Inspection on 19/07/05 for Elkington House

This inspection was carried out on 19th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Elkington House 15/06/07

Elkington House 25/07/06

Elkington House 09/02/06

Elkington House 24/02/05

Elkington House 21/09/04

Similar services:

Claremont House

Coopers Mill Ltd

Pocklington House

Newton Court (1-2)

Firstlings

Fen Road

Newton Court (3-4)

Dial House Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Elkington House 9 Imperial Avenue Westcliff-on-Sea Essex SS0 8NE Lead Inspector Christine Bennett Unannounced Tuesday 19th July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Elkington House Address 9 Imperial Avenue Westcliff-on-Sea Essex SS0 8NE 01702 348200 01702 348200 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Southend Blind Welfare Organisation Ms Sarah Jayne Richardson CRH Care Home 25 Category(ies) of DE(E) Dementia - over 65 (25) registration, with number SI(E) Sensory Impair - over 65 (25) of places Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24th February 2005 Brief Description of the Service: Elkington House provides accommodation for twenty five older people who have a sensory impairment and/or dementia. The home is situated within easy reach of the seafront, Southend shopping centre, and is close to rail and bus links. There is parking to the front of the property. The accommodation is on two floors and there is a passenger lift to enable access to both floors. There are single and shared bedrooms, some of which have en suite facilities, lounge/dining areas and a large rear garden. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on 19th July 2005 over 6 hours 20 minutes. The inspection process included discussion with the manager, 6 members of staff, a district nurse, a visiting hairdresser, 9 residents and 2 visitors to the home. A tour of the premises was undertaken and an inspection of sample records and policies. What the service does well: What has improved since the last inspection? What they could do better: Some staff did not have a clear understanding on forms of abuse and reporting abuse and there had been no recent training in this area. The policy relating to abuse was also not clear as to action that would be taken. Although four members of staff have completed the NVQ level 3, and two are near to completing it, there has been no additional training in any area this year. There was no evidence in the home that residents, visitors and staff were consulted on the running of the home, although the manager said that this had been done, but was not available on the day of inspection. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 6 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. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,6 The home operates a thorough pre admission assessment ensuring appropriate admissions to the home. EVIDENCE: The manager described a thorough admission process, through which she assessed whether the home can meet individual needs. Two care plans viewed, gave clear evidence of pre admission assessments, and residents and visitors confirmed that they had had the opportunity to visit the home before moving in on a month’s trial basis. A review is then carried out to ensure all parties were satisfied that needs would be met. The home does not provide intermediate care. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 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 standard(s) 7,8,10 The health needs of residents are well met with good multidisciplinary working taking place. The home has a stable staff team who have a good understanding of residents’ needs. Staff treat residents with respect, and encourage them to maintain their independence where possible. EVIDENCE: Two care files were inspected and they were clear and comprehensive. They covered key needs and had been regularly reviewed but did not evidence that residents or their representative had been involved with these reviews. Daily records varied in the information written but should generally give more information on how a resident has spent their day. Nutritional charts are kept but do not give any indication of how much a resident has eaten at each meal and these should be developed to include this information. Discussions with staff and residents evidenced that the care staff had a good understanding of individual care needs and residents and visitors were very complimentary about the way the care was given. One resident said, “they are all very kind, nobody bosses you about”. Records showed good monitoring of health needs and appropriate referrals were made to medical professionals. The district nurse and a community psychiatric nurse were visiting the home during the inspection and the district nurse confirmed that the home always cooperates with her. No residents had pressure sores, and appropriate pressure relief Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 10 equipment was in use. A visitor to the home said that her father was always spoken to respectfully, and received his mail unopened. A resident said that she had her own phone in her room and was able to make her calls in private. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 Residents experience a stimulating and varied life in the home. Visiting arrangements are open and relaxed. The home supplies sufficient quantity and quality of food to meet individual nutritional needs. EVIDENCE: Discussions with residents and staff evidenced that routines were flexible in the home and individual choices were respected. An activities coordinator is employed for three mornings and she organises quizzes, dominoes, exercise and various other forms of entertainment. A summer fair is being held at the home later in the month and Christmas and Easter parties are organised. Residents who do not wish to join in these activities have the opportunity of 1 to 1 pampering and entertainers come in to the home on a regular basis. Staff were seen to spend time talking and listening to residents. Visitors confirmed that they are always made to feel welcome and can visit freely. Residents were complimentary about the food provided and confirmed that a choice of food was available. Menus viewed showed a good range of meals, incorporating fresh vegetables and fruit. One resident said, “the food is very good, I get a choice and I could have extra if I want”. Special diets are catered for and the cook had a good knowledge of individuals and their likes and dislikes. She spoke of sieving porridge for one resident to encourage them to eat and a visitor said, “they go out of their way to mash his food and feed him”. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The complaints procedure is satisfactory. Not all staff were aware of issues relating to the protection of vulnerable adults and this has the potential to put residents at risk. EVIDENCE: Residents, visitors and staff all said that the manager was approachable and they felt comfortable discussing any concerns, and felt they would be sorted out. One resident said, “the manager is lovely and understanding, she tries to put things right for me”. No complaints have been received by the home or CSCI. The home’s policy on the protection of vulnerable adults does not reflect the need to make referrals to other agencies in the event of suspicion of abuse. Some staff were unclear about different forms of abuse and the reporting of abuse. The staff had had no training on abuse this year and this could mean that residents are put at risk if allegations are not dealt with properly. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) N/A EVIDENCE: The environment was not looked at in detail but the manager confirmed that ramps had now been placed to the front and rear of the building to enable easier access. Handrails must be placed to the front ramp to ensure safety. The home was clean with no unpleasant odours. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,30 The deployment of staff is sufficient to meet the needs of residents. Staff training has not been provided in a planned way to ensure that training and skill requirements are provided for. EVIDENCE: Staffing levels have been adjusted to reduce the number of care hours by 63 hours per week. The manager must ensure that this is not detrimental to the upkeep of the home and the needs of the residents. There is at present a vacancy of 30 care hours and the manager was recruiting on the day of inspection. Staff spoke of a good team spirit and agency staff who are familiar with the home cover any shortfalls. No member of staff works excessive hours and a random check of the duty rota showed adequate cover throughout the day and night. Four members of staff have completed NVQ level 3 training and two more are near to completion of this course. Two more staff are intending to commence this training. However there has been no other training undertaken this year, and the manager has recognised this shortfall, and arranged an in-house training programme with Mulberry to rectify this problem. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33 The manager provides leadership, guidance and direction to staff to ensure residents receive consistent quality care. Records should be kept in the home confirming that staff, residents and visitors are consulted on the running of the home. EVIDENCE: The manager has been working in the home for ten years, and has managed the home for three years. She has achieved NVQ level 3 and intends to commence NVQ level 4 this autumn. Residents, visitors and staff made positive comments about the management of the home and felt supported by her. The home has devised a quality assurance questionnaire for residents and their relatives but results were not in the home for inspection. The home should formally document a programme of self-review, alongside consultations with residents, relatives and staff in order to evidence that it is committed to review its performance on a regular basis and forward a copy of this plan to CSCI. Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 3 2 x x x x x Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 17 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 18 30 Regulation 13(6) 18©(1) Requirement The registered person must provide training to protect residents from abuse. The registered person must provide training appropriate to the work staff perform This is a repeat requirement The registered person must consult with residents and their representatives regarding the quality of care, and supply a report to the Commission Timescale for action 1/10/05 1/10/05 3. 33 24 31/12/05 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 7 Good Practice Recommendations Daily records and nutritional records should be developed to include more information. Evidence that residents or their representative have been involved in care plan reviews should be recorded. A minimum of 50 of care staff achieve NVQ level 2 by 2005. The manager achieves NVQ level 4 by 2005. 2. 3. 28 31 Elkington House I56 I06 S15433 Elkington House V239147 190705 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-on-Sea Essex, SS2 6BG 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. 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