CARE HOME ADULTS 18-65
Elliott Residential Care Home 46-48 Highfield Street Leicester Leicestershire LE2 1AD Lead Inspector
Kim Cowley Unannounced Inspection 22nd June 2006 11:00 Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 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 Elliott Residential Care Home DS0000006423.V292441.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 Adults 18-65. 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. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Elliott Residential Care Home Address 46-48 Highfield Street Leicester Leicestershire LE2 1AD 0116 254 4458 0116 254 4458 elliot.4648@aol.com 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) Mr M Elliott Mrs Elliott Mrs Shirley-Ann Kendall Care Home 17 Category(ies) of Learning disability (17), Mental disorder, registration, with number excluding learning disability or dementia (17) of places Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No additional conditions of registration. Date of last inspection 22nd November 2005 Brief Description of the Service: The home is situated on 46-48 Highfield Street just off London Road, and a short distance from Leicester city centre. The home has 17 places for people with learning disabilities and/or mental health needs. It is close to bus routes, a mainline train station, shops, and a variety of places to eat and drink. There is a quiet lounge, a smoking lounge, and a dining room. To the rear of the home is a secluded paved garden with plants and a fountain. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a key inspection that included a visit to the home and inspection planning. Prior to the home visit, the inspector spent half a day reviewing the last inspection report, and information relating to the home received since that inspection. During the course of the inspection, the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that the inspector looked at the care provided to three residents living at the home by talking with the residents themselves; talking with the Manager and staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were inspected. Four other residents, three members of staff, and the Manager were also interviewed. The staff team is commended. What the service does well:
Elliot Residential Home offers a homely, stable environment to residents with learning disabilities and/or mental health needs. The atmosphere is relaxed and friendly and those residents interviewed during the inspection said they were settled and happy. One resident commented, ‘I want to stay here. I wouldn’t want to be anywhere else. This is my home.’ The home takes both male and female residents, but at the moment all the residents are male. There is an established staff team, some of whom have worked at the home for many years. The Manager said, ‘We try to employ people who are likely to stay long-term, as residents need the continuity.’ The staff on duty were down to earth and caring, and appeared to have excellent relationships with the residents who live in the home. One resident said, ‘If I feel down I can have a chat with the staff and then I feel better’, and another commented, ‘The staff are easy going which is good.’ The Manager has been in post for three years, having previously worked at the home for 12 years. She said, ‘We try and maintain a family atmosphere here. It’s the residents’ home, not an institution, and we want it to be as comfortable as possible for then. There are very few rules in the home, and those that do exist mainly concern health and safety. A resident said, ‘We have some rules but we need them.’ The home is clean and comfortable and decorated to a good standard throughout. Bedrooms are homely and personalised. All the residents
Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 6 interviewed said they liked the premises. Comments included, ‘There’s lots of room here and it’s comfy’, ‘It’s fairly tidy here, I like that’, and ‘We’ve all got little jobs to keep the home looking nice.’ 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. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ needs are assessed prior to admission to ensure the home is suitable for them. EVIDENCE: The Manager said that most admissions begin with a telephone enquiry and at this stage basic details about the prospective resident are taken. The Manager then visits the prospective resident in their own home or in hospital to carry out a written assessment of their needs. Other parties, including friends/family/social workers/nurses, etc, are consulted where necessary and asked to contribute to the assessment. The potential resident is encouraged to visit the home as often as they want prior to admission to see if it suits them. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents care needs are met. EVIDENCE: Staff produce good care plans in conjunction with residents, where possible. They are holistic and contain information about residents’ social and leisure interests, preferred lifestyle, and goals and aspirations. Risk assessments have been completed for all residents and are in their case files. Residents are encouraged to become independent and to make choices about their lifestyles. The routine in the home is flexible. For example, breakfast is served from 8 – 9am, but residents can help themselves if they get up later. Residents are encouraged to go to bed by 1am, but if they are unwell or want to talk they stay up later. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are encouraged to lead full and active lives. EVIDENCE: Residents have individual programmes of activities depending on their interests. Regular activities include: • • • • • • day centres college attendance karaoke barbecues trips out (staff have the use of a people-carrier) bingo and chess On the day of inspection a lottery-funded community arts group was visiting the home with a view to organising some activities for the residents.
Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 11 The home is well established in the local community and residents make use of local shops and other amenities. Residents’ families and friends are made welcome at the home and can drop in at any time. Residents are encouraged to help in the home and most have their own area of responsibility, for example setting tables or washing up. Some do their own laundry and clean their rooms with staff help where necessary. Two residents said they would like a pool table in the home, or other opportunities to play pool. Staff should discuss these suggestions with the residents to see if they are viable. Care staff are responsible for the cooking. A cooked or continental breakfast is served every day. Lunch is a light snack, for example soup, sandwiches, or salad. The main meal of the day is served in the early evening. Menus showed that a wholesome and varied diet is offered with choice at every meal. One resident said, ‘The food’s not bad’, and another commented, ‘My favourite meal is fish and chips which we have once a week.’ The food served is predominately English but residents from a non-English background have culturally-appropriate meals once a week. Some of the residents are vegetarians and vegetarian choices are available at every meal. Staff serve hot and cold drinks in the dining room every hour. Residents can make their own drinks at other times, with staff supervision if necessary. Two residents have kettles in their rooms and make their own drinks there. Both the staff team and the resident group are multicultural. Residents ethnic backgrounds include English, Polish, West Indian, and Gujerati. All residents are English-speaking. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health and personal care needs of residents are met. EVIDENCE: Residents are registered with a range of local GPs. Annual dental and optical checks