Inspection on 10/12/07 for Elizabeth Road Nursing Home

This inspection was carried out on 10th December 2007.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elizabeth Road Nursing Home 31/07/06

Elizabeth Road Nursing Home 17/02/06

Elizabeth Road Nursing Home 27/10/04

Elizabeth Road Nursing Home 02/04/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Elizabeth Road Nursing Home 45 Elizabeth Road Huyton Liverpool Merseyside L36 0TG Lead Inspector Mrs Janet Marshall Key Unannounced Inspection 10th December 2007 09:30 Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 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 Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 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 Adults 18-65. 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 Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elizabeth Road Nursing Home Address 45 Elizabeth Road Huyton Liverpool Merseyside L36 0TG 0151 4430732 0151 4430732 elizabethroad@c-i-c.co.uk www.c-i-c.co.uk. Community Integrated Care 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) Miss Geraldine Atkinson Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 5 LD Date of last inspection 31st July 2006 Brief Description of the Service: Elizabeth Road is a bungalow providing accommodation & nursing care for up to 5 adults with a learning disability. The service is provided by Community Integrated Care (CIC), a voluntary organisation and is managed by Ms Geraldine Atkinson, a qualified nurse. The home is located in a residential estate, in Huyton. As a bungalow, all accommodation is located on one level. There is a private garden to the rear of the bungalow. Shops are a short distance by transport, along with leisure and community facilities. Buses and other transport serve the area and Liverpool/Merseyside is accessible. On street parking is available for visitors. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection. The Commission considers 22 standards for Care Homes for Adults as Key Standards, which have to be inspected during a Key Inspection. An Expert-by-Experience also assisted in the inspection process. An Expert-by Experience is a person who because of their shared experience of using services and/or ways of communicating, visits a service with an inspector to help get a picture of what it is like to live in or use the service. The report has been put together using information gathered from a number of sources including information that the commission have received about the service since the last inspection and details provided in the Annual Quality Assurance Assessment (AQAA). The AQAA, which is in two parts, a selfassessment and dataset, has replaced the pre-inspection questionnaire. The document, which was sent out to, the service was completed and returned to the commission before the site visit took place. A number of surveys were sent out to people as part of the inspection a number of staff surveys were returned and. The inspection also involved an unannounced visit to the home (site visit). This was carried out with the Registered manager Geraldine Atkinson who was on duty at the time. Records that were examined, staff comments and observations made during the visit have also been used as evidence for the report. All the residents that live at the home have limited verbal communication skills so were unable to express their views and opinions about the service. However, a number of residents were case tracked. This process involved talking to staff, looking at the environment and a selection of residents records such as assessments, care plans and daily notes to get an idea about peoples experiences and to find out if they are receiving the care and support that they need and which have been agreed by their representatives. What the service does well: The home has availabe detailed information about the service as well as procedures for assessing and admitting new residents to ensure that they choose a home which is right for them . Support plans and communication profiles provide staff with up todate information about how best to support people to be independent in a safe way and which gives them oppertunities for personal development. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 6 Staff support residents to eat healthily and take part in activities of their choice so that they live active and healthy lifestyles. Residents personal and healthcare is well understood, monitored and recorded to ensure they stay well and their privacy and dignity is respected by staff. This was supported by the following comments made by staff during the site visit: “I always shut blinds and curtains in rooms where I am helping a resident with personal care” “It is important to know the persons routine”, “I always talk to the person when helping them” “I always knock on doors and never just walk in ” The home has a complaints procedure to ensure that people are protected and their views and concerns are listened to and acted upon. Recruitment and training procedures and practices ensure the protection of residents. Staff are provided with ongoing training to ensure they have the knowledge and skills to meet residents needs, develop within their role and are up to date with current care practices. The home is well managed to the benefit of the residents. Systems, which are in place, ensure that their health, safety and welfare is protected and promoted at all times. Staff were complimentary of the Registered Manager and confirmed she was approachable and supportive. Staff made the following comments about the manager: “The manager is very good” “She listens and is very approachable” “The manager is very good and fair” Record keeping and administrative procedures, which are in place, ensure that people’s health, safety and welfare is promoted. The expert by experience said: “Overall I felt there was a team effort from everyone who worked at the house they all love the residents and treat them like family. They know how to communicate with each resident in there own ways, and the residents are treated with respect at all times. I would live at the home”. What has improved since the last inspection? Carpets in the lounge, hallway and residents bedrooms, which were heavily stained, have been replaced enhancing the comfort of the residents. The electrical sockets in a resident’s bedroom have been re positioned making them safe. Health and safety training has been updated for all staff so that they have up to date knowledge about the law and safe working practices. