Inspection on 09/02/06 for Elkington House

This inspection was carried out on 9th February 2006.

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 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 Unannounced Inspection 9th February 2006 11:15 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.V277963.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 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.V277963.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 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 DS0000015433.V277963.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection which took place on 9th February 2006 over four hours. The inspection process included discussion with the manager and three members of staff. Time was spent amongst the residents of the home and discussion took place with five of them. A tour of the premises was undertaken and a random sample of records and policies. What the service does well: 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.V277963.R01.S.doc Version 5.1 Page 6 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.V277963.R01.S.doc Version 5.1 Page 7 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): EVIDENCE: These standards were not looked at in detail at this inspection, but the standards were met at previous inspections. The manager confirmed there has been no change to the pre admission process. Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 8 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): 7,9 The completion of care plans and the administration of medication ensures the needs of the residents are fully met. EVIDENCE: Individual care plans are kept for the residents. These detailed the care needs of the individual to enable staff to give good care. Daily records varied in content and did not always indicate how a resident had spent their time. Nutritional charts give no indication of amounts eaten to ensure a resident has an adequate diet. There was evidence that regular reviews were done to reassess individual care needs but no evidence to show that the resident or their relative had been involved. Residents were positive about the care that they were receiving from the staff. Staff had a good knowledge of each resident and how to care for them and seemed to be sensitive and caring in their dealings with the residents. The home has appropriate storage facilities for medicines held on behalf of the residents. MAR sheets were well completed and medication agreed with the amount recorded as having been received into the home. Training has been arranged in March 2006 for staff who administer medication in the home. Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 9 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): 14 The home is operated to maximise residents’ capacity for independence and choice. EVIDENCE: Residents confirmed that they had been able to bring items of furniture and personal possessions into the home. Due to their visual problems they have equipment aimed at promoting their independence. Many residents have speaking watches which allows them to tell the time. No resident uses advocacy at the moment but details are available to residents. The activities coordinator comes in to the home three times a week and does exercises to maintain their mobility. Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 10 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 complaints procedure protects the residents, but lack of POVA training and an updated policy could leave residents at risk. EVIDENCE: The home has had no complaints since the last inspection. The complaints policy is in the process of being updated. Residents confirmed that they felt the manager is approachable and they thought any concerns they had would be sorted out. The policy for the protection of vulnerable adults has not been updated yet and the manager and staff have not received any training in this area to remain updated. There have been no POVA issues at the home. Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 11 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, 21, 22, 24, 25, 26 The home is clean and comfortably furnished and proposed building will enhance the quality of the residents’ lives. EVIDENCE: Plans have been passed by the local council for a new lift shaft, two en suite bedrooms and an extension to the rear lounge. Work is due to start immediately and will last for approximately six months. This will be advantageous to the residents as the existing lift breaks down periodically, leaving residents isolated in their bedrooms. Bedrooms were seen to be personalised and the home is clean and tidy. Ramps and handrails have been placed to the front and rear of the building to enable easy access for the residents. The home was clean with no unpleasant odours, and is comfortably furnished giving a homely atmosphere. The temperature of the water being delivered in some of the bedrooms was above 44 degrees, which could put the resident at risk of scalding. The manager is aware of this problem and the plumber had been in the home the previous day to fit a new thermostat and to check the boilers and water Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 12 temperatures. Some radiator covers did not allow access for individual heat control. The manager spoke of the lack of storage in the home as pads and gloves are on display throughout the home. Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The arrangements for recruitment of staff could potentially put the residents at risk. Staff training needs to be planned to ensure staff have the skills to perform their care role. EVIDENCE: The manager said that she has a care staff vacancy of 24.5 hours per week. She uses an agency to fill these hours, but only has staff who know the residents and their needs. One resident said, “I don’t think there are enough staff, we have to wait our turn” when talking about coming down to the lounge in the morning. Staff spoke of a good staff team and one said, “each and every one of them is conscientious” and another said, “everyone is approachable, I really like it here”. Six members of staff have completed NVQ level 3 and one has completed NVQ level 2. One member of staff has commenced NVQ level 3. There has been no additional training since the last inspection but the manager confirmed that the home has recently purchased a training package from Mulberry and an in house training officer has been employed from the end of February 2006. She will be responsible for all staff training, including induction. Training will be tailored to the residents’ individual needs and she will be responsible for keeping staff training records. The recruitment files were viewed for two recent members of staff. Both of these had a CRB from a previous employment and a POVA 1st had not been obtained prior to commencement of this employment. Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 14 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, 35, 36, 38 The manager provides clear leadership in the home, ensuring the residents receive good care. EVIDENCE: The manager is dedicated and is working hard to make improvements. She is also starting her NVQ 4 qualification in care and management. She feels she is well supported by the trustees of the home. Staff and residents all said that they found the manager approachable and felt that any concerns would be sorted out. The manager is developing the quality assurance of the home and has recently sent a questionnaire to relatives. She speaks to each resident individually on a weekly basis, as she finds that this works better than meetings, due to their visual impairment. This needs to be documented more formally. The manager is planning to collate any information acquired from these sources and develop an action plan at the end of March 2006. Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 15 Any monies that the home looks after for residents, is stored securely and was recorded accurately. However this must not be pooled but stored individually. Evidence was seen of staff supervision and the manager has an open door policy to give staff the opportunity to discuss things when it is convenient for them. The trustees are at present arranging a staff manual and company manual with all policies and procedures being reviewed. Job descriptions are also being reviewed. There were areas in the home where the safety of the residents was compromised, and these were discussed with the manager at the inspection. One area was the temperature at which hot water is being delivered in some rooms. This is discussed earlier in this report. Although the registered manager is the designated first aider, staff need to have current training in first aid, food hygiene, infection control and fire prevention. This will be the responsibility of the new trainer. Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X 3 3 X 3 2 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 3 2 X 3 3 X 2 Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 17 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 OP18 Regulation 13(6) Requirement The registered person must provide training to protect residents from abuse. This is a repeat requirement The registered person must provide training appropriate to the work staff perform This is a repeat requirement The registered person must carry out a thorough recruitment process. The registered person must consult with residents and their representatives regarding the quality of care, and supply a report to the Commission This is a repeat requirement The registered person must ensure that it protects the health and welfare of the residents. This includes the temperature at which hot water is delivered and first aid training. Timescale for action 30/04/06 2. OP30 18©(1) 30/04/06 3. 4. OP29 OP33 19 (1) (b) 24 31/03/06 30/04/06 5. OP25OP38 12 (1) (a) 31/03/06 Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 18 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 involved in care plan reviews should be recorded. Specimen signatures should be recorded for staff administering medication. Daily fridge temperatures recorded to ensure medication is stored at the right temperature. Pads and gloves should be stored out of sight to maintain the privacy and dignity of residents. A minimum of 50 of care staff achieve NVQ level 2. The manager achieves NVQ level 4 in management and care. 2. OP9 3. 4. 5. OP10 OP28 OP31 Elkington House DS0000015433.V277963.R01.S.doc Version 5.1 Page 19 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.V277963.R01.S.doc Version 5.1 Page 20 - 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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