Inspection on 25/07/06 for Elkington House

This inspection was carried out on 25th July 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 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 09/02/06

Elkington House 19/07/05

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 Key Unannounced Inspection 25th July 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 Elkington House DS0000015433.V305708.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. Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elkington House Address 9 Imperial Avenue Westcliff On Sea Essex SS0 8NE 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) 01702 348200 01702 348200 Southend Blind Welfare Organisation Ms Sarah Jayne Richardson Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Sensory registration, with number Impairment over 65 years of age (25) of places Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th February 2006 Brief Description of the Service: Elkington House provides accommodation for twenty five older people who have a sensory impairment with/without dementia. The home is situated within easy reach of the seafront and Southend shopping centre. It is close to rail and bus links. There is parking to the front of the property. The accommodation is on two floors and there are 2 passenger lifts 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. The home has an up to date Statement of Purpose and Service User Guide. A copy of these and the last CSCI inspection report are available in the entrance hall. The current scale of charges as at July 2006 ranges from £405 - £425 per week. Extras charged are for hairdressing, chiropody, toiletries and newspapers. Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key site visit was unannounced and took place on 25th July 2006 over an 8 hour period. At this inspection all the key standards and the progress since the last inspection were assessed. A pre inspection questionnaire had been completed by the home prior to this visit. 7 surveys were sent to residents, of which 7 were returned, 11 to relatives, of which 4 were returned, and 3 to health professionals, of which 2 were returned. The registered manager was available throughout the day to assist with the inspection process. A tour of the premises took place and a random selection of records and policies were examined. Time was spent with the residents, observing care practices, and conversation took place with most of them. Visitors to the home were given the opportunity to speak to the inspector. Staff were asked their opinions during the day. Feedback was given to the registered manager at the end of the site visit. What the service does well: The home has a manager who knows all the residents well. She has a good staff team who were praised by the residents and the relatives. Some of the comments made were, “we have always been impressed by the caring attitude of the staff. They have always made us welcome and communications are good”, and “we are most impressed by the standard of care towards residents.” The home is clean and there are no unpleasant smells. The residents were complimentary about the food and said there was a choice and “plenty of it”. The booklets about the home and all the policies have been reviewed so that any information is up to date. The home has somebody come into the home three times a week to provide activities for the residents. Elkington House DS0000015433.V305708.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. Elkington House DS0000015433.V305708.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 Elkington House DS0000015433.V305708.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): 1.2,3,5,6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. The pre admission assessment means that people’s diverse needs are identified and planned for before they move to the home. EVIDENCE: The Statement of Purpose and Service User Guide have recently been updated and are available in the entrance hall of the home. The manager explained that these can be provided in any form necessary for a prospective resident, and a copy is given to them when interest is shown in the home. At present the home is not admitting new residents due to extensive building works. The manager was able to detail a thorough admission procedure, where she visits people in their own home to make sure that the home can meet all their needs. They and their relatives have the opportunity to visit the Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 9 home and spend some time there before deciding if it is the right place for them. Approximately one month after they move in, a review is held, involving the resident, their relatives and any other representative, to make sure everybody is happy with the arrangements. Evidence was seen in two care plans that this procedure is carried out. All the residents who responded in the survey felt that they had received enough information before moving into the home. The contract with the terms and conditions of the home was updated in January 2006 and is given to each resident. Intermediate care is not offered by the home. Elkington House DS0000015433.V305708.