Inspection on 25/10/06 for Elizabeth Court Care Centre

This inspection was carried out on 25th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Elizabeth Court Care Centre 17/03/08

Elizabeth Court Care Centre 04/06/07

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Elizabeth Court Care Centre New Street Sutton St Helens Merseyside WA9 3XE Lead Inspector Miss Diane Sharrock Unannounced Inspection 10:00 13th 25 October 2006 th 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 Elizabeth Court Care Centre DS0000066312.V320916.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. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elizabeth Court Care Centre Address New Street Sutton St Helens Merseyside WA9 3XE 01744 821700 01744 821701 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) Key Healthcare (St Helens) Ltd. Mrs Elizabeth Baldwin Care Home 43 Category(ies) of Dementia - over 65 years of age (43) registration, with number of places Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Brief Description of the Service: Elizabeth Court is a care home that provides nursing and personal care for up to 43 Residents. The home is registered to provide Nursing care for Elderly Infirm older Persons with a diagnosed condition of dementia. The home is a privately owned by Keys Healthcare and Mr Keys is the Responsible Person and the registered Manager is Mrs Baldwin. The home is newly registered and has been open now for over 6 months. The home is purpose built over 2 floors and each bedroom has its own ensuite toilet and basin area. The Home has gardens to the rear. Parking is available to the front and the rear of the building. The care home is fully equipped with grab rails and other aids to assist disabled service users manage the premises. It has a call system located throughout the building. The care home integrates easily into the local environment being of a pleasant appearance. Elizabeth Court is located in an established residential area of St Helens with easy access to local facilities. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two days and was the homes first inspection since the home had been registered with the Commission for social care and Inspection. This inspection was unannounced. Information for the inspection was gathered in a number of ways, this included, a tour of the building, informal discussion with some of the Residents and Relatives and reading records and documents in the home. A selection of comments cards were also left in the home. In total just one has been sent in. Feedback was given to the Manager at the end of the inspection. The homes pre inspection questionnaire gave the details for fees for the home ranging from £400 per week to £550 per week. What the service does well: What has improved since the last inspection? Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 6 This is the homes first inspection so there are no other reports to compare with, however the home have presented a very well managed home offering very high standards. What they could do better: Full feedback was given to the Manager at the close of this inspection. This inspection was very positive and there were just some issues to develop further to meet the standards. Some areas of health and safety needed attention such as occasional holes to radiator tops needed covering, as radiators were hot to touch, most were found to be appropriately covered. 1 bathroom flooring was coming up on its edges and needed a risk assessment and repair to prevent any accidents. The storage of cleaning trolleys in the linen cupboard should be reviewed to provide another area for its storage. The Training records are well developed. Some attention should be given to all mandatory training so that all Staff know when they will be attending training such as, food hygiene, abuse awareness, challenging behaviour and dementia. The Service User guide and Statement of Purpose must be updated and made accessible to everyone and should include details on the changes to the home regarding the residential and nursing areas of the home. Details must be given on the companies commitment to a Staffing level for the home and include the current fees. Future developments should include questionnaires with everyone’s opinions and the results publish in these reports. The Company have master copy care records that meet the standards however those care plans looked at needed further input by the Staff to make sure the records were up to date and met the Residents needs. The management of medications was well managed. Some areas needed further review including some controlled drugs that needed disposing of, and daily records should be kept of the drugs fridge. There were positive comments from people regarding communication at the home. However further developments were needed in developing regular Resident/relative and Staff meetings. Supervisions should be developed regularly for all Staff so they can discuss all areas of their work. A development plan should be developed for the home, which can then be shared with Staff/Residents and Relatives explaining what plans there are for Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 7 the home, giving everyone the chance to express their opinions about the plans. 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. The summary of this inspection report can be made available in other formats on request. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 8 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 Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1/3 standard 6 is not applicable Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home did make sure they are able to meet resident needs and choices prior to them moving in. However some records needed to be up-to-date and accessible to make sure everyone is aware of what the home has to offer. EVIDENCE: A review of one Residents records showed a detailed assessment carried out prior to their admission. This helped the home to assess that they could meet the person’s needs. In discussion with the manager it was noted that another care file did not have a care plan in place. This should be reviewed and an appropriate care plan, agreed by the resident, should be in place. This should give enough detail for Staff to support the resident with their needs. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 10 A review of the homes Service User guide and Statement of Purpose showed they must be updated and made accessible to everyone and should include details on the changes to the home regarding the residential and nursing areas of the home. Details must be given on the companies commitment to a Staffing level for the home and include the current fees. Future developments should include questionnaires with everyone’s opinions and the results publish in these reports. Most people were happy with the home but some people when asked did not know about the previous Residents meeting or were the statement of purpose or Service User guide were kept. