Inspection on 02/11/05 for Elizabeth House

This inspection was carried out on 2nd November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Elizabeth House 21/11/06

Elizabeth House 24/03/06

Elizabeth House 09/03/05

Elizabeth House 01/11/04

Elizabeth House 12/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Elizabeth House 147-155 Walshaw Road Bury Lancs BL8 1NH Lead Inspector Stuart Horrocks Unannounced Inspection 2nd November 2005 09:30 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 House DS0000008401.V263018.R01.S.doc Version 5.0 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 House DS0000008401.V263018.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elizabeth House Address 147-155 Walshaw Road Bury Lancs BL8 1NH 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) 0161 762 9394 0161 764 6700 Canbra Care Limited Ms Lynn Parsons Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2005 Brief Description of the Service: Elizabeth House is owned and managed by Ms Lynn Parsons. The home can provide 24 hour care for up to 18 older people. The property is on Walshaw Road Bury and is about one mile from the town centre. There is a bus stop on the main road close to the home and there are shops nearby. The accommodation is provided on two levels with a lift giving access to the first floor. The home has ten single bedrooms and four rooms that are shared all of which have an en-suite toilet and handbasin. There is a well furnished and comfortable lounge, a dining room and a conservatory that can be used all year round. Toilets and bathrooms are provided on both floors. The home has a garden area with seating that can easily be reached from the conservatory. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was started at 9.30am.It took place on one day and it lasted for about six hours. The time was split between talking to the manager and checking records, and looking around the home, watching what was happening and talking to residents, visitors and other staff. Four residents, four visitors and three staff were spoken with. What the service does well: What has improved since the last inspection? What they could do better: Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 6 The home needs to make sure the a certain risk assessments are done, kept up to date and reviewed so the residents are protected and safe. 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. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The above key Standard 3 was not examined at this inspection. It will be checked at the next inspection. It should however be noted that this standard was met at the previous inspection Elizabeth House does not provide intermediate care services (key Standard 6). This standard does not therefore apply. EVIDENCE: Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 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 the following standard(s): 7 and 8. Although arrangements are in place that generally ensures that the resident’s health care needs are monitored and met some risk assessments need to be made better therefore making sure that the residents are safe. Individual care plans are also in place, which were up to date, regularly reviewed and provided the staff with the information they needed to give a good standard of care. EVIDENCE: The care files of three residents were looked at. Each of these files contained a detailed and comprehensive care needs assessment that describes the help that the resident needs with everyday living including health, personal and social care needs. All of this paperwork had been reviewed at the required monthly interval using a separate document that described any changes in the way that the resident needed to be looked after. Those staff that the inspector spoke with said that the residents care plans were always available for them to read and that they used them so that they knew what care the residents required. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 10 Talking to residents, the manager and the staff and looking at records showed that the resident’s health care needs are taken care of and that when necessary health workers such as doctors, nurses and opticians are called. Looking at a number of residents records also showed that the weight of the residents’ is also regularly checked. Various risk assessments were in place which were up to date apart from those for safe moving and handling which seemed to have been last reviewed in January 2005.The inspector is of the opinion that theses should be up-dated at a minimum of every six months. A requirement has therefore been made reminding the manager to make sure that this is done. Suitable equipment is available for the treatment and prevention of pressure sores although the inspector was told that no resident had such sores at the time of this inspection. The manager is aware that should anyone develop this condition the treatment and progress of the ailment must be properly written down. The inspector was aware that the home has one set of bed rails, which can be used when necessary, to stop residents from falling from their bed. The use of this equipment often carries risks such as residents becoming trapped in the rails and being injured. If these rails are to be used the manager must do a thorough written risk assessment and must also consult with professional workers such as nurses, the doctor and the local Social Services Department to make sure that it is right and safe to use them. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 ,13 and 15. The home offers a number of leisure activities, which help to keep the residents interested and stimulated. The visiting arrangements are flexible thus enabling residents to have good contact with family and friends as they please. The meals at this home are good, offering choice and variety, and catering for individual dietary needs. EVIDENCE: The residents have choice about their daily routines thus they are able to spend their time as they wish. Those residents spoken with said that they decide about such things as going to bed and getting up times, which clothes to wear, which lounge they sat in and how they spent their day. They said that were comfortable living at the home and that the home was “relaxed” and “restful”. The home provides a number of recreational and stimulating activities (e.g. quizzes, exercises, crafts, reminiscence sessions, entertainers, shopping trips) that the residents are encouraged to join in with. At the time of this inspection early preparations were being made for the Christmas celebrations with various sorts of outings and entertainment being considered. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 12 Discussion with residents and staff confirmed that the visiting arrangements are flexible with these being described in the resident’s information guide. Those residents spoken with said that they “were free to see their visitors wherever they wanted to”. They described taking visitors to their bedrooms for privacy or seeing them in the main lounge. The residents said that visitors are made welcome and that they (the visitor) can have a warm drink if they so wish. Visitors were seen to be coming and going from the home throughout the inspection. These people were made welcome and they said “that they could visit whenever they wished to”, and that no restrictions were imposed. Community contact is enabled by pupils from a local school who visit the home on Wednesday afternoons when they help the residents with arts and crafts activities. The home uses a three-weekly menu that offers a variety of good nourishing food. This menu provides a single choice but alternatives are readily available and are regularly provided. This is a relatively small home where individual choices are known and easily catered for. This was confirmed by the residents who said that the food was “good”, “appetising”, that “you get enough to eat” and that “you can have something else” if you don’t want what in on the main menu. Warm food is always offered at midday and a warm choice is also often available at teatime. The staff helped those resident who were unable to eat themselves. Everyone spoken to praised the food and no complaint was made. A choice of hot and cold drinks and snacks are available throughout the day. Meals were seen to be presented in an appealing manner with good portions offered. They are eaten in a comfortable and attractive dining room. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16. The home has a clear complaints system ensuring that concerns are speedily dealt with. EVIDENCE: The home has a straightforward complaints procedure, which is displayed in the home and is also available in the resident’s information guide. A book for recording complaints is kept at the home. One complaint has been made directly to the CSCI since the last inspection in March 2005.This complaint has been fully investigated. Some parts of this were found to be upheld with steps having been taken to put things right. The residents said they felt that any concerns that they had would be listened to and acted upon. The residents said that they would feel comfortable about raising concerns and that they would “talk to Lynn” (the manager) or to the staff if they had any worries. The relatives that the inspector spoke with also said that they would have no anxiety about raising concerns with either the manager or the staff although they said that they were “well satisfied” with the care provided. It was clear in discussion with staff that they also knew what steps to take should a resident make a complaint. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Elizabeth House care home provides clean, comfortable, homely and friendly surroundings for the people living there. EVIDENCE: Elizabeth House is generally well maintained to both the inside and the outside. Redecoration and replacement of furniture and equipment etc is done on a continuous basis. New easy chairs have recently been provided, the residents’ beds are presently being renewed and a programme of re-carpeting is underway. A new safety shower has been fitted and it is intended that the woodwork to the outside of the home will be re-painted shortly. There is a well-kept garden area at the rear of the home that is easily accessible from the conservatory, which is provided with seating. The home has acted upon any recommendations made by the local environmental health department and is in the process of completing the work required (smoke seals to fire doors) by the Fire Service thus ensuring everyone’s safety. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 15 The home’s laundry is presently in a wooden building, which is in the rear garden. The manager told the inspector that this building is shortly to be replaced (10th November 2005) by a fitted out prefabricated laundry structure which will also be positioned in the rear garden that will be masked by trees and shrubs. Written information about the control of infection is available. The home was clean and tidy throughout and was free from any offensive odours therefore providing a pleasant place to live. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30. Staffing levels were satisfactory thus ensuring both consistency of care and that the assessed need of the residents were met. Staff morale was good with the staff saying that they enjoyed their work at the home. The staff are properly trained to give the care that the residents need. EVIDENCE: Many of the staff team have worked at the home for a considerable time. This helps provide continuity and a good standard of care for the residents. The residents said that the staff were “easy to get along with” and that they were helpful and considerate. Staff morale was good with staff saying that “we work together well as a team”. Both residents and staff said that Elizabeth House was a “happy home”. Looking at duty rotas showed that staff were regularly available in sufficient numbers to ensure that care was properly provided. The manager and the staff said that the current staff numbers were sufficient to meet the needs and dependency levels of the residents living at the home at the time of the inspection. The staff are seen to be carrying out daily tasks but they also had time to sit and talk to the residents. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 17 The home employs one care worker who is under the age of 18 years, the manager must remember that this worker must not give personal care to the residents until they reach the age of 18. The staff gave examples of the training that they had done. This included induction to the job training, NVQ assessment, the giving out of medicines, safe moving and handling, fire safety, food hygiene and first aid. The provision of this training was confirmed when looking at staff training records. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 and 38. A satisfactory accounting system is in place which protects both the residents and the staff interests. Generally procedures and practices within the home promote and safeguard the health, safety and welfare of the people living and working in the home. EVIDENCE: The home has a satisfactory accounting system in place. The manager was able to show exactly how much money the home was holding for each person (four checked) and how the money was being spent. Records are kept of each financial transaction. Looking at records and maintenance certificates showed that these were up to date and the examination of paperwork and conversations with staff also confirmed that they had been provided with the necessary training so that they can work safely. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 19 The home is safely maintained with fire precautions tests done weekly and details of accidents are properly written down. Water temperatures at most hot taps are controlled is such a way as to prevent scalding, however the hot outlets on the two baths are not controlled in this manner. Although these have been risk assessed for safety and residents are not allowed to use the baths unsupervised the inspector strongly recommends the fitting of thermostatic mixer valves to these bath taps therefore reducing the risk of accidental scalding. Although some the windows on the upper floors of the home are made in such a way as to stop them being opened too widely some have not with the risk of falling from them being dealt with by risk assessment. The manger must make sure that the risk assessments for these windows and for hot water are kept up to date and under review. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 13,14 Timescale for action The registered person must 31/12/05 ensure that the’ manual handling and moving risk assessments for residents’ are reviewed and up dated regularly. The registered person must 19/12/05 ensure that the one outstanding item (smoke seals to fire doors) arising from the Fire Service inspection of 26th April 2005 is dealt with (Previous timescale of 30th April 2005 not met) . The registered person must 30/11/05 ensure that the use of bed rails is both risk assessed and recorded thus ensuring that the use of such equipment is safe. The registered person must 30/11/05 ensure that the risk assessments for upper floor opening windows and for the hot water outlets to baths are kept up to date and under review thus making sure that the residents are safe. Requirement 2 OP19 23 3 OP8 13 4 OP38 13 Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 22 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 OP38 Good Practice Recommendations The registered person should give serious consideration to the fitting of thermostatic water mixing valves to the hot taps on the homes two baths therefore making sure that the residents cannot be scalded. Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Elizabeth House DS0000008401.V263018.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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