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Inspection on 31/08/05 for Elizabeth House

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

This inspection was carried out on 31st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People who live at the home are able to take part in planning what they need and want to do and the home promotes residents` rights and responsibilities. There is a very thorough and comprehensive assessment process prior to admission to the home. There are plenty of opportunities for residents to access the community either independently, supported by staff or through group activities. Daily routines within the home promote residents independence. Staff at the home work flexible shift patterns in order to provide suitable cover and support for residents chosen activities.

What has improved since the last inspection?

Residents commented that the food provided at the home has improved dramatically in recent times.

What the care home could do better:

There were no requirements or recommendations made as a result of this visit.

CARE HOME ADULTS 18-65 Elizabeth House MacCallum Road Enham Alamein Andover, Hants SP11 6JS Lead Inspector Laurie Stride Unannounced 31/08/05 10.45am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Elizabeth House Address MacCallum Road, Enham Alamein, Andover, Hants, SP11 6JS 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) 01264 345800 Enham Mrs Lynne Hewitt CRH 20 Category(ies) of LD, PD, PD(E) registration, with number of places Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional service users may be admitted in the LD category Date of last inspection 28/04/05 Brief Description of the Service: Elizabeth House is part of the Enham organisation, which is situated at Enham Alamein, Andover. The home is registered to accommodate and provide care and support for 20 physically disabled younger adults. The home was registered in January 2003 and is a purpose-built building. Cedar Park, the main building, houses the medical consulting area, dining facilities as required for some service users and the large social area used by service users throughout the site. Elizabeth House provides physical and emotional support to individuals who have a physical disability, sensory impairment or learning disability. Additionally, service users participate in structured programmes at the work development resource centre, which is also on the site and which operates in tandem with the care programme. The purpose is to enable people with disabilities to realize their full potential, both by listening to their expectations, providing a structured work setting, assessing their needs and by providing advice and guidance from health care sources. Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two annual inspections of the home and was unannounced. The visit lasted approximately three hours, during which the inspector spoke with residents, staff and the registered manager and viewed some of the home’s records. The inspector looked mainly at the three key standards not assessed at the last inspection and therefore this report should be read in conjunction with the previous report. What the service does well: 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 H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The arrangements for assessing prospective resident’s needs enable their full participation in the process and exceed the standard. EVIDENCE: Since the last inspection the home had admitted three new residents and records were seen in relation to the admission and assessment process. Information is obtained from the existing residential establishments, together with a report from social services, health authority or personal reports and this information is generally collated prior to a three-week stay spent in the site assessment flat. The pre-assessment information includes, for example, a brief history of the individual and details of any identified risks, medication needs and contacts. A strengths and needs assessment is also requested in relation to mobility, personal care, social skills and other areas. A pre-assessment meeting is then held with the prospective resident and their representatives prior to the three-week assessment being undertaken. This allows all parties to identify any requirements the person might have during the assessment. The three-week multi-disciplinary assessment takes place at William House, one of the homes within the Enham complex, which has a flat designated for this purpose. During this period both residential and development programme assessments are undertaken and reports are written. The residential report includes information such as social skills, communication, compatibility, personal care, Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 8 emotional needs and physical health, and concludes whether or not the home can meet the person’s needs. The development programme report includes suggestions for personal development plans and activities, for example work experience, art, drama, life skills, numeracy and literacy study. A report is also made by the Occupational Therapist. At the time of the inspection the home was arranging a three-monthly review for each new resident following their initial probationary periods. This is also seen as a settling-in period, during which the home continues to work with residents to establish their aims, strengths and needs. A care plan is formulated from all the information collected and signed by all parties. A care plan review is held every six months. There are no potential restrictions placed on choice, freedom or services. Family and carers’ needs are taken into consideration, subject to residents’ agreement. Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion. Please refer to the previous report. EVIDENCE: Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 and 16 The service is well organised in providing residents with opportunities for accessing the community and promoting rights and responsibilities in residents daily routines. EVIDENCE: There is a written policy on community links and social inclusion that aims to foster good working relationships with the local community and support residents in maintaining contacts. The development programme works towards encouraging outside employment. There are links with community work placements and colleges and plans for further links with community groups. The registered manager reported that the home was currently working with the community learning disability team in relation to improving a resident’s confidence and independent access to shops. Several forms of transport are available on the site, which staff are trained to drive, and the village provides nearby shops, bus and taxi services. The Enham organisation run a bus service into the local town on Saturdays and residents are entitled to bus and taxi tokens. Newsletters and notices provide Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 11 details of local services and activities. Staff rotas were organised to provide flexible cover according to resident’s needs and activities. Information is available to residents and staff about the Disability Discrimination Act, and staff undertake disability awareness training that is updated periodically. Staff also have training in equality, diversity and rights. Residents have access to discussion groups and the internet through the resource centre. Staff reported that all residents are registered to vote and information is available regarding political parties. Good neighbourly links were reported. A ‘fit for fun’ day was scheduled for September with residents from across the Enham site and other people with disabilities from Andover attending. Two drama groups composed of residents from all units perform at local schools and the leisure centre. Residents and their families had held a barbecue in the grounds over the bank holiday weekend. The home had recently been given control over the food budget and this had resulted in more community access with residents assisting with food shopping. Residents are assessed on their abilities to undertake household routines and can choose whether or not to join in with activities. There is a privacy policy statement made within the Charter of Rights provided to all residents and which covers their rights and responsibilities with regard to privacy. Staff were observed to knock on resident’s doors and wait to be invited in. All residents are provided with keys to the home and to their accommodation and there is a buzzer and intercom system which gives residents choice about whether to see visitors or not. Residents confirmed that they receive their mail unopened. Staff deliver mail to individuals, which is collected from the main Cedar Park complex, or some residents choose to collect their mail from the office. Assistance is given where requested in relation to reading and responding to mail. Residents were observed to have unrestricted access to the communal areas of the home and grounds. There is a non-smoking policy in the communal areas of Elizabeth House which staff observe by smoking outside. One resident smokes in his/her flat and there is a risk assessment in place. The keeping of pets is restricted. There is a tropical fish tank in the dining room which is taken care of by staff. Through the result of a resident survey, budgies previously kept in the home had been donated to an aviary. Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion. Please refer to the previous report. EVIDENCE: Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion. Please refer to the previous report. EVIDENCE: Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion. Please refer to the previous report. EVIDENCE: Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Residents are supported and protected by suitable numbers of trained staff. EVIDENCE: The home’s rota clearly showed those staff members on duty or on training. Staffing levels appeared suitable to meet resident’s needs and were clearly flexible around residents’ activities. The work development programme’s team of staff provide additional support hours. Permanent care staff can also undertake some bank work at Enham and this gives continuity of care to residents. One resident remarked that he/she was very happy with the way staff worked. Another resident commented that staffing levels were right, but staff working additional shifts could become tired. One member of staff had worked on twelve consecutive days. Through discussion with staff it appeared that it was possible to work additional hours and still have sufficient breaks between eight-hour shifts, for example between an early shift and a late shift the following day. The home should continue to monitor staff working hours. Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed on this occasion. Please refer to the previous report. EVIDENCE: Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 4 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x 3 x x 3 x Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elizabeth House Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 18 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Elizabeth House H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 19 Commission for Social Care Inspection 4th Floor, Overline House Blechyden Terrace Southampton, Hants SO15 1GW 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 H54 S37083 Elizabeth House V237068 310805.doc Version 1.40 Page 20 - 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!