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7/8/9/10 Quality in this outcome area is, good, This judgement has been made using available evidence including a visit to this service. The home did manage Residents health and personal care needs to a good standard. EVIDENCE: Four care plans were reviewed for case tracking. Most gave good details of the Residents needs and the care required. The Company have master copy care records that meet the standards however those care plans looked at needed further input by the Staff to make sure the records were up to date and met the Residents needs. One care plan did not have dates or signatures for the bed rail assessment, another had a personal hygiene record in place but Staff had not recorded in this useful assessment. One care file was noted to not have a care plan in place, this was discussed with the Manager. Regular care plan reviews would make sure all the plans are checked and have the right details for all of the Residents needs. In discussion with Visitors and Residents they expressed how happy they were with the care. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 12 There were many positive and complimentary comments both from Residents, Relatives and Staff, including comments such as, “She is very happy here and very settled, she also has a key so she can keep her room locked and she just pulls the cord if she wants the Staff.” The Staff are very good, she likes her room and has everything she needs.” “We are very happy with the home we think its brilliant.” “You couldn’t get better Staff.” In speaking to Residents it was obvious that Staff had taken time and care in supporting Residents with their personal care and helped them dress in clothes they chose. The management of medications was well managed. A sample of medication records and storage of medicines was seen during this visit. Some areas needed further review including some controlled drugs that needed disposing of, and daily records should be kept of the drugs fridge, as currently they are not recorded. Most of the medications administrations was found to be in good order. Regular medication reviews would make sure that the management of medications was carried out appropriately to safe guard all practices with medications. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12/13/14/15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provided adequate support to Residents to meet their social needs EVIDENCE: The home have now managed to appoint their own activities organiser who explained what plans she had to develop activities. She is currently doing her care award at level 2 and works five days a week, 9am to 5pm. She is also attending a course specifically on activities for people with Dementia, which she is hoping, will be useful to develop the programme further. Some activities were displayed on the notice board, and one Resident made a comment that he couldn’t read it. It may be beneficial to have large prints developed and have them displayed on all notice boards and stairwells as some Relatives made the comment they didn’t know what was going on and hadn’t seen the notice. Some Relatives said they didn’t know of the previous managers surgery or the Residents/Relatives meeting and would be keen to have more easily information displayed. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 14 On the ground floor notice board within the Residential unit the Staff have all of the pictures displayed, which helps people know who each member is. Relatives said they could call whenever they wanted and were always made to feel welcome. One person said they would like to see a video on the upstairs nursing unit and would welcome more activities. During this visit the Staff were carrying out beauty treatments providing manicures and the hairdresser was in also in attendance. One person stated, “she is very happy here and very settled, she also has a key so she can keep her room locked and she just pulls the cord if she wants the Staff.” One Resident showed the Inspector her room and said that she has a key and can use it whenever she wants; she felt very happy and settled at the home and said she had everything she needs. During meal times, Staff were observed providing support to Residents with their meals. Residents and Relatives said, “The food is very good here.” All being complimentary about the meals. Menus could be developed in large print so that some Residents can read them easily. The Cook has a very organised kitchen and always records when there are any complaints or comments about the food so that he can show what he has done following their comments. Kitchen Staff have updates to their training qualifications, however it was noted that they did not have regular supervision and they had been involved in an organised Staff meeting. Regular supervision and Staff meetings will help Staff to have open communication to discuss all aspects of the work. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16/18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Training records and complaint polices make it clear that Staff are informed how to protect Residents. EVIDENCE: The homes complaints procedure is displayed on the notice board and most people said they would speak to the Staff or the manager if they had concerns. One persons said they were not sure who they would go to with concerns and 3 people did not know were to find a Statement of Purpose or Service Users guide which also has the homes complaints procedure. If this policy is regularly discussed at meetings and accessible in these documents it will help people with Staff support to be confident in accessing this policy. Regular training has been provided and carried out by the company. One person acknowledged they had not yet received their training in “abuse awareness”. This was discussed with the manager, as this mandatory training must be provided for all Staff employed at the home to ensure the ongoing safety of Residents at the home. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 16 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. 