Inspection on 01/12/08 for Ellesmere Community Nursing Home

This inspection was carried out on 1st December 2008.

CSCI found this care home to be providing an Excellent service.

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

Ellesmere Community Nursing Home 05/01/07

Ellesmere Community Nursing Home 21/02/06

Ellesmere Community Nursing Home 15/11/05

Ellesmere Community Nursing Home 14/02/05

Ellesmere Community Nursing Home 08/09/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ellesmere Community Nursing Home Trimpley Street Ellesmere Shropshire SY12 0AE     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Joy Hoelzel     Date: 0 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Ellesmere Community Nursing Home Trimpley Street Ellesmere Shropshire SY12 0AE 01691622364 01691622364 ecnh@micro-plus-web.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ellesmere Community Care Centre Trust Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 9 Number of places (if applicable): Under 65 Over 65 7 0 old age, not falling within any other category physical disability Additional conditions: 0 2 The bedroom with the high window must only be used for clients receiving respite care or, in other instance, by direct written agreement with CSCI. The home may accommodate a maximum of 9 service users The home may accommodate a maximum of 9 Older Persons and 1 person may be receiving respite care, 2 may have a physical disability. The home must comply with the Staffing Notice issued by the Shropshire Area Health Authority dated 14th February 1995 Date of last inspection Brief description of the care home Ellesmere Community Nursing Home is situated in Ellesmere Town Centre and benefits from varied local amenities which means it can be accessed by a variety of public Care Homes for Older People Page 4 of 26 Brief description of the care home transport. The home is owned by the Ellesmere Community Care Centre Trust, and is registered to provide accommodation and care, including nursing, for nine people. Occupying the upper floors of the former Ellesmere Cottage Hospital, it is accessed via shaft lift or stairs. The ground floor of the building is leased to the Meres Day Centre, which is managed by Shropshire Social Services. Bedroom accommodation comprises of seven single and one double bedroom. The majority of these have en suite facilities. The residents have the opportunity to access a communal lounge and dining room also located on the first floor. Information on the service is currently being reviewed and revised. The reader of this report may wish to obtain more information of the service and the level of fees directly from the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last unannounced key inspection was completed on 5th January 2007 with an annual service review on 21st January 2008. This unannounced inspection took place over four hours on Monday 1st December 2008. A first level nurse was in charge of the home, supported by care staff and ancillary personnel. A look around the home took place, which included a number of bedrooms as well as communal areas. The care documents of a number of people using the service were viewed including care plans, daily records and risk assessments. Other documents seen included medication records, service records, some policies and procedures and staffing records. Discussions were held with people living, visiting and working at the home. Some people were unable to fully comment about their experience of life at the Care Homes for Older People Page 6 of 26 home. Observations were made of how they spent the day and of the interactions offered by staff in an attempt to obtain an overview of how they may be feeling. Prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was posted to the home for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for providers to share with us the areas that they believe they are doing well. It is a legal requirement that the AQAA is completed and returned to us within a given timescale. The acting manager completed this document and returned it the commission. Comments from the AQAA are included within this inspection report. Six Have Your Say surveys were completed by people living in and visiting the home prior to this inspection. The comments received are included in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need Evidence: Information on the provision of the service and the current level of the weekly fees was unavailable at the time of the inspection. The person in charge stated that the acting manager is currently reviewing and revising the statement of purpose and service user guide. The case file of the person who recently moved into the home was looked at to see if information had been sought regarding this persons needs prior to moving in. Information had been gathered from the previous health care setting and a pre admission assessment was completed by the service. This person discussed the Care Homes for Older People Page 10 of 26 Evidence: admission process and expressed a satisfaction with the current arrangements. Other case files looked at included a pre admission assessment by the home in addition to social worker reviews, assessments from Primary Care Trusts and community care services. This gathering of information ensures that the service can be confident of meeting a persons care needs. The service does not provide an intermediate care service but has an agreement with the local primary care trust for one bed to be available for short stay assessment purposes. A relative of a visitor to the home discussed this facility and confirmed that the arrangements were very suitable for his relatives needs. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The plan is person centred and focuses on the individuals strengths and personal preferences. The delivery of personal care is individual and is flexible, consistent, reliable, and person centred. Staff respect privacy and dignity and are sensitive to changing needs. Evidence: All people have a plan of care that is initially generated from the assessments obtained prior to the person moving into the home. Two plans were selected for inspection with people being at the home for varying lengths of time. The plans evidenced that the person and/or their representative is fully involved in the care planning and review process. Each plan contained assessments for maintaining a persons safety and when a risk is identified it is linked with a corresponding plan of care. For example one person is currently at risk of developing pressure areas due to a specific condition, the care plan indicates the pressure relieving equipment to be used and the regular interventions needed by staff to reduce the risk. Staff discussed the care of this person and the individual needs of other residents and described the way they helped and Care Homes for Older People Page 12 of 26 Evidence: assisted with the activities of daily living. Medication is administered to people by the registered nurses using a monitored dose system with additional boxes and bottles of medicines. The procedures were looked at, staff explained the processes and all evidence points to good arrangements being in place for the safe administration of medications. Staff were observed to be very patient, understanding and very caring, assisting people with care needs in a discreet and respectful way Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. The meals are balanced and nutritious and cater for the dietary needs of individuals. Care staff are sensitive to the needs of people who find it difficult to eat and give assistance with feeding. Evidence: The staff organise and arrange social, leisure and recreational activities, both in house and in the community, following discussions with the people living at the home. People spoken with that live at the home stated that there is always something going on. One person stated that they had never been bored since they came to live at the home and was fully satisfied with all that was on offer. Another person said there was lots of activity. Four people during the morning were enjoying a game of dominoes and stated that they enjoyed this regular activity. During the afternoon some of the residents were planning to join in with carol singing in the day centre. One person completed the Have Your Say survey and made an additional comment in the What the service does well section, absolutely everything, healthy diet, suitable activities, very friendly staff always helpful and cheerful. Trips out, social activities at Care Homes for Older People Page 14 of 26 Evidence: the home. People stated that friends and families are able to visit at suitable times and that they found the arrangements very satisfactory. The main front door is kept locked for security reasons, entry to the home is gained by staff answering the door. A push button devise is used for exiting the premises. No other doors were locked with the exception of storage cupboards; people have unrestricted access to areas within the unit. The dining area is prepared in advance of meals with people being encouraged to sit at the table, but people are able to have their meals in their preferred place. People spoken with stated that they enjoyed the meals provided, had plenty to eat and a good choice. Staff were observed to be sitting with people who required help to eat and drink and were very patient, discreet and encouraging. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and others involved with the service say that they are satisfied with the service provided and know what action to take if they have concerns Evidence: The complaints procedure has recently been reviewed but does not include our current contact details. The person in charge offered an assurance that this will be included as soon as possible. People spoken with stated that if they had any concerns they were confident that it would be swiftly sorted out. But currently they have no concerns about the service with everything being satisfactory. The Annual Quality Assurance Assessment indicates The Complaints Policy & Procedure is prominently displayed at the reception area for all to access. POVA (protection of vulnerable adults), training for all staff. We have only received one complaint in the last twelve months this was immediately investigated and has been resolved both parties happy with the outcome. There is a good rapport between all staff, residents and families. Everyone knows the manager is available at any time.We use the social functions to chat in an informal way. The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this were seen. All transactions are recorded on individual balance sheets with invoices and receipts kept. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a physical environment that is satisfactory to the specific needs of the people who live there. It is well furnished, comfortable and homely. Evidence: Ellesmere Community Nursing home provides accommodation for nine people. The communal and private areas of the home are furnished and maintained to a high standard. People spoken with said they were very satisfied with their accommodation and that it was a home from home. Redecoration and the replacement of the fabric and furnishings continue on an as required basis. The windows have been replaced in the lounge and are now at a lower level. People sitting in the lounge are now able to look out of the windows easily and see the happenings in the community. The person in charge spoke of the plans for further improving areas around the home. One person made an additional comment in the completed Have Your Say survey regarding the premises it is unfortunate that the first floor rooms become a barrier to the outside (independently). The ground floor of the building being accessed by a passenger lift or flight of stairs. One person stated that when and if they wished to go downstairs, a member of staff would be available to escort them. The local fire safety officer has visited this year and made recommendations for Care Homes for Older People Page 18 of 26 Evidence: improvements to the environment. The environmental health officer has also visited. The person in charge of the home confirmed that the advice and recommendations have been complied with. A closed circuit television camera is sited at the entrance to the home for security purposes. The Annual Quality Assurance Assessment completed by the acting manager describes the plans for improvement Make the seating area in the garden a more pleasant area to sit in for residents and their families,weather permitting and we shall be starting in the spring. All areas of the home were spotlessly clean and hygienic. Hand wash facilities have been provided in all communal areas and at the point of the delivery of care for general hygiene purposes and to ensure effective infection control. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. Evidence: A duty rota is maintained on a weekly basis to identify the members of staff in the home at any one time. During the morning of the inspection the registered nurse was in charge of the home supported by two care staff and ancillary personnel. Eight people are currently resident and stated the staff are excellent and are available to help when I need them. A visitor to the home expressed a great satisfaction with the care that staff provided to his relative. One person made an additional comment in the completed Have Your Say survey The staff are very committed and work very hard to provide a positive living environment for all the residents. General observations and discussion with staff confirmed that staffing numbers and Care Homes for Older People Page 20 of 26 Evidence: skill mix enable a service provision, which meets the care needs of the people living at the home. The Annual Quality Assurance Assessment completed by the acting manager indicates that four out of the five care staff have National Vocational Qualification level 3 in care. Staff also have the opportunity for training in dementia awareness, protection of vulnerable adults, mental capacity act and deprivation of liberty safeguards. Staff spoken with confirmed the training opportunities in the mandatory and specialist topic areas. Two staff files were selected for inspection, each contained details of the checks necessary to ensure that suitable people are employed by the service. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in the care home because it is led and managed appropriately. The environment is safe for people and staff because appropriate health and safety practices are carried out. Evidence: Ms Elaine Stockdale has been recruited as the acting manager following the resignation of the previous care manager. Ms Stockdale is a first level nurse and has been in a senior position at the home for the past eight years. A formal application for the position of registered manager will need to be completed and sent to us for processing. A staff nurse was in charge of the home at the time of this inspection and offered her full cooperation. All staff spoken with demonstrated a good knowledge of the very individual care needs of the people living at the home. The AQAA completed by the acting manager contains clear, relevant information that is supported by a wide range of evidence. The AQAA lets us know about changes they Care Homes for Older People Page 22 of 26 Evidence: have made and where they still need to make improvements. It shows clearly how they are going to do this. Quality assurance and monitoring of the service is ongoing with satisfaction surveys being distributed to people living and visiting the home. The monthly visits by the Trustees of the home continue with a report produced. The home offers a facility for residents to deposit personal monies for safekeeping; records relating to this have been maintained and fully receipted. Records, documents and certificates are available for inspection to ensure that the weekly, monthly and annual health and safety checks are being carried out. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 Information of the home and the provision of the service should be available in the statement of purpose and service user guide. Details of the weekly fees should be included. A formal application for the position of registered manager should be submitted to us as soon as possible. 2 31 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!