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 7 All staff have completed protection of vulnerable adults training (POVA) so that they know what do if they witness or suspect abuse is taking place. Medication, which is no longer required, is appropriately disposed of to ensure the health and safety of the residents. 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. The summary of this inspection report can be made available in other formats on request. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes assessment and admission procedures ensure that people choose a home that will meet his/her needs. EVIDENCE: Records held by the commission and discussion with the manager showed that one resident has passed away since the last inspection. There have been no new residents admitted to the home since the last inspection. The manager said that she has received some enquires about the vacancy at the home. The manager confirmed that she would be fully involved in the process of assessing and admitting a new resident to the home and clearly described the process that she would follow. This included giving people information about the home such as the Statement of Purpose and a Service user Guide. Both documents, which were looked at, included all the information that people need to know about the services and facilities, which the home has available. They also provided other information such as details of the staff team, emergency procedures and the arrangements made for dealing with complaints. The documents were available in an easy read format. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 10 The next stage explained by the manager would be for her to carry out a full and detailed needs assessment with the involvement of the prospective resident their families and other professionals such as social workers, doctors and nurses. The assessment covers things such as how the person communicates, family/social contact, physical and mental health care and risk management. Once completed the assessment gives people a good idea as to whether the home would be a suitable place for them to live. If they decide it is then the person would be offered a planned and gradual move to the home including short visits and overnight stays to meet with other residents and staff. Needs assessments carried out by the home and other professionals such as social workers and nurses were available for the four people that currently live at the home. They covered important things about the person including health and personal care, risk management, communication, family contact and finances. The expert by experience said, “I would live at the home”. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents assessed needs are clearly set out in individual person centred plans so that staff have all the information that they need to enable people to live independent and safe lives. EVIDENCE: Residents had an individual plan of care, which were called support plans. Each persons support plans were kept, securely in the home to ensure their confidentiality. Support plans for two people were looked at in detail as part of the case tracking process. They both showed that they have been reviewed and updated since the last inspection which ensures that peoples assessed and changing needs are met. The plans were person centred which means they are very individual and specific to the person. A person centred care plan enables people to have more independence, choice and control over their own lives. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 12 The manager said all staff are supported and encouraged to work in a person centred way. Support plans which were looked at covered all aspects of each person’s personal and social support such personal and health care, independent living skills, accessing the community, relationships and financial needs. The plans also covered in detail things such as what is important to the person, what they are good at doing, what they like and dislike, what they need help with and what they want to happen with their lives. Support plans, which were looked at, showed that they have been reviewed and updated involving residents and important people in their lives such as their family/representative and key worker. Discussion with staff showed that they are given up to date information about the needs of the people they support or care for, for example, in the support plan. Staff had a good understanding of care plans and the importance of them one member of staff said, “They are a way of getting to know the person, their likes, dislikes and preferred routines”. None of the residents that live at the home can communicate verbally, however they can communicate in a lot of other different ways. Staff spoken with gave examples of how they communicate with residents, this included body language, facial expressions, gestures, sounds and the use of pictures and photographs. On the day of the inspection visit staff were seen communicating effectively with residents using these different ways. Each person support plan had a section, which provided staff with important information about how best to communicate with residents such things as what they are feeling, were to go and what they want to eat. The expert by experience met with all the residents and reported that staff communicate very well with them, they gave the following examples of how people communicate: ‘One resident communicates using facial expressions or with his eyes and smiles if he is happy’ Another resident communicates by humming or if he is not happy he makes loud sounds’. Staff demonstrated an understanding of how to ensure resident’s rights are promoted and how limitations are only put in place for their safety and welfare. Residents’ personal files and discussion with staff showed that independent advocates are consulted when necessary. Some residents present with challenging behaviour. Support plans provided staff with clear instructions about how to deal with this type of behaviour in a positive way and they are given training to help them with this. Residents are encouraged to take responsible risks, a range of risk assessments, which have been carried out, ensure their independence is Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 13 promoted and they are protected from the risk of harm. The assessments clearly described the action that staff must take to minimise risks. A selection of risk assessments were viewed and showed that they are reviewed and updated at regular intervals. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to live healthy and active lifestyles. EVIDENCE: Care records which were looked at, the AQAA and discussion with staff showed residents social care needs have been assessed and there is a range of activities available inside and outside the home to meet peoples needs and promote their personal development. None of the residents are currently involved in any employment, training or educational programmes however discussion with people and care records showed that each of the residents are supported to live enjoyable and active lifestyles. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 15 One resident enjoys gardening and loves watching old movies on T.V. Another resident enjoys sensory lights and listening to music, staff supported the resident with these activities on the day of the inspection visit. Daily records showed that residents have been involved in activities in the community such as shopping for clothes and other personal items, bowling, holidays and trips to the local pub and cinema. The AQAA showed that arrangements are made for residents to go on holiday at least once a year. As well as recreational and leisure activities resident are also encouraged and supported to take part in small tasks around the house including cooking and cleaning. Staff described how they encourage and support these activities for residents. None of the residents have keys to the home this is because assessments showed that it is not safe for them. This information and the reasons why was recorded in their plans of care. Daily records showed that residents are encouraged to maintain contact with family and friends and personal relationships are respected and appropriately supported by staff at the home. Staff explained that a resident was planning a short stay with her mother over the Christmas period. The manager said visitors are welcomed at the home and there are no restrictions placed upon them. Records showed that one resident receives regular visits from members of their family. Menus which where viewed at the home showed a variety of healthy meals. The manager said that menus are often changed at a resident’s request. A member of staff showed a good awareness of the importance of nutritious and balanced diets and records showed that staff have undertaken training in food hygiene. The AQAA and discussion with the manager showed that dieticians and speech and language therapists are consulted and provide staff with information about special dietary needs. Residents have the use of a family sized dining table in the dining room during the inspection visit they were seen eating their meals at the dining table and others who prefer to, ate their meals in their bedrooms. Some residents need assistance at meal times, a member of staff was seen assisting a resident with their breakfast, and this was done in a patient and sensitive way. Residents were offered plenty of drinks and snacks throughout the day. Care plans included information about peoples likes and dislikes with regard to food and how they communicate them. A member of staff said about one Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 16 resident, “If he does not want something he will turn his head away and he is offered something else” A good stock of fresh, frozen and tinned food was seen at the home. There were also sufficient crockery, cutlery pots and pans, which were of good quality. There was a fridge, freezer and microwave which were all of a domestic style and in good condition. On the day of the inspection visit the manager and a member of staff carried out the main weekly shop. Discussion with staff and records showed that none of the residents enjoy taking part in the main weekly shop for food although they do like and are supported to shop for their own personal items and daily essentials such as bread and milk. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s health and personal care is well supported and monitored. Procedures for recording medication are not as robust as they should be which has the potential to put residents health at risk. EVIDENCE: Care plans, which were viewed, included detailed information about the type and level of support that each person requires with personal care as well as their preferred routines. Health action plans, were part of each person’s support plan. They covered in detail the person’s healthcare, needs and the support that they need to stay well. Records within this section showed that residents are offered minimum annual health checks. As well as visits to primary healthcare services such as dentist, opticians and doctors residents are also supported to attend specialist services. Records detailing the visits were available in good detail as was information about specialist health care appointments. Where appropriate visits to the home by healthcare professionals are arranged. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 18 Communication profiles show how a person communicates if they are in pain or unwell and the action staff should take in response. The service operates a key worker system to enable residents to develop a closer relationship with a specific staff member particularly in the areas of health and personal care. The key worker is responsible for reviewing the resident’s monthly plan and for to arranging their healthcare appointments etc. During discussion several members of staff described clearly their role and responsibilities as a key worker. Staff also showed a very good understanding of each person’s personal care routines and health care needs. During the inspection visit staff were observed assisting residents with personal care in private and in a gentle and polite way. Observations made during the inspection visit and discussion with staff showed that they understood the importance of ensuring residents privacy and dignity. The following comments made by staff during the inspection visit