom and communal living facilities exceed the required standards and the home has pleasant and well-kept grounds and gardens. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection reviewed key standards only as the home is currently considered to be performing well and thus warrants the application of a reduced methodology The inspection was unannounced and commenced at 10am. It included observing activity within the home, inspecting the premises, looking at records and case tracking and talking to the Proprietor and three staff who were welcoming and helpful throughout the inspection. Three residents were at home at the time of inspection and appeared well looked after and content. It was found that the National Minimum Standards assessed had been met with a number exceeded, and that the overall quality of care provided was good. Visitors, relatives and visiting professionals have expressed satisfaction with the service and care the residents are receiving and have been complimentary regarding the management and care practices at the home. What the service does well: This is a home for adults with learning difficulties where the residents are looked after well. The staff respect the individuals in their care and follow detailed individual care plans encouraging each to maintain current skill levels and take part in a wide variety of activities that they evidently enjoy and benefit from. All necessary records and policies are professionally maintained. The home provides a very pleasant and personalised environment to live in. It was evident through discussions with the staff that there are clear lines of accountability within the homes management structure and through discussions and observations it was considered that the management approach created an open and positive atmosphere from which the service users benefit. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 6 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. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 4 The policies and procedures that are in place, and have been professionally followed, ensure that the home undertakes all necessary assessments for successful and satisfactory admissions to take place. EVIDENCE: All the required information for prospective residents is available. One admission has taken place since the last inspection. Full and comprehensive assessments were made, prior to admission, covering all the required elements of these standards, the home fully demonstrated its capacity to meet the assessed needs and the transition to being resident at the home was conducted professionally and sensitively with all relevant persons involved. Pre-admission visits and meetings took place and these were recorded in detail. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 Each resident has a comprehensive and updated care plan, which includes aspects of daily living and care they require. Staff evidently respect resident rights and there is a constant monitoring and review process to ensure their identified needs are being met and individualised care given. EVIDENCE: Care documentation pertaining to the one resident, who had been admitted since the last inspection, was read. The care plan was very comprehensive and provides the staff team with the necessary information required to meet the individual’s needs. Detailed reports are completed in preparation for reviews. With staff support, the residents who are able are engaged in all aspects of the running of the home. Individual and generic risk assessments are well established. At the time of this inspection it had been identified that the home could no longer meet the needs of one resident, whose health had significantly deteriorated and it was considered that the home will be working sensitively and professionally with the placing authority to find an alternative and Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 10 satisfactory placement for the individual, who has lived at Elizabeth House for a number of years. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15 The lifestyle of the residents living at this home appeared satisfactory and through a framework of activities, independence, personal and social skills they are encouraged to develop. Family ties are maintained and visits and meetings with relatives are encouraged and supported EVIDENCE: The residents disabilities would prevent them from entering a world of work however the majority attend college and participate in basic skills, literacy and numeracy, basic computing, cooking, music and hair and beauty. Local day services are also attended and the Monkmoor centre and Patchworks are also attended. To the extent they are able, residents are all encouraged to personally develop and those who are able enjoy a number of activities, parties and holidays. Visitors are encouraged and welcomed and residents are supported to maintain links with their families. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 The health and personal needs of service users appeared to be met with evidence of regular review and of multi disciplinary working taking place on a regular basis. EVIDENCE: Residents records seen and discussions with staff indicated that the staff monitor health needs, make appropriate referrals and appointments to health care professionals. The support individuals require is well documented and on inspection it was evident that residents preferences for times of getting up and having meals etc were being respected. The Proprietor recently requested a full review for a resident whose health has significantly deteriorated. At the time of this inspection it appeared that medication was being administered, recorded and secured satisfactorily. The support of Doctors and Consultants for all residents is ongoing Behavioural changes of service users are also monitored and plans and risk assessments for activities are in place. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Elizabeth House has appropriate policies and procedures in place for the protection of service users. EVIDENCE: No complaints have been received since the last inspection. A full complaints procedure is available and given that the residents would have some difficulty understanding the concept of a complaint it was evident that staff are sensitive and have developed methods to identify what residents like, dislike or object to and explore new avenues in efforts to overcome the difficulties. At the time of this inspection it was very evident that the residents are very confident to do what they want within the homes environment. Robust procedures are in place to protect service users from abuse and are included in all aspects of staff training. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27,28 and 30. The standard of the environment within the home is very good, providing service users with a warm, safe and homely place to live. EVIDENCE: All areas of the home were seen to be very well maintained and homely. All residents bedrooms are personalised. The home is furnished and equipped to a high standard throughout. Lounges, dining areas and a fully fitted kitchen are provided and outdoor space is proportionate to the number of people residing at the home, is attractive and well maintained with pleasant seating areas. At the time of this inspection the standard of cleanliness and hygiene was excellent and at the time of the most recent Fire Officers and Environmental Health Officers inspections matters were reported to be satisfactory. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Service users are supported by a well trained and committed staff group who are meeting the needs of each individual in a sensitive and professional manner. EVIDENCE: No staff have been recruited since the last inspection and all necessary staff records are maintained. The management continue to support staff to undertake their NVQ 2 and 3 awards, a very good variety of other training has been undertaken and the staff on duty indicated that they were very sensitive to the service users needs and disabilities and that their attitudes and practice were monitored and supervised by the management. Appraisals, recorded supervisions and regular team meetings take place. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 There are clear lines of accountability within the homes management structure and the management approach creates an open and positive atmosphere from which the service users benefit. The home regularly reviews all aspects of its performance and meets the requirements of the Fire Officer and Health and Safety Officer, promoting the health, safety and welfare of the service users. EVIDENCE: The Proprietor is fully quailfied and has run the home for over 10 years and has recently attended a variety of relevent training courses to keep herself up to date and to enable her to cascade the training to all staff. The manner in which the Proprietor and staff responded to this inspection indicated that a sound management approach is in place and that staff are committed to achieving best practice and to developing equal opportunities. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 17 Health and Safety matters appeared satisfactory and no potential hazards were identified. All necessary records required are maintained and all staff have received training in Health and Safety matters. Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 3 3 3 x 4 Standard No 11 12 13 14 15 16 17 x 4 4 x 3 x x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elisabeth House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 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 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 Good Practice Recommendations Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn Shrewsbury SY2 5DE 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 Elisabeth House E56 S20684 Elisabeth House V219832 UI 260705 Stage 4.doc Version 1.40 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. 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!