CARE HOMES FOR OLDER PEOPLE
Elizabeth House Dolbery Road Parkstone Poole Dorset BH12 4PX Lead Inspector
Trevor Julian Unannounced Inspection 20th December 2005 01:00 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 DS0000004045.V274681.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 DS0000004045.V274681.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Elizabeth House Address Dolbery Road Parkstone Poole Dorset BH12 4PX 01202 744545 01202 744545 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) Care South Mrs Christine Kerr Care Home 42 Category(ies) of Dementia - over 65 years of age (11), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (11), Old age, not falling within any other category (31) Elizabeth House DS0000004045.V274681.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. One named person (as known to CSCI) under the age of 65 may be accommodated within the category of PD (Physical Disability). This condition will not apply after the person’s 65th birthday. The person as referred to in condition (1) may be accommodated under the age of 65 (this condition will not apply after the persons 65th birthday) 12th July 2005 Date of last inspection Brief Description of the Service: Elizabeth House is a large, purpose built home in the Parkstone area of Poole. The building is leased from the Borough of Poole, and managed by Care South, a local non-profit making organisation that owns and manages various care homes and community services in Dorset and the South West. The home is registered with the Commission for Social Care Inspection to accommodate a maximum of 42 adults over the age of 65 years, with 11 of these places being registered to accommodate service users with specialist mental health needs, 11 with dementia related needs, and the remainder to accommodate service users with needs relating to old age. No nursing care is provided by the home. Accommodation is offered over two floors, accessed by a 6-person passenger lift. There are various communal areas, thirteen W.C.s: seven on the ground floor and a further six upstairs. There are 6 bathroom facilities (with assisted baths) and all bedrooms are single. Two have en-suite facilities. There is a large conservatory leading to a secure garden and courtyard area, with further lawn and wooded garden areas. The home is close to many local amenities, and offers access to a main bus route serving nearby towns and villages. Elizabeth House DS0000004045.V274681.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection took place on Tuesday 20th December 2005 between 13:00 and 16:00. The whole process including preparation and report writing took 8 hours. This was the second of two statutory visits carried out during the year. Before the visit comment cards had been received from residents, visitors, GPs Community Nurses and Care Managers. The responses showed very good levels of satisfaction with the services provided by the home although a very small number commented about staffing levels and the laundry service. During the visit information was gathered through discussion with residents and staff, touring the premises and reviewing records. The manager and deputy were on the premises throughout the visit. This was a brief visit to consider the key standards not checked during the previous inspection, please refer to the previous report. For the purpose of this report the terms residents and service users are interchangeable. What the service does well:
The home is well managed and benefits from a stable workforce allowing good continuity of care. The manager and staff continued to work hard in order to meet the National Minimum Standards. Residents and visitors seen during the visit were very positive about the care provided in the home. Visitors said they were always made welcome and the staff dealt with any concerns they had. The laundry service was discussed with some people, they felt the service was good, there were occasions when items were mislaid but the staff would try to locate the item once they were aware of the problem. The residents could not identify any areas where they had concerns. They said the staff respected their privacy and their were no rules. The food was of a good standard and there was always a good level of choice. The home provided information to residents and visitors about how to raise concerns. Residents and visitors spoken to during the inspection had not made formal complaints but had raised concerns with staff who had responded appropriately. The staff were aware of their responsibilities regarding adult protection. All staff received training in the matter. Elizabeth House DS0000004045.V274681.R01.S.doc Version 5.1 Page 6 Staff felt the training programme was very good. One person said the Dementia training was very useful and had been able to apply some of the ideas in her work. Nearly half the staff were either trained or were part way through NVQ level 2 or 3 in care. The manager had completed the Registered Manager Award. The home received monthly visits from head office staff who monitor standards in the home reports from the visit were sent to the manager and the Commission. 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 DS0000004045.V274681.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 DS0000004045.V274681.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): Not assessed during this inspection. Please refer to previous report. EVIDENCE: Elizabeth House DS0000004045.V274681.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): Not assessed during this inspection. Please refer to previous report. EVIDENCE: Medication was not fully assessed during this visit. Records were checked and showed that any handwritten entries and amendments were verified and approved by a second person to reduce the risk of transcription errors. Elizabeth House DS0000004045.V274681.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): Not assessed during this inspection. Please refer to previous report. EVIDENCE: Elizabeth House DS0000004045.V274681.R01.S.doc Version 5.1 Page 11 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 The organisation’s complaints procedure allows residents and visitors to raise concerns with confidence that the issues will be investigated. Systems were in place to ensure that the staff were able to respond correctly to any signs or allegations of abuse. EVIDENCE: A notice in the main hallway provided residents and visitors with information on how to raise complaints. None had been received by the home or the Commission since the last inspection. Records were in place to record complaints and compliments. The file contained several letters and cards thanking the staff for the care of their relatives and friends. During the visit several residents said they could talk to the staff about concerns. One person said she regularly saw the manager around the home and felt confident enough to raise issues if needed. One visitor said she was often in the home, she had not made any formal complaints, but occasionally there were problems and the staff were approachable and always sorted them out. All staff receive basic training in adult protection procedures during their induction, this is followed by more detailed training course. The manager and the staff spoken to were clear in their responsibilities should concerns arise.
Elizabeth House DS0000004045.V274681.R01.S.doc Version 5.1 Page 12 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): Not fully assessed during this inspection. Please refer to previous report. EVIDENCE: The premises were well maintained and the rooms seen were comfortable. Residents said the home was kept warm during the cold periods. Elizabeth House DS0000004045.V274681.R01.S.doc Version 5.1 Page 13 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): 28, 30 Staff training and development systems provide a sound basis to assist the staff to have the appropriate skills to provide care to a good standard. EVIDENCE: Staffing levels were not fully examined during this visit. Two comment cards suggested that staffing levels might not be sufficient. From discussion with the manager, extra hours had recently been added to the early afternoon to improve staffing levels after lunch. Two members of staff on duty said the increase had made a difference and that they felt they were not so pressured to get things completed before the end of the morning shift. Generally, staff said shifts were manageable. A total of 12 people had achieved NVQ level 2 or 3 in care and another 4 were part way through, 2 were nominated and another 4 would be nominated once they had completed their trial period. The manager said that there was an expectation that all new staff would undertake the NVQ award. The organisation currently has an induction and foundation training programme for all new staff. The manager said this was being revised in line with guidance from Skills for Care. In addition to the initial training, the staff access other core and specialist training as their needs are identified through the supervision process. Each member of staff had a training record.
Elizabeth House DS0000004045.V274681.R01.S.doc Version 5.1 Page 14 One recent recruit said she found the training very good she and was currently working on NVQ level 3. Another member of staff in the special care unit said she had completed a Dementia course and had found the information very useful in practical terms. Elizabeth House DS0000004045.V274681.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): 31 The senior team manage the home for the benefit of the residents. EVIDENCE: The manager has the required level of qualification and experience to manage the home effectively. The senior team have good levels of experience and the home benefits from having a stable workforce. The organisation carry out monthly monitoring visits to ensure standards are maintained; reports of the visits are copied the home’s manager and the Commission. Residents and staff said the manager and senior staff were always available. During the visit the manager was seen with several residents and it was apparent she often spent time with them. Elizabeth House DS0000004045.V274681.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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X X Elizabeth House DS0000004045.V274681.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. Refer to Standard Good Practice Recommendations Elizabeth House DS0000004045.V274681.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 DS0000004045.V274681.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!
