Inspection on 27/04/05 for Elizabeth House

This inspection was carried out on 27th April 2005.

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 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 01/11/07

Elizabeth House 20/06/06

Elizabeth House 15/12/05

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Elizabeth House 35 Queens Road Oldham Lancashire OL8 2BA Lead Inspector Sandra Bennett Unannounced 27th April 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. Elizabeth House Version 1.10 Page 3 SERVICE INFORMATION Name of service Elizabeth House Address 35 Queens Road Oldham Lancashire OL8 2BA 0161 626 6435 0161 287 8191 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) Elizabeth House (Oldham) Ltd Mr Philip Leicester CRH 26 Category(ies) of DE Dementia - 2 registration, with number DE(E) Dementia over 65 - 15 of places MD(E) Mental Disorder over 65 - 5 OP Old age - 26 Elizabeth House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1 The home is registered for a maximum of 26 service users to include up to 5 service users in the category of MD(E) (Mental disorder excluding learning disability or dementia over 65 years of age). Up to 15 service users in the category of DE(E) (Dementia over 65 years of age). Up to 2 service users in the category of DE (Dementia under 65 years of age). Up to 26 service users in the category of OP (Old age not falling into any other category). The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. No more than two service users may be admitted into the home between 55 and 64 years of age. 2 3 Date of last inspection NA Brief Description of the Service: Elizabeth House is a large detatched property situated close to Oldham town centre. Accomadation is presently 22 single ensuite rooms and two shared ensuite rooms. There are four lounges with dining areas and a large dining room. Adapted bathing facilities are provided with communal toilets being situated close to lounge areas.Outside of the property consists of a large garden patio to the front and enclosed patio to the rear also a small parking area. Elizabeth House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unscheduled inspection took place on the 27/4/05 over an eleven-hour period. It found that some of the National Minimum Standards had been met or partially met. The inspector had the opportunity to speak to eight service users, two relatives and one health professional who were satisfied with the on going refurbishments in the home and care delivery. Areas of concern were raised by service users which were addressed throughout the inspection. At the end of this inspection the manager was advised of the action they need to take to remedy shortfalls identified in this report. What the service does well: What has improved since the last inspection? A spacious environment, ensuite accommodation and attractive garden areas have been provided. The refurbishment of the home is still ongoing but have been completed sufficiently has to reduce the disruption to service users. The home’s quality assurance systems have improved to include the views of professionals and service users representatives. Elizabeth House Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Elizabeth House Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Elizabeth House Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3, (6 NA) There was a lack of information available for service users to make an informed choice about what the home offers and the terms and conditions of residency. Service users needs are assessed prior to admission. EVIDENCE: Although the homes statement of purpose and service user guide had appropriate information this was in a format which was not user friendly making it difficult to understand. One relative stated that her mother had been in the home for nearly three weeks and they had still not received any information on what the service offers or the terms and conditions of residency. Examination of satisfaction questionnaires found other relatives in their feedback had also commented on this. Four-service user files were examined one of which was an emergency admission all were found to have detailed assessments of their needs. Elizabeth House Version 1.10 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,10 The health care and privacy needs of service user are not fully identified or consistently met. Service users right to privacy are not fully protected. EVIDENCE: Although the home had received detailed assessments of the service user needs prior to admission the latest admission into the home did not have a detailed care plan which reflected their assessed needs. Interviews with care staff and service users identified that the care needs of service users were being met. However inconsistencies may occur unless full details of the service users needs are accessible for staff to refer to. The recording systems in the home were not compiled in a comprehensive manner making case tracking difficult to follow. This was obviously so for care staff as a number of omissions to the recording of service users needs were identified. There was insufficient evidence of access to health care professionals or details of care delivery in daily reports for all service users. There was evidence of nutritional screening and weight monitoring of service users. Aids and adaptations were provided i.e. pressure mattress. Elizabeth House Version 1.10 Page 10 Interviews with a visiting District Nurse found that the home consults regularly with them on the