supported this: “I always shut blinds and curtains in rooms where I am helping a resident with personal care” “It is important to know the persons routine”, “I always talk to the person when helping them” “I always knock on doors and never just walk in ” The expert by experience reported that the residents are treated with respect at all times. None of the residents take their own medication. The trained nurse on duty administers all medication. This is because the home is registered as a nursing home. A requirement was given as part of the last inspection report for Medication Administration Record (MAR) sheets to be signed at the time of administering medication. This was because at the last inspection there was evidence that some records had not been signed at the time medication was prescribed. This put the residents at risk because there was no guarentee that the person had received their prescribed medication. MAR sheets which were looked at during the visit were fully complete and up to date. A stock check of all medication is carried out reguarly. The stock check register which was examined during the visit showed the records for one item of medication was incorrect. The balance on the record sheet did not corresepond with the stock kept at the home. The manager checked both the stock and the records and confirmed that a mistake had been made on the records. The manager described how the mistake had been made and showed that the correct amount of medication was in stock. The manager was Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 19 advised to ensure that all staff ensure that medication stock counted and recorded correctly at all times to ensure the health and safety of the residents. A policy for the safe handling and administration of medication was availble at the home Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives have the information that they need to make a complaint and procedures carried out at the home ensure that they are protected from abuse. EVIDENCE: Records held by the Commission showed that we have not received any concerns, complaints or allegations about the service since the last inspection. The service has however investigated a complaint made directly to the home against a member of staff. The complaint is ongoing. Records held by the commission show that the appropriate action has been taken and the complaint is being fully investigated to ensure the protection of the residents. There was a complaints procedure and a complaints book on display at the home. The Service User Guide and the homes Statement of Purpose also included a summary of the homes complaints procedure. The information was available in easy read format. It was not possible to assess residents understanding of the complaints procedure due to their limited understanding. The AQAA showed that all residents are issued with a copy of the complaints procedure and it is explained to them at a pace and manner they are able to understand. The manager said residents and their families/representatives are advised of who they can speak to if they have any concerns or issues in the hope that that Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 21 these can be openly discussed and action taken before a complaint is raised. Staff interviewed said that they knew about the complaints procedure and would be confident about raising any concerns or complaints if they needed to. During discussion staff showed a good awareness of what to do if they suspected or witnessed abuse. A copy of the Local Authorities Protection of Vulnerable Adults (POVA) procedure was available at the home as well as CICs own POVA procedures. The AQAA showed that staff have received Protection of Vulnerable Adults training. This was also confirmed by a number of staff during discussion with them. Other policies, which were available at the home, that aim to protect people included whistle blowing and staff recruitment. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a comfortable and pleasant environment, which was free from hazards, although some improvements would benefit the residents. EVIDENCE: The home is a bungalow, which has five single bedrooms and a number of shared rooms including a lounge, dining room and kitchen. The home has two bathrooms, which are fitted with specialist equipment so that residents can bath/shower without difficulty. The home is located in a popular residential area of Huyton, Merseyside close to transport links and local shops. It is in keeping with the local community and provides with a comfortable and homely environment for the people that live there. There is a garden and driveway at the front of the house and a large enclosed back garden. Parking is also available on the road directly outside the front of the property. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 23 The manager said that the back garden, which has recently been tidied up, is being developed to provide a sensory garden, patio and garden furniture for residents to use in the warm weather. A number of requirements were given as part of the last inspection report. This was because resident’s comfort and dignity was undermined by parts of the home, which were in an unsatisfactory condition. The AQAA and a tour of the home showed the following improvements to the environment since the last inspection. • The carpets in all bedrooms, lounge and the main hallway which were heavily stained have been replaced • The lounge, which was looking tired and worn, has been up-dated with new decoration and new furniture and fittings including, a modern leather settee and chairs, TV, pictures and ornaments. • The dining room has been fitted with new wood effect flooring. • All bedrooms have been fitted with new blinds. On the day of the inspection visit residents were seen using all parts the home. Each of the resident’s bedrooms was attractively decorated and furnished to a good standard. They were warm, bright and well ventilated. All bedrooms were personalised to suit each person’s own tastes. On the day of the inspection visit the home was clean and tidy and there were no hazards identified. A housekeeper works at the home four days a week and is responsible for most day-to-day general cleaning duties as well as larger cleaning tasks such as cleaning windows and interior woodwork. All cleaning materials and products were stored in a locked cupboard. Laundry facilities are sited in a utility room separate to the kitchen. Laundry areas, which were looked at, were clean, well organised and equipped with sufficient washing, drying and ironing machines and equipment. The AQAA showed that the required policies and procedures for control of infection and cleaning routines are in place at the home. It also showed that soiled laundry is washed appropriately and clinical waste is disposed of in the correct way. The AQAA, discussion with staff and examination of records showed that staff have completed training in relation to infection control. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 24 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment and training procedures ensure the protection of residents. EVIDENCE: The staff team is made up of the registered manager, two other qualified nurses, support workers, and a housekeeper. The AQAA and discussion with the manager showed that the staff are of various age, gender and culture and all rotas are put together taking into account the residents care and support needs so that they are able to lead full and active lives. Information about each member of staff including their experience and qualifications were available at the home. The AQAA showed that all new staff are given a copy of their job descriptions when they are recruited. Staff spoken with during the inspection visit showed a clear understanding of their roles and resposibilites and were very knowledgable about each of the Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 25 residents and their specific needs. The manager and five other staff were on duty at the time of the inspection visit when all residents were home. The manager reported that there is a qualified nurse on duty at all times with a minimum of four support workers throughout the day and one support worker at night. Staffing rotas for a period of four weeks that were examined also showed this. The files for new members of staff were looked at during this inspection visit, this showed that strict recruitment procedures are followed at the home including police checks (CRB) which are carried out for staff before they are allowed to start work at the home. The registered manager confirmed that she is involved in all areas of recruitment to ensure that the staff recruited meet the needs of the residents. A new member of staff who was on duty at the time of the visit said: “The manager interviewed me, I wasn’t allowed to start work until my CRB check came back”. The manager reported that all new staff complete a probationary period and an induction programme. The new member of staff said: “I am still on my induction, the first week I worked here I shadowed other more experienced staff and learned a lot about the residents and emergency procedures at the home. All the staff made me feel welcome”. All staff spoken with confirmed that they receive a lot of training including protection of vulnerable adults (abuse), health and safety, medication awareness and other specialist training which is specific to the residents needs such as communication and positive intervention. The AQAA showed that all staff have an individual training plan and most staff have completed a National Vocational Qualification (NVQ) in Care level 2 or above and others are working towards the award. The expert by experience said: “Overall I felt there was a team effort from everyone who worked at the house Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 26 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed to the benefit of the residents and staff. EVIDENCE: Geraldine Atkinson has been the registered manager of the home for a number of years. Records held by the Commission and information given in the AQAA show that she is qualified and experienced to manage the service Mrs Atkinson is an Registered General Nurse (RGN) and has obtained an National Vocational Qualification (NVQ) Level 4 in Care. The AQAA and discussion with the manager showed that she has undertaken periodic training to update her knowledge and skills whilst managing the home. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 27 Staff spoken to during the inspection were complimentary of the manager, comments they made included: “The manager is very good” “She listens and is very approachable” “The manager is very good and fair” The AQAA and a selection of records viewed during the inspection visit showed that systems are in place to ensure the ongoing monitoring and improvement of the service. This includes supervising staff, reviewing administrative procedures and reviewing resident’s care plans to ensure their care need requirements are being met at the home. A manager within the company carries out regular audits of the homes systems and procedures. CIC is an equal opportunities employer, discussion with staff and information provided in the AQAA showed this. The AQAA also showed that all other policies, procedures and codes of good practice, which are required for this type of service, are available at the home. There was evidence to show that most of the documents have been reviewed and updated in the last three years so that residents and their representatives have accurate and up to date information about their health safety and welfare. The AQAA showed that all the required checks have been regularly carried out on equipment used at the home. They include electrical circuits, portable electrical equipment, heating system and gas appliances. A selection of certificates and records, which were seen, supported this information. Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 28 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Elizabeth Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 29 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 YA20 Regulation 13(2) Requirement All medication kept at the home must be recorded correctly to ensure the health and safety of residents. Timescale for action 14/12/07 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 Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries.northwest@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 Road Nursing Home DS0000005456.V349969.R01.S.doc Version 5.2 Page 31 - 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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