Inspection on 18/10/05 for Elizabeth House [Gloucester]

This inspection was carried out on 18th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

Elizabeth House [Gloucester] 06/06/07

Elizabeth House [Gloucester] 06/03/06

Elizabeth House [Gloucester] 25/02/05

Elizabeth House [Gloucester] 23/09/04

Elizabeth House [Gloucester] 22/03/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

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

CARE HOME ADULTS 18-65 Elizabeth House Denmark Road Gloucester Glos GL1 3HW Lead Inspector Caroline Jones Announced 18 October 2005 10:00 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 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 D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Elizabeth House Address Denmark Road Gloucester Glos GL1 3HW 01452 782960 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) National Star College Care Home 24 Category(ies) of Physical Disability (24) registration, with number of places Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25/02/05 Brief Description of the Service: Elizabeth House is one of two residential homes providing off site accommodation to students from the National Star College. The college owns the property, which was converted and fully refurbished into accommodation for 24 students with a physical disability almost 5 years ago. Situated in a residential area, the home provides easy access to the centre of Gloucester. Most students have single accommodation, some with en-suite facilities, which include a shower. There are three double rooms and sufficient bath/shower rooms and toilets. An independent living flat and training kitchen are also provided. Students have access to a spacious and comfortable lounge and a dining room.The home has two mini buses and students also use taxis and local transport systems. The National Star College have submitted an application for the manager to become the Registered Manager. Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over two days. The lead inspector and a colleague visited the home on the evening of Monday 17th October to meet with individuals or groups of students for them to comment about Elizabeth House and their experiences of living there. The lead inspector returned the next day and met with the manager and most of the staff on duty, toured the building and tracked the records for some students. In addition to the comments made during meetings with students, a further 5 student questionnaires were completed and returned. Additional inspection of staff recruitment, staff training and quality assurance systems were obtained during the inspection of The Star College main campus in mid November. What the service does well: What has improved since the last inspection? There has been a smooth transition following the retirement of the former manager and appointment of a new manager. Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 6 The catering in Elizabeth House has improved in response to comments from students. There is greater choice at the evening meal and an evening drinks trolley is a social focus. Using the kitchen on the ground floor for some students has eased congestion in the dining room, although further extensions to the dining room are being considered. The arrangements for students starting at the beginning of their first term have improved with groups of students returning over three successive days. 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 D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 7 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 D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 8 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 & 3 Students make positive choices to move to Elizabeth House and can be confident that staff in the home will meet their needs and aspirations. EVIDENCE: Students moving to Elizabeth House have generally spent at least one year at the college staying in the on-site accommodation. Student’s needs are known and college managers have made judgements so that students’ needs could be met if they move to Elizabeth House. This year all but three students were new to Elizabeth House. At the beginning of the first term, staff complete new care assessments on all students, there is a process of staggered admissions to assist this process. The Manager has identified further ways of improving the admissions arrangement at the start of the college year. Case tracking confirmed that students are assessed on arrival at Elizabeth House. Comments from students indicated that they had made a positive choice to move from the main campus to Elizabeth House and felt that they had greater freedom living there. The manager gave details of situations where students have been able to leave Elizabeth House if their move to the home was not successful. Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.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) 6, 7 & 9 Students work in partnership with staff to identify their needs and goals. Students are supported in taking risks and encouraged to increase their independence. EVIDENCE: This inspection took place within the first half term of the college year and whilst basic care assessments were in place key workers were still completing personal development profiles and Target Action plans with students. In the records inspected as part of the case tracking exercise, differences in some key areas were noted between the records held by care and nursing staff. The integrated care and education assessment process is wide ranging and gives a full picture of students’ needs, aspirations and goals. Files examined contained only very current information, however access to some of the past information and recording is recommended as this might have a bearing on current actions and events. The ethos of the college continues at Elizabeth House, with students fully involved in making decisions in all aspects of their lives. Records confirmed that planning meetings often involve both care and education staff. Where Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 10 measures are in place to protect a student, this is supported by a written verification of the students’ consent, for instance where ‘cot sides’ are used. Students confirmed that there are fortnightly house meetings; the records showed that students have been able to effect changes at Elizabeth House, for instance with choices of meals and facilities in their rooms. Students described the comprehensive risk assessment process in place, where they progress in a staged manner towards independence in the community. This was recognised as a ‘safe’ system designed with their protection in mind. Files tracked included copies of Manual Handling Risk Assessments, which are also available in students’ bedrooms. Files inspected included specific risk assessments related to the needs of each student. It was reported that Risk Assessments relating to students who are self medicating on arrival at Elizabeth House, are not held by the nursing staff, but they could be transferred from records held on the main campus. Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 11 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) 12, 15, 17 Students are involved in arranging activities, which supplement and support their college courses. Whilst staying at Elizabeth House students maintain contact with family and friends as well as making new friendships. At Elizabeth House students have access to a healthy diet and choices at meal times. EVIDENCE: In discussion students were positive about the activities available to them outside their college day. Within Elizabeth House they have set up their own committee and started to arrange a number of different clubs and events, including gardening, quiz nights and computer games nights. As a part of the college, most students return home during the holidays. They said that family and friends are able to visit. One student commented ‘I met my girlfriend here’ which confirmed the inspector’s observation that students are supported when they develop friendships whilst at college. The College citizenship and Personal Development syllabus provides students with information and advice on maintaining their personal safety. Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 12 Discussion with students and the cook indicated that there have been some changes with meals at Elizabeth House. A choice is now offered at supper time and to avoid waste students are asked to pre-order a couple of days in advance. Students indicated that they were happy with this arrangement. Menus were varied and the cook is evaluating new dishes being introduced and seeking to involve students with meal planning. The cook is notified of students with any special dietary needs and would seek advice from a dietician where necessary to provide appropriate food. Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 13 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) 19 & 20 Students are encouraged to take responsibility for their own health care needs, with support and guidance when initially taking on these tasks. Staff follow safe procedures if meeting health care needs, including administering medicines, although occasionally nurses would benefit from having more information. EVIDENCE: Students said that they work with staff to write their care plans; copies are then kept for reference in their rooms. Students at Elizabeth House are registered with a local GP practice and whenever possible visit the surgery for medical appointments. Case tracking confirmed that students received support from staff at Elizabeth House for their health needs, as well as access to appropriate specialists. Some instances of shortcomings in detailed medical information were noted on the records maintained. One of the nursing staff has responsibility for organisation of medicines at Elizabeth House. Records seen and the system described indicated safe practice. Students are able to manage their own medicines, although the assessment process is not usually started until after the first half term break. Some students spoken to were already managing their own medicines. The system described allows students to take staged responsibility, with suitable Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 14 means of checking in place. Students confirmed that they are provided with lockable cabinets for their medicines. Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 15 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) (Neither of these standards were inspected on this occasion.) EVIDENCE: Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 16 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) 24 & 29, 30 Elizabeth House provides students with a clean, comfortable and homely environment. The building has been adapted to suit the needs of students with physical disabilities, although there are some limitations in dining room space and in reliability of the shaft lift. EVIDENCE: The accommodation at Elizabeth House is generally comfortable and clean. It is adapted to suit the needs of students with physical disabilities. A small lounge is to be created in addition to the large lounge on the ground floor. The dining rooms are in the basement and can be cramped and crowded; the manager was aware of this problem and reported that there may be plans to extend the dinning room area. Students are able to eat in the student kitchen on the ground floor. Most accommodation had adequate heating and ventilation, however there are some bedrooms on both the first and second floors that do not have proper ventilation; these are rooms that have fire doors to external fire escapes. The manager confirmed that the cracks to walls around the home continue to be monitored by engineers. The building is subject to high and heavy use by Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 17 students and their equipment, however the college maintenance staff quickly attend to general maintenance issues. Specialist equipment is provided for students to meet their individual needs, however the shaft lift in the building has become increasingly unreliable and is a source of anxiety and frustration to students and staff. The manager confirmed that there are plans for a second lift to be fitted. Satisfactory arrangements have been put in place when the lift has broken down. Elizabeth House appeared clean at the time of inspection. There were no comments made by students about the standard of cleanliness in the home. Some students commented about the laundry facilities at Elizabeth House, suggesting that there was insufficient equipment for the number of students. The manager reported that some changes are to be made to the laundry room, although individual students’ personal organisation was said to be the reason for the perceived shortage of laundry equipment. Not all students were aware of the additional washing equipment located on the lower ground floor. There are sluicing facilities on both the 1st and 2nd floors, which appear to offer adequate levels of cleaning for low to medium level risk items. Both care and nursing staff were clear about procedures for the control of infection. Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 18 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) 34 & 35 Students can be confident of having well trained staff working with them, who have generally been carefully recruited. EVIDENCE: Staff recruitment arrangements were examined during the inspection of the main campus. A sample of recruitment records was examined. The CSCI are happy for the personnel records to be maintained centrally on the main campus. Overall the college has very efficient recruitment systems and procedures, although some of the records examined did not have two references on file obtained before an appointment is made. The college report that three references are taken up on preferred candidates, as well as checks made with previous employers involving children or vulnerable people. Where there were gaps in employment records, there was no evidence that these had been satisfactorily explored. Whilst it was noted that students might not be involved in the recruitment of all staff, they do participate in the selection of senior positions. Detail of the training and development programme for all college staff was examined during the inspection of the main campus, where the Continuing Professional Development Department is located. Both new and existing staff are provided with induction, refresher and ongoing training. The value of the Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 19 mentoring system for new staff was commented on positively. Staff said that they receive appropriate updating and are being supported to gain Vocational Qualifications. There are regular training events for all staff for core subjects, such as manual handling, first aid and fire safety. Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 20 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) 39 Students can be confident that their views and opinions will be sought as part of the college’s comprehensive quality assurance process and students’ comments will affect goals developed for the service. EVIDENCE: Information about this standard was gained during the inspection of the main campus. The college undertakes regular comprehensive self-assessment, which includes consultation with service users. A copy of the draft summary report supplied included a good range of student comments. Students confirmed that they are consulted about matters affecting Elizabeth House and that their observations had resulted in change. Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 21 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 3 3 x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x 2 3 Standard No 11 12 13 14 15 16 17 x 3 x x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elizabeth House Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 4 x x x x D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 22 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. 2. Standard Regulation Requirement Timescale for action 1st September 2006 29 23.2 (c), (n) A reliable means for students to get to all parts of the building must be provided. 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 YA 6 YA 9/20 YA 34 Good Practice Recommendations Greater co-ordination and sharing of information is recommended between care and nursing records. It is recommended that copies of existing Risk Assessments for students self medicating are transferred to their current files. It is recommended that recruitment systems are tightened to ensure that references are on file prior to a persons appointment being confirmed and there is evidence that any gaps in employment have been explored. Continued monitoring of the of the amount of dining room space is recommended. 4. YA 24 Elizabeth House D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 23 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 D51_D03_S16429_ElizabethHouse_V203139_181005_Stage4_A.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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