Inspection on 24/08/06 for Elizabeth Welsh House

This inspection was carried out on 24th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Welsh House 17/11/05

Elizabeth Welsh House 27/06/05

Elizabeth Welsh House 16/09/04

Elizabeth Welsh House 10/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Elizabeth Welsh House Pennine Way Harraby Carlisle Cumbria CA1 3QD Lead Inspector Margaret Drury Unannounced Inspection 24th August 2006 10:00 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 Welsh House DS0000035205.V295562.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 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 Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elizabeth Welsh House Address Pennine Way Harraby Carlisle Cumbria CA1 3QD 01228 606394 01228 606401 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) www.cumbriacare.org.uk Cumbria Care Miss Evelyn Marion Nelson Care Home 40 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (40) of places Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 40 service users to include: up to 40 service users in the category of OP (Older people not falling within any other category) up to 8 service users in the category of DE (Dementia over 65 years of age) When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 17th November 2005 3. Date of last inspection Brief Description of the Service: Elizabeth Welsh House is a care home registered with the Commission for Social Care Inspection to provide personal care and accommodation for up to forty residents. The home provides permanent accommodation for residents and short term intermediate care to assist people to regain their independence and return to their own homes. Elizabeth Welsh House is owned and carried on by Cumbria Care, which is a Cumbria County Council business unit. Miss Evelyn Nelson is employed as the registered manager of the home. The home is located in a residential area on the outskirts of Carlisle, close to local shops and services and on transport routes into the city centre. The property consists of a purpose built two storey building set in its own grounds. Accommodation is provided as forty single bedrooms, four of which have ensuite facilities. There are accessible toilet and bathing facilities close to all the accommodation used by residents. Shared space is provided in the form of three sitting/dining rooms, a separate smoking room and a large, comfortable entrance hall. The layout of the home meets the needs of the residents living there. The home provides pleasant outdoor areas with seating for residents. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. These visits, that form part of the annual key inspection, took place over one and a half days in August. The visit on the second day took place in order for the inspector to speak with the registered manager, as she was unavailable on the previous day. The inspector was assisted during the first day by the supervisors on duty at the time. Time was spent speaking with the residents, family members who were visiting the home, and members of the staff team. Care plans and documentation concerning the care of the residents and running of the home were examined. This documentation was found to be up to date and gave the care staff the necessary information to provide a high level of care. Medication records were examined and found to be neatly and correctly completed. As the visit took place during the lunch period the inspector was able to observe the midday meal being served on one of the units. This was carried out in a relaxed manner with staff providing assistance when required. A tour of the building took place and residents were observed making full use of the internal and external shared areas. The fees in this service range from £317.00 - £422.00 per week as at the time of the visit. There are extra charges for chiropody, hairdressing, newspapers and toiletries. What the service does well: The home has a comprehensive admission procedure that includes a full assessment of needs and capabilities. Residents who spoke with the inspector said they liked the staff and they received “very good care”. Comments such as “they are lovely girls” they can’t do enough for you” and “they are very caring” were made to the inspector. Care plans are comprehensive and were up to date, with monthly reviews being completed. The home ensures the safe handling of medication by means of a second member of staff acting as a “checker”. The home provides warm, comfortable and safe surroundings for the residents. Healthcare needs are met with the help of visiting healthcare professionals. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 6 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 Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 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 Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 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): 2, 3, 4, 5 & 6 The quality in this outcome area is good. This judgement was made using the available evidence including a visit to the service. The home has an in-depth admissions procedure that includes a full assessment of needs. EVIDENCE: Admissions to the home do not take place until a full assessment of needs has been completed. This assessment is carried out in addition to social services management plans also received by the home. The dependency levels of those already living in the home are also taken into consideration when assessing prospective residents. Wherever possible family members are present during the assessment, which ensures they can discuss the facilities on offer and know the home will be able to meet the assessed needs. All prospective residents and their families are invited and encouraged to visit the home prior to their admission. This gives opportunity for them to meet the staff and talk to other people living there. Some residents have previously received respite care and were already familiar with Elizabeth Welsh House and so were pleased to move in. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 9 All residents are given a contract and terms and conditions of residency and there is also a copy held on each resident’s file. The home provides intermediate care for up to 4 residents on Petrel Unit and staff work hard with members of the intermediate care support team to ensure the residents are rehabilitated and given sufficient confidence to be able to return to their own homes. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9, & 10 Quality in this area is good. This judgement was made using the available evidence including a visit to the service. . Healthcare needs are met through detailed and up to date care plans and input from visiting healthcare professionals. EVIDENCE: Each resident has a care plan that follows the corporate format and is used as a working tool and understood by all staff. It is written in clear language with resident involvement wherever possible and is used to ensure the correct level of care is delivered. Each care plan includes a comprehensive risk assessment. Management of risk takes into account the needs of residents and demonstrates a balanced view in maintaining safety while also offering choice. The care plans are updated each month by the senior care staff, who also review the risk assessments at the same time. The manager regularly checks the care plans and discusses care issues with the senior staff. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 11 All professional healthcare visits are recorded in detail and the manager and supervisors confirmed that they have a very good working relationship with doctors and district nurses who visit the home when required. Optical, chiropody and dental services are arranged when necessary. The medication is received in a monitored dosage system and all the lead senior carers responsible for giving out the medication have completed training in “safe handling of medication”. Records were checked and found to be in order. The corporate medication policy allows for a second member of staff to act as a “checker” to ensure that any errors do not occur or are kept to a minimum. All the delegated staff/checkers receive internal medication training. Residents who spoke with the inspector said that the staff always treated them with respect and kindness and that any personal care required is given in the privacy of their own rooms. They are always asked how they wish to be addressed. Visitors in the home at the time of the visit all spoke highly of the management and staff and the care received by the residents. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14 & 15 Quality in this area is good. This judgement has been made using the available evidence including a visit to the service. The daily life and social activities are flexible in order to meet the changing needs of the residents. EVIDENCE: All residents are allocated a key worker and the inspector was able to speak with those on duty during the inspection. Interviews with residents indicated that the residents were happy with their daily routines and the choices given about how they wished to spend their day. One gentleman told the inspector he liked the opportunity to “ have a lie in until 10 o’clock on some mornings”. The home provides group activities organised by the activities co-ordinator with members of staff also involved.. Recent work by the supervisors and care staff on each of the units has produced many good ideas about activities within the home and outings to places of choice and interest. The residents who spoke with the inspector all said how much they enjoyed “what the girls organised”. These include, a fortnightly bingo group with prizes, quizzes and games on each of the units, and sing-a-longs. Earlier this year the manager introduced reminiscence sessions that have proved so popular that most of the Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 13 residents now join in. One of the residents told the inspector how much she enjoyed talking about the old days. Also popular are the outings to nearby places that the residents like to visit, with family members sometimes accompanying the staff. Recently there was a “fish and chip supper” when the residents had “chips out of the paper” which all enjoyed very much. Local ministers visit and some residents attend the church of their choice. The inspector was able to observe the lunch being taken when the residents all agreed that they enjoyed their food, although some did remark that they would like lunch to be served a little later in the day as it was “quite close to breakfast”. The meals were served in a relaxed manner and any help required was given in a discreet way. Discussions with the cook on duty evidenced that residents enjoyed their food and meals were often discussed during residents’ meetings. Cumbria Care, as an organisation, is introducing healthy eating in the homes and there was lots of information around the home for the residents and staff to see and read. Every effort is made for the residents to “get their 5 a day”. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 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 the following standard(s): 16 & 18 The quality in this area is good. This judgement was made using the available evidence including a visit to the service. The home has a suitable complaints procedure and residents are confident that their views and concerns are listened to. Internal adult protection training is organised, which ensures the protection of the residents. EVIDENCE: The home has a complaints procedure in place with a copy on display in the hall. The record of complaints was checked although there had been no complaints to record. Residents spoken with were confident that any complaints or concerns expressed would be taken seriously and dealt with as soon as possible. The supervisor who assisted the inspector on the first day confirmed that the residents are not afraid to express “niggles” about anything to the staff. The training matrix indicated that training in elder abuse forms part of the training programme with dates for training for supervisors and the manager organised for September. Interviews with the staff indicated that they were aware of adult protection issues and what constituted abuse. They were all aware of what signs to look for and the procedure to follow should this be necessary. This subject is also covered in one of the NVQ training units. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this area is good. This judgement was made using available evidence including a visit to the service. The home provides a suitable, clean and safe environment for those living there. EVIDENCE: The home is purpose built over two floors, the upper being served by a passenger lift. It is well maintained with the corridor and some of the bedrooms on Eden unit recently redecorated. There is a maintenance programme that is overseen by the organisation’s head office, working within the constraints of the annual budget. Work on the replacement lift has been completed since the last inspection and the remaining metal windows frames have been replaced with UPVC frames. There are communal areas on all the units, although some are small, and outside space for the residents to enjoy particularly during the warm weather. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 16 There is a range of equipment available in the home to assist people in their day-to-day life. This includes a passenger lift, hand and grab rails, assisted baths and toilets and hoists. There are sufficient bathrooms and toilets for the residents, all of which are suitable for people with a disability. The bedrooms that were inspected during the visit were all personal to the individual, with ornaments, pictures and photographs from the residents’ own homes. The home employs domestic staff to ensure the home is clean and although one of the intermediate care rooms had a slight odour the home was, on the whole, very clean and fresh throughout. Gloves and protective clothing are provided, which reduces the risk of cross infection. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 17 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): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement was made using the available evidence including a visit to the service. Staffing arrangements are good, ensuring the needs of the residents are met. Staff are well trained and provide a skilled and experienced workforce. EVIDENCE: The manager uses her allocation of staff hours extremely well, the result being a staff team that works together for the benefit of the residents. There is sufficient care staff on duty during the day to meet the assessed needs of the residents and provide a high level of care. However, there are only 2 members of waking staff on duty through the night to care for up to 40 older people, some of whom having varying forms of dementia. It would be beneficial for there to be at least one extra member of waking night staff on a permanent basis although the manager does bring in extra night staff should this ever be necessary. Extra, allocated, staff hours are utilised for a member of staff to be available to work with the seniors as a “checker” when giving out the medication. The supervisors take on projects for the home to ensure the level of care provided remains at a high standard. These have included, the provision of optical care and the staff induction process. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 18 The home uses the organisation’s recruitment policy and procedure, which means all the required checks are completed prior to employment starting. There is a good training programme with each member of staff being responsible for keeping their own continuous professional development files up to date. A review of the staff files showed the home adhered to the recruitment procedures. Over half of the care staff are qualified to NVQ level 2 with a further 1 working towards the award. Training recently completed includes, moving and handling updates, emergency action and infection control. Cumbria Council also organises corporate training courses for staff working in the organisation. These have included equality and diversity, recruitment and selection and health and safety. Staff interviewed all confirmed that they enjoyed the training that was organised and although one member of staff told the inspector that although she did not want to complete the NVQ she was happy to attend any other training courses. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 19 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, 32, 33, 34, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement was made using the available evidence including a visit to the service. . The manager has the required experience and qualifications to run the home and there are sound policies and procedures in place ensuring the home is run in the best interests of the residents. EVIDENCE: The registered manager has the required qualifications and experience to run the home. She was at a manager’s meeting for Cumbria Care managers on the first day of the inspection but was available to speak with the inspector during the second visit. She has an open style of management and the residents and staff confirmed that she is available at any time to discuss matters to do with Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 20 the running of the home. She meets with the senior team on an “away day” each year to discuss the plans for the following year and what needs to be the priorities to ensure the home delivers the best possible standard of care. She meets with residents on a regular basis to obtain their opinions about the home and any improvements that could be made. Copies of the minutes of the meetings were available on the notice board in the hall. There are some personal monies held in safekeeping with records of all transactions kept showing 2 staff signatures and regular checks by the regional operations manager. As Cumbria Care is an internal business unit of Cumbria Council the main financial procedures are the responsibility of the Head Office. Staff are supervised every two months with a record held on each individual file. The home works to corporate policies and procedures and staff are required to ensure they familiarise themselves with the policies and discuss them during staff supervision. The health and safety of residents and staff is promoted through regular maintenance and safety checks in the home and staff are trained in manual handling and health and safety. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 21 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 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 3 3 3 3 Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP27 Good Practice Recommendations It is recommended that at least 1 extra member of waking night are employed. Elizabeth Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Welsh House DS0000035205.V295562.R01.S.doc Version 5.2 Page 24 - 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. 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