CARE HOMES FOR OLDER PEOPLE
Elizabeth House Sandy Hill Werrington Stoke On Trent Staffordshire ST9 0ET Lead Inspector
Sue Jordan Unannounced Inspection 27th February 2006 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 DS0000004936.V284914.R01.S.doc Version 5.1 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 DS0000004936.V284914.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Elizabeth House Address Sandy Hill Werrington Stoke On Trent Staffordshire ST9 0ET 01782 304088 01782 304088 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) Mr Philip Harold Fradley Mrs Susan Elizabeth Fradley Mr Philip Harold Fradley Care Home 23 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (23), of places Physical disability over 65 years of age (6) Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th August 2005 Brief Description of the Service: Elizabeth House is a Registered Care Home for 23 older people, initially registered by the present Proprietors. The premises were originally a barn conversion and the proprietors former home. There is an existing single storey extension and a four-bedded extension. The Home stands in private grounds, which provides ample car parking for visitors. The Home is situated in Werrington, in a residential area on the outskirts of Stoke-on-Trent, bordering the Staffordshire Moorlands. The Home presents as an attractive and wellmaintained building. Internally the accommodation is of a high standard with a good standard of housekeeping throughout. It is warm, well furnished, appears comfortable with good décor and offers a choice of three lounges/sitting rooms of varying sizes with a separate dining room. Residents bedrooms are situated on both ground and first floor with access via stairs and a stair lift. All rooms are single occupancy with various en-suite facilities. Assisted toilet and bathing facilities are available. Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The key standards have all been inspected over a twelve-month period and therefore this report must be read in conjunction with that from August 2005. This Unannounced inspection took place over six hours and the methodologies used were scrutiny of staff and service user records, informal discussions with approximately six residents and some staff. What the service does well:
The residents spoken to praised the staff and management team and the quality of the food provided. The Home provides a comfortable, safe and homely environment. The needs of prospective residents are assessed prior to admission ensuring that the Home is able to support them. The Home’s documentation is current and allows prospective residents and their families to make an informed choice as to whether they wish to live there. Care planning continues to be high priority and service user needs are reviewed regularly. Health needs are monitored and professional services accessed appropriately. There have been no complaints made to the Home or the Commission for Social Care Inspection. Staff training is well planned and courses arranged within the appropriate frequencies. Recruitment procedures are robust and all of the required checks are made prior to employment. Record keeping is of a high standard and the management team regularly audit finances and accidents. A flexible approach to daily routines is encouraged. Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 6 No requirements have been made as a result of this visit and all previous requirements have now been met. 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. Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 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 DS0000004936.V284914.R01.S.doc Version 5.1 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): 1, 2, 3, 5 Prospective service users and their families have the information needed to make an informed choice as to whether they live in Elizabeth House and the manager ensures that the Home is able to meet their needs. EVIDENCE: The Home’s Statement of Purpose was updated in January 2006, ensuring a current reflection of the service provided. Four residents have come to live in the Home since the last inspection and two of their files were checked. The manager ensures that he receives an assessment and care plan from the referring social worker and also undertakes his own assessment prior to admission. One of the residents had previously stayed in the Home for respite care, whilst the other three were able to visit with their social worker or advocate. The Home develops contracts for those residents purchasing their own care and these are signed by the manager and service user and/or their representative.
Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 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, 8, 9, 10 Health and personal care needs are outlined within the care plans and delivered accordingly. EVIDENCE: Medical intervention is well documented and there is evidence of health monitoring and access to appropriate services facilitated. Individual care plans are promptly developed after admission and regularly reviewed. The medication procedures were observed and continue to be robust. It was discussed as to whether the dining room is an appropriate venue to administer eye drops. Privacy has improved for those residents for whom a lock has been fitted to their bedroom door. One of the residents confirmed her pleasure and satisfaction with the door lock. An observation of staff and resident interaction is that it is positive and respectful. Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 The Home has a flexible approach to daily routines and delivers care specific to needs of the individual. EVIDENCE: The Home develops a four weekly activities programme. Two of the residents spoken to say that they enjoy the entertainment brought into the Home and that they had a really good Christmas. Religious needs are accommodated and efforts are made to facilitate activities, which suit individuals. For example, one of the residents is artistic and likes to paint, so this has been organised. One of the residents did say that she got bored and this was passed onto the management who promised to investigate. Residents report having regular visitors and that they are made welcome. The residents confirmed that they are enabled to have flexible lifestyles; breakfast is offered all morning and one of the residents said “the kitchen never shuts”. A four weekly menu has now been created, which has been a great success and residents confirmed that they could have alternatives if they wish. One of the residents reported that when feeling poorly and ‘off her food’, the manager had asked what meal she really fancied and said that he would
Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 11 arrange for it to be provided. The possibility of making cool drinks available in the communal areas and that a choice of drinks with lunch could be offered was discussed. One of the residents also said that the care delivered is the same high quality for the all residents whether they purchase their care privately or not. The care staff are not informed to avoid any prejudice. Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Complaints are addressed appropriately and there have been no Protection of Vulnerable Adults issues. Systems are in place, which protect the residents however additional training in the local procedures is recommended. EVIDENCE: The Home has received one complaint since the last inspection. This was investigated, responded to and logged appropriately. One of the residents said that she would feel comfortable approaching the manager if she was unhappy. There has been no Protection of Vulnerable Adults referrals or concerns. Staff undertake training in Adult Abuse. The manager was recommended to contact the Local Authority Adult protection team to access additional training and instruction on the appropriate local procedures to follow. Staff recruitment is robust and Protection of Vulnerable Adults and Criminal Records Bureau checks are undertaken for all potential staff. Service users finances are well-managed and documented and regular audits undertaken. Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24, 25, 26 The environment of the Home is continuously maintained and re-decorated as necessary, ensuring a safe and comfortable place to live. EVIDENCE: The Home continues to be well maintained and redecoration and refurbishment undertaken as part of a rolling programme. Two remaining radiators have been covered and problems with the water temperatures monitored and addressed. A hand-washing sink has been fitted in the laundry, as previously required. Two of the residents said that they loved the environment and felt really comfortable. The temperature in the Home was pleasantly warm during the inspection. Eleven of the bedrooms have been fitted with an appropriate lock. This has proved to be a success. Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 14 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): 29, 30 The residents are supported by a safe and competent staff team. EVIDENCE: Previous staffing issues have been addressed and the Home has employed a large number of new staff since the last inspection. The Home’s recruitment procedures continue to be robust; the files contain all of the required elements and appropriate Protection of Vulnerable Adult and Criminal Records Bureau checks are made prior to appointment. The management team maintain a training matrix, which enables monitoring and planning of the required courses. Staff are encouraged to undertake NVQ awards and additional training, which will allow them to progress within the Home. Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 15 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): 33, 35, 38 The management systems in the Home protect the residents and support the staff team. EVIDENCE: The Home undertakes an annual Quality Audit and the results are collated into a summary, which is available to the residents and the families. It was recommended that the views of stakeholders and visiting professionals also be sought. The system used to safeguard the residents’ monies was checked and found to be satisfactory. A six-monthly audit of the service user finances and valuables is undertaken. The Home has complied with the Environmental Health Officer’s requirements. The management team monitor all accidents in the Home by way of a monthly analysis.
Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 16 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 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? No 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. 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 2 3 Refer to Standard OP9 OP15 OP18 Good Practice Recommendations The manager should consider whether it is appropriate to administer eye drops in a communal area. The manager should explore the possibility of making cool drinks available in the communal areas and that a choice of drinks with lunch could be offered. The manager is recommended to contact the Local Authority Adult Protection Team to access additional training and instruction on the appropriate local procedures to follow. It is recommended that the views of stakeholders and visiting professionals also be sought as part of the Home’s Quality Audit process. 4 OP33 Elizabeth House DS0000004936.V284914.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 DS0000004936.V284914.R01.S.doc Version 5.1 Page 19 - 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!