health care needs of service users. Staff had received training in the needs of people with age related diseases including dementia and training in the administration of handling of medication. The privacy of service users was compromised by the lack of locks to toilet and bathroom doors in addition to this one of the shared rooms did not have a privacy curtain in place. Elizabeth House Version 1.10 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 standard(s) 12,13,14,15 There is a lack of social activities for service users and a need to better take account of service users wishes and choices regarding their preferred lifestyle. Meal times were well managed and offered a range of choices. EVIDENCE: This inspection began at 6.30 am at which time nine service users were up, five of which were fast asleep in their chairs. Two of the service users confirmed they got up early to aid staff routines. Examination of one of the service users file found that their preferred time for rising was 9am. As the morning progressed other service users got up at various times with a positive feature being able to have a cooked breakfast if they wished. In addition to allocated meal and snack times service users asked for drinks, snacks and fruit quite freely indicating this was normal part of their daily life. All the service users and relatives interviewed were complimentary regarding the quality and choices of food available to them. One relative commented that the service users had only been in the home two weeks and had gained weight and there had been a big improvement in their personal appearance. Elizabeth House Version 1.10 Page 12 Two service users stated they went out of the home unaccompanied with others requiring assistance. Comments were made also of a local church visiting the home. Both relatives and service users spoke about the lack of social activities, which recently had only been undertaken on staff availability. Elizabeth House Version 1.10 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 standard(s) 16,17,18 Service users legal rights are protected and safe guards are in place to ensure they are protected from abuse. There was a lack of evidence that complaints made directly to the home are taken seriously. EVIDENCE: The home has a detailed complaints procedure which service users were aware of. No record was kept by the home of any complaints made or action taken. One complaint had been received by the CSCI over the last year alleging poor practice, in that service users were made to get up to early in the mornings. This complaint was upheld. A procedure for responding to allegations of abuse was available for staff with staff at interview being aware of how abuse may present and the action required to be taken should abuse occur. Staff confirmed they had undertaken training in the prevention of adult abuse. There was evidence of service users having a postal vote for the forthcoming general election. Elizabeth House Version 1.10 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 standard(s) 19,20,21,24,25,26 Further work is needed to ensure the environment is safe, clean and comfortable for all service users. EVIDENCE: Since the last inspection the home has continued with their refurbishment programme, which is still ongoing. A number of areas still require to be addressed. The inspector was let in to the property early morning by a service user whilst staff were assisting other service users to get up It was some time before staff were available, leaving service users on the ground floor at risk from intruders. Building work is still ongoing on the inside of the home which has resulted in other areas requiring new carpets and redecorating. Odours were present in certain areas of the home. Elizabeth House Version 1.10 Page 15 Service users commented that they were pleased with the refurbishments so far, which had given them an additional lounge/dinging area, and a smoke room. Radiator covers had been provided in high-risk areas with risk assessments being undertaken on the remaining radiators, the replacement of which forms part of the refurbishment programme. Privacy for service users was compromised due to the lack of locks on toilet and bathroom doors. Water temperature was delivered to hot too ensure the health and safety of service users. Records had not been maintained of checks to the control valves on water temperatures. Elizabeth House Version 1.10 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 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) 27,28,29,30 Staff recruitment and training were not robust enough to provide adequate protection for service users. The lack of ancillary staff over the weekend period compromised the safety and hygiene standards in the home. The number of staff who holds NVQ needs to be increased. EVIDENCE: The homes duty rota did not reflect the hours worked by management, also there were insufficient ancillary hours provided over the weekend period. There had been a high turnover of staff over the last six months. All staff receive a two day induction with an outside agency as an initial introduction process. Unfortunately this had not been continued to include an in-depth approach to service users needs in the home. There is a need to promote NVQ training for staff. Examination of duty rotas, interviews with staff and service users highlighted a shortfall of ancillary staff over the weekend period, with care staff being required to perform domestic duties. This resulted in service users receiving