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Inspection on 08/07/05 for Elizabeth House Care Home

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

This inspection was carried out on 8th July 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.

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

Elizabeth House offers a homely environment. The manager and staff encourage residents to be as independent as possible and to be part of the day to day running of the home. Residents are treated with a good level of dignity and respect and staff presented a gentle understanding of the individual needs, preferences and personalities of each resident. There is a warm rapport between staff and residents. Residents presented as well groomed and there was lots of conversation and laughing between residents and the staff. Care plans are comprehensive and form a good basis for an assessment of need and to provide the day to day support to enable residents to maintain their independence and be provided with appropriate care and support. Health care needs are well met and the staff at the home liaises well with health care and medical agencies.

What has improved since the last inspection?

The manager and staff have improved the recording in the home. Care plans are detailed, terms and conditions have been updated and the storage of records has improved. The staff said that they were pleased with the level of training in the home and this has included adult protection and how to deal with complaints. Water temperatures have been regulated

What the care home could do better:

The manager needs to record risk assessments for safe working practices in the home.

CARE HOMES FOR OLDER PEOPLE Elizabeth House 2 Church Hill Avenue Mansfield Woodhouse Nottingham NG19 9JT Lead Inspector Elaine Cray Unannounced 8 July 2005 14:00 th 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 C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Elizabeth House Address 2 Church Hill Avenue Mansfield Woodhouse Mansfield Nottingham NG19 9JT 0162 365 7368 0162 343 1325 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) Mrs Vijay Rammarain Mrs Vijay Rammarain Care Home - Private 16 Category(ies) of OP - Old Age - 16 registration, with number of places Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 3rd November 2004 Brief Description of the Service: Elizabeth House is a care home providing personal care and accommodation for 16 older people. The home is located in Mansfield Woodhouse, in a quiet residential area and close to shops, pubs, the post office and other amenities. The home is an older style domestic property with a more recent two floor extension. There are 14 single, and 1 double berooms, which are located on both floors and there is a passenger lift. There is a variety of lounge areas. There is a garden that is easily accessible for service users. There is limited car parking available on the homes driveway and further parking is available on the street. The manager and at least two staff are on duty throughout the day and night care staff are available throughout the night. Staff have received training to enable them to care for the older people living at the home. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 8th July 2005 over a period of 3 hours. The manager was present for the visit and the staff were attending a fire training session, but were available for the last hour of the inspection. Five residents and one relative were spoken with and all expressed a high level of satisfaction with the care provided in the home. Two care plans and a variety of records were inspected. A tour of the building was not carried out on this visit. What the service does well: What has improved since the last inspection? The manager and staff have improved the recording in the home. Care plans are detailed, terms and conditions have been updated and the storage of records has improved. The staff said that they were pleased with the level of training in the home and this has included adult protection and how to deal with complaints. Water temperatures have been regulated Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 6 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 C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 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 C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 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) 2, 3 and 5 The home provides accurate information about the services available to prospective service users, relatives and representatives, who are able to visit the home to look around and meet the manager, residents and staff in order to discuss the prospective service user’s needs and to find out about the running of the home. EVIDENCE: Service users spoken with said that they or their relative had visited the home prior to moving in. One relative said he came and was welcomed by the manager and staff of the home, other residents visited and were able to meet the other people who lived at the home. The manager also visits prospective residents in hospital or in their own homes so that she can tell them about the home and talk about their needs before deciding if the home is suitable. The manager and service users confirmed that the needs of each service user and the services available are discussed before moving into the home. All service users were very complimentary about the staff and how helpful and supportive they had been they had first moved to the home. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 9 Terms and conditions have been updated and were available in the two care plan files viewed on this visit. Both copies had been signed by the manager and the resident or relative. A relative and resident said that they had been asked about likes, dislikes, what help was needed and how residents preferred to have support. Care plans included a pre-admission assessment record and a further assessment, which informed the care plan. Documentation was detailed and had been signed by the resident and/or relative. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 10 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 and 9 The health care and medical needs were identified, well met and promoted, including the management of medication. There is a warm and interactive rapport in the home and residents are treated with respect and dignity. EVIDENCE: Two care plans were viewed on this inspection. Medical histories, health assessments and how and who were involved in meeting these needs were comprehensively recorded in each plan. The manager and staff on duty at the time of this inspection provided a clear and detailed insight into the medical and health needs of the residents. Residents and a relative were very pleased with the health care and support provided by the home. One resident and a relative commented that health has improved greatly since living at the home. A relative commented that the home communicates well about the health needs of his relative. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 11 The regular visits and details of consultations made by doctors, district nurses, the optician, chiropodist and other medical professionals are recorded. Records provided evidence that the home liaises with relevant medical agencies to seek advice and further consultation when necessary. The manager demonstrated a good knowledge of the policies and procedures relating to administrating medication. The storage and recording of medication was well organised There was a warm and respectful rapport between the staff and residents. Staff were observed to provide a sensitive level of care in terms of ensuring the privacy and dignity of residents is maintained. Residents and a relative said that staff were very polite and kind, knocking on bedroom doors and speaking to people with respect. Residents said that staff help with personal care and take their wishes around privacy into account. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 12 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 and 14 This home provides a warm and enabling environment, promoting the wishes, views, independence and choices of residents. The home provides a warm welcome to visitors and residents are encouraged and helped to maintain contact with family, friends and community networks. EVIDENCE: Care plans documented the residents’ cultural, religious, social and family arrangements and preferences. The manager had an indepth and individualistic knowledge of the likes, dislikes and dispositions of all the residents living in the home. This knowledge was reflected in the personal approaches to residents, understanding who liked to be private and quiet, who liked to join in and have a joke and those individuals who were unable to fully communicate their needs and needed more guidance or help in expressing their wishes and views. All the residents spoken with on this visit happily commented on the warm and friendly approaches in the home. Some residents were happy to join the manager and inspector to discuss aspects of the inspection. Staff were observed to provide choices to all residents irrespective of their levels of understanding and confusion. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 13 Relatives are very involved in the home. On the day of this inspection a relative was calling the bingo numbers, other relatives were chatting to a number of residents and one relative commented that the manager and staff are very welcoming, provide excellent care to the residents and involve him in all aspects of his relative’s care. The home provides activities such as bingo, keep fit, prize raffles, singalongs and visiting musical entertainers. There is a summer fayre planned for the near future and some residents are looking forward to a day trip to Skegness. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 14 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 and 18 The procedures for the protection of residents from abuse are promoted in the home. Residents and relatives are confident that they are able to express any concerns to the manager and staff and that these matters will be addressed. EVIDENCE: Staff were aware of the Nottinghamshire Adult Protection procedures and had attended training. The manager and staff presented a good understanding of the vulnerability of older people living at the home, the need for consistent observation, individual assessment of risk and providing a safe environment. Risk assessments were well documented within the care planning format. All residents and relatives spoken with on this inspection presented a clear confidence that they could discuss any concern with the manager and staff in the home. Staff were observed to listen to all the residents, who presented as confident in expressing their views. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 15 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) NA The environment was not inspected on this visit. EVIDENCE: The environment was not inspected on this visit. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 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 and 29 The staffing arrangements in the home are well managed and staff working there are able to meet the needs of the residents. EVIDENCE: On the day of this inspection, the home was adequately staffed. Some of the staff have worked at the home for an extensive period of time and provide a good level of experience. Staff said that training is good and has included adult protection, dementia, first aid, moving and handling and infection control. Fire training was taking place at the time of this inspection. All the residents and relative spoken with on this visit gave positive comments about the staff. Residents said they felt safe and well looked after, with staff showing them kindness, respect and encouraging them to be independent and providing support when needed and requested. Discussion with the manager and observation of the staff demonstrated that staff were knowledgeable about the needs of the residents, were aware of the policies and procedures of the home and the inspector observed appropriate care practices throughout the inspection. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 17 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) 33, 37 and 38 The management of the home was well organised with records well maintained, accurate and up to date. EVIDENCE: The manager was present throughout the visit and had a thorough knowledge of the management, administration systems and the running of the home. The manager is present at the home on a daily basis and was observed to maintain positive relationships with residents, relatives and staff. The majority of staff have worked together for an extensive period of time and the staff team provides positive and informal support to each other. Record keeping in the home was detailed, accurate and up to date. Care plans were very comprehensive and practical for the day to day care for each resident and other required records were available in the home. Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x 3 3 Elizabeth House C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 19 yes 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 38 Regulation 13 Timescale for action The requirement to carry out risk Immediate assessments on safe working - 25th July practices is outstanding from 2005 2002 and an Immediate Requirement was set at this inspection. Requirement 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 C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 C53 C03 S8668 Elizabeth House V233968 080705 Stage 4.doc Version 1.30 Page 21 - 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. 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