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 is very well maintained and offers a high standard of living. EVIDENCE: An inspection of a sample of living areas in the home showed a very clean and pleasant area to live. Residents and Relatives were all saying they were very happy with the facilities and one lady liked the idea of being able to lock her bedroom. All bedrooms seen had colour co coordinated linen with attention to detail to their living space and each bedroom had ensuite toilet areas. The Manager explained further development in the home in which they are planning to develop the gardens to include facilities suitable for people with dementia. The home was noted to be highly maintained with just some issues that needed attention and risk assessment to be applied to any hazard noted. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 17 ; Such as occasional holes to radiator tops needed covering as radiator’s were hot to touch, most were found to be appropriately covered. 1 bathroom flooring was coming up on its edges and needed a risk assessment and repair to prevent any accidents. One bathroom was noted to have a collection of toiletries that shouldn’t be left around in a communal area for people in this category of care. The storage of cleaning trolleys in the linen cupboard should be reviewed to provide another area for its storage. The Staff room was noted to be wedged open and will need to be risk assessed as it was seen as a fire safety door. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27/28/29/30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provided sufficient, experienced and trained Staff to meet Residents needs. EVIDENCE: Staffing rotas were seen during this inspection and most Staff and Residents felt they had enough Staff to carry out the care needed. Residents and Relatives didn’t know how many Staff are usually on duty and were unsure of the usual numbers. One Relative explained that since the home had opened they had experienced a lot of Staff, movement especially when the home changed the ground floor to a residential unit. However they did acknowledge that as the home admitted more Residents that mores Staff were employed at the home. There was no display of the homes staffing notice or details in the homes statement of purpose regarding what the Staffing levels the company commits to. This should be reviewed to ensure that all parties are given this necessary information to assist in their choice in coming to the home. The company must also evidence how the Staffing levels meet the ongoing dependencies of the Residents. This will show the commitment to appropriate Staffing levels to meet the Residents needs. A sample of 4 Personnel files were looked at and were noted to be very organised and detailed with all necessary records and checks including police (CRB) and Protection of Vulnerable Adults (POVA) checks. This showed a good Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 19 recruitment and selection policy, which helps to safe guard Residents in the home. A sample of Staff training records showed most to be up to date and clear and Staff stated they were enjoying all the training offered by the company. This showed evidence of experienced Staff to meet the Residents needs. The homes pre inspection questionnaire did not give details of how many Staff have their care qualification (NVQ) but the manager explained that she felt most Staff had this qualification including domestic Staff. During interviews with Staff and in reviewing Staff training records it was acknowledged that some Staff had not yet received their mandatory training in some areas including, abuse awareness, food hygiene, challenging behaviour and dementia. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31/33/35/38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well managed and run in the best interests of Residents. EVIDENCE: The manager offers a good standard of management and ethos in how she manages the home. There were various positive comments about the manager including, “The manager is lovely nothing is too much trouble for her, and there are never any smells.” The Provider carries out monthly unannounced visits to the home and covers a lot of areas of the home, which measures against the national standards. He also includes an action plan following each visit which helps Staff to further meet the standards in those areas identified as needing more input. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 21 A sample of financial records managed on behalf of Residents and Relatives showed detailed accounts managed in the best interest of the Residents. The home is well managed and offers a high standard to the environment. There were just a few areas of health and safety needing attention and risk assessments to be put in place, as listed previously in this report. Health and safety polices are in place with detailed records kept of all checks including all contractor and maintenance checks. Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 22 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 2 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 X X 3 Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 23 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 OP30 Regulation 18 1 c Requirement The Registered Person must ensure that all Staff have necessary training to meet the needs of Residents at the home. Timescale for action 22/01/07 2 OP19 23 1 The Registered Person must 22/01/07 carry out health and safety risk assessments detailing what actions are taken to evidence the home is safe in all areas. 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 OP1 Good Practice Recommendations To provide an accurate and accessible Service User guide and Statement of Purpose to Residents and all other parties, to include details of changes at the home and to include the homes Staffing notice. To carry out regular medication audits to evidence what actions are taken to meet the standards Activities should be further planned and developed to meet DS0000066312.V320916.R01.S.doc Version 5.2 Page 24 2 4 OP9 OP12 Elizabeth Court Care Centre 5 OP7 resident’s social needs. To develop large print activity programmes suitable to individual needs. To organise regular Resident and Relative meetings to evidence how they can participate in the home. The Responsible Person must ensure that care plans are developed to meet standards7 & 8 in full. To develop large print menus suitable to all Residents individual needs, to have regular discussions regarding menus and any proposed changes. To develop regular Staff meetings for all Staff. To ensure all Staff have regular supervision sessions. To evidence how current Staffing levels meet the Residents dependency levels. 6 7 OP15 OP31 Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Elizabeth Court Care Centre DS0000066312.V320916.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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