a lesser degree of attention and hygiene standards than they were normally used to. Elizabeth House Version 1.10 Page 17 Criminal Records Bureau checks had not been requested for two members of staff, the ones on file having been brought to the home by staff from a previous employer. Elizabeth House Version 1.10 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 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) 31,32,33,34,35,36,37,38 The management of the home needs to improve as there is a lack of formal staff supervision to ensure consistency in care practices. The home had taken positive steps in the consultation of service users and their representatives. Service users finances are not safeguarded recording systems are poor. EVIDENCE: Regular staff supervision had not been undertaken. Interviews with staff showed that there were no systems in place for care task allocation, although at change of shift a handover took place regarding the care needs of service users. This method does not promote accountability in the home and may lead to tasks being overlooked. Staff reported that staff meetings did take place regarding ongoing developments in the home. Elizabeth House Version 1.10 Page 19 There was no job description for the assistant manger and a lack of clear lines of accountability in the management team. Service user confirmed meetings took place and satisfaction questionnaires had been sent to service users, relatives and health professionals. Examination of monies and accounts held on behalf of service users found that these were held in the home’s business account with several service users having substantial amounts. This matter must be addressed with some urgency. While service users and their visitors made positive comments about the staff team comments were made regarding the lack of information available to them. Many staff had undertaken training in health and safety, including infection control, food hygiene and first aid. Good risk assessments had been carried out on all aspects of the home and building work while the refurbishment of the home is still ongoing. Elizabeth House Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 2 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 3 2 2 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 3 3 2 2 3 2 2 2 2 2 Elizabeth House Version 1.10 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 1 Regulation 4/5 Requirement The registered person must ensure that service users are provided with sufficient information on which to make an informed choice on what the service offers The registered person must ensure that service users and their representatives are provided with a copy of their terms and conditions of residency. The registered person must ensure that all service users have in place a care plan at the point of admission to the home The registered person must ensure a planned programme of activities is developed for service users. The registered person must ensure that privacy locks are provided on toilets and bathrooms.Privacy screens must be provided in shared rooms The registered person must ensure hygiene standards are maintained and the home is free from odours. The registered person must ensure that night staff and Version 1.10 Timescale for action Immediate 2. 2 5(1)b Imediate 3. 7/37 15(1) Immediate 4. 12 16 (2)m 31/8/05 5. 24 12(4) 6. 26 16(2)(k) 13(3) 18(1) Immediate Timescale of 31/12/04 not met Immediate 7. 27 Immediate Elizabeth House Page 22 8. 28/30 18(1) 9. 29 19 Schedule 2 12(1) 10/12 10. 11. 31 32 12. 34, 35 17 Scchedule 4 18(2) 13. 36 14. 38 13(4)(a) ancillary staff are provided in sufficient numbers to meet the assessed needs of service users. The registered person must ensure the number of staff who hold NVQ is increased to 50 . Staff inductions must be extended to include ongoing care practices in the home. The registered person must ensure that criminal records bureau checks are obtained for staff before their employment is confirmed. The registered person must provide a job disicription for the assisstant manger. The registered person must ensure that staff roles and responsibilities are clearly defined in order to provide an organised structure and clear lines of acountability for staff (Timescale of 1/10/04 not met) The registered person must ensure that service users finances are not held with the homes buissness account. The registered person must ensure that staff supervision is carried out a minimmum of six times a year. The registered person must ensure that hot water is delivered at a temperature no greater than 43 degrees. 31/12/05 Immediate 31/7/05 Immediate 31/7/05 31/12/05 Immediate 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 14 Good Practice Recommendations The registered person should ensure the choices and wishes of service users regarding their lifestyle in the Version 1.10 Page 23 Elizabeth House 2. 3. 16 25 home is obtained and recorded on care plans The registered person should ensure that complaints recieved by the home are recorded togeather with action taken. The registered person should ensure that the refurbishment plan includes covers to remaining exposed pipework and radiators and is completed within timescales. Water tempratures should be recorded on a regular basis. 4. Elizabeth House Version 1.10 Page 24 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton under Lyne OL7 OQD 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 Version 1.10 Page 25 - 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!