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 outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents can be sure that their health and personal care needs will be fully met. The recording of some medication is not accurate enough to ensure errors are not made. EVIDENCE: A new format for care plans has been introduced in March 2006, which the manager and staff think are easier to record details of care. Two care plans examined had care needs identified and how to manage them. Daily records varied in content, but mainly focused on a person’s immediate health needs, with little detail of the person. Nutritional charts should be developed to include amounts for residents who have been identified as at risk. The manager is trying to involve the residents/relatives in the reviews and this must be recorded on the care plan. The staff had a very good knowledge of each individual resident, and appeared kind and caring in their dealings with them. Residents were complimentary about the care received and they said in the surveys that the staff always Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 11 listen to them. One resident commented, “Carers spend time, kind, thoughtful and respectful – If I need something, the carers provide it. Relatives were also complimentary and one said, “My relative frequently comments on how content she is at Elkington House and I always find the staff friendly and helpful. I am pleased my relative is a resident here”. Another said, “I am always able to chat to the manager – she is always willing to accommodate mums wishes. There is a good standard of care”. The home has appropriate storage facilities for medicines held on behalf of the residents and medication records were generally satisfactory. The recording of homely remedies and some painkillers for residents must reflect the amounts held by the home. Training for staff who administer medication is due to be updated. The staff are aware of the need to respect the residents’ privacy and dignity when delivering health and personal care. The home provides screens in shared rooms and respects some residents’ wishes to enjoy the privacy of their own room. Residents who have a personal telephone have large dial buttons to enable them to use them independently. Some residents have their care needs displayed on the outside of the wardrobe door. Pads are not at present stored discreetly and the manager is aware of this problem. As part of the redecoration programme, she is making provision for the storage of pads and gloves in an enclosed area. Elkington House DS0000015433.V305708.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 outcome area is good. This judgement has been made using available evidence including a visit to the service. A range of activities within the home means the residents have the opportunity to keep occupied if they choose. Meals are well managed and varied to meet the nutritional needs of residents. EVIDENCE: Many residents have equipment aimed at promoting their independence. An activities coordinator visits the home three times a week and has group sessions and individual sessions with the residents. These include quizzes, exercises and reminiscence. All the residents who responded in the survey said that there are activities arranged for them. One resident has books and a newspaper delivered in tape form and many residents have speaking watches which allow them to tell the time. Two residents have ministers come to the home to enable them to continue to practise their religious faith. Family and friends feel welcome and know that they can visit the home at any time. Entertainers come to the home on a regular basis. The home has recently sent out surveys and two residents commented, “More outside activities” “Like to go out more”. Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 13 Residents are able to have personal possessions in their rooms to make them more homely for them. Residents were positive about the food in the home. An experienced cook is responsible for providing the meals. There is a choice on the menu and a resident confirmed that there is always plenty to eat. Residents have the opportunity to use modified plates and beakers, which enable them to eat and drink without assistance. Tea was observed, and most residents sat in the dining area of the home. Staff were available and offered help sensitively where required. Elkington House DS0000015433.V305708.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s complaint procedure and staff knowledge of POVA. EVIDENCE: The home has had no complaints since the last inspection. The complaints policy has been updated this year. Residents who responded to the survey all knew who to speak to if they were unhappy and knew how to make a complaint. The manager has an open door policy and relatives confirmed that they can speak to her at any time if there is a problem. The policy for the protection of vulnerable adults has been updated and two staff have attended POVA training since the last inspection, with plans for further staff to attend training in the near future. All staff spoken with had a good knowledge of forms of abuse and the reporting of abuse. Training specifically for managers should be sought to ensure the manager is aware of her responsibilities. There have been no POVA issues at the home. Elkington House DS0000015433.V305708.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and comfortably furnished, ensuring the residents live in pleasant surroundings. EVIDENCE: Building work is in progress at the home and is due to be finished in the autumn. A new lift shaft, an enlarged lounge and two en suite bedrooms are being built. These improvements will give the residents more space in the home and easier access to the upstairs bedrooms. The residents and staff said that there has been minimal disruption to the home. The home has had low surface temperature radiators fitted and water checked randomly from the hot taps is being delivered below 44 degrees centigrade. Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 16 The home was clean and tidy with no unpleasant odours. A maintenance programme has been produced to refurbish many areas of the home when the building work is completed. This includes seven bedrooms and communal living areas. The manager said that there are plans to have the garden landscaped to make it “wheelchair friendly” and therefore more accessible to residents. Elkington House DS0000015433.V305708.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 adequate. This judgement has been made using available evidence including a visit to this service. Staff training must continue to be developed to ensure staff have the skills to perform their work. EVIDENCE: The manager is in the process of recruiting staff. She uses agency staff to cover shifts and these are staff that work at the home on a regular basis and know the residents well. During the building works, the home is not admitting any new residents to allow staff more time with the residents to help them adjust to any disruption. The residents’ surveys indicated that they felt there were enough staff in the home to meet all their needs. There have been no new recruitments since the last inspection. The recently appointed administrator will be responsible for updating staff records to comply with regulation. Application forms were seen for two potential members of staff and these detailed a 10 year work history. Five members of staff have completed NVQ level 2 or above. This is approximately 25 of the care staff working in the home. Two staff are in the process of doing their NVQ level 2 training, and the manager explained that as these two finish, two more staff will be put forward for this training. The home has recently started to use the Mulberry training package and the manager has taken responsibility for individual staff training programmes, Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 18 recognising the benefits to the residents and staff. At present the training programme is at a fairly early stage but the manager spoke of future training that is planned to give staff the skills to do their job more effectively. An outside trainer is visiting the home in the autumn to provide three training sessions on first aid. This will enable all staff to attend. Elkington House DS0000015433.V305708.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): 31,33,35,36,37,38 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The manager provides stability to the home and must continue to develop a quality assurance programme that evidences residents views are paramount in the running of the home. EVIDENCE: The manager has commenced her NVQ level 4 in care and management. She has worked at the home for many years and knows the residents and their families well. She feels well supported by the trustees of the home and an administrator has recently been appointed to assist her in her role. Residents, relatives and staff all commented that she is approachable and will endeavour to sort out any problems. Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 20 A questionnaire was sent to relatives and residents and other stakeholders in March 2006 as part of the home’s annual quality assurance programme. The manager is in the process of accumulating this information to show any action necessary and will make the findings available to the residents and CSCI. She explained that due to the residents’ visual impairment, group meetings are not usually successful. She finds that speaking to residents individually once a month is more beneficial and these conversations must be evidenced to show that the residents’ views are sought with regard to the running of the home. Money held by the home for residents was checked randomly and found to be accurate. This is now stored and recorded individually. Formal supervision for staff has lapsed although the senior care assistants have received training in this area. The manager intends for them to develop the supervision of the care staff. The policies and procedures of the home have all been reviewed and updated where necessary in 2006. Staff training in food hygiene, fire, storage of dangerous substances, and POVA has recently taken place. A fire drill is held twice a year and involves the night staff and a fire risk assessment has been carried out in April 2006. Water was checked randomly and is being delivered at a safe temperature and radiators have been changed to make sure they are not too hot for residents to touch. Elkington House DS0000015433.V305708.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 3 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 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 X X X X X x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 3 Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP9 Regulation 13(2) Requirement The registered person must record medication in the home in such a way as to ensure there has been no mishandling. This refers to homely drugs and prescribed painkillers. Staff to receive updated training in the administration of medication. The registered person must conduct the home to the protect the privacy and dignity of residents. This includes the storage of pads, and care needs written on wardrobe doors. The registered person must continue to provide training appropriate to the work staff perform. This includes basic training and speciality training including dementia, diabetes awareness, and visual impairment This is a repeat requirement Timescale for action 01/12/06 2. OP10 12(4)(a) 01/10/06 3. OP30 18(1) 31/12/06 4. OP29 19 (1) (b) The registered person must carry 31/10/06 out a thorough recruitment process. This requirement is carried over as no new staff are in post since the last inspection DS0000015433.V305708.R01.S.doc Version 5.2 Page 23 Elkington House This is a repeat requirement 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 OP7 Good Practice Recommendations Daily records and nutritional records should be developed to include more information. Evidence that residents or their representative have been offered the opportunity to be involved in care plan reviews. A minimum of 50 of care staff achieve NVQ level 2. The manager achieves NVQ level 4 in management and care. Care staff to receive formal supervision at least 6 times a year. The manager undergoes POVA training relating to her managerial role. 2. 3. 4. 5. OP28 OP31 OP36 OP18 Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Essex Local Office 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. Extracts may not be used or reproduced without the express permission of CSCI Elkington House DS0000015433.V305708.R01.S.doc Version 5.2 Page 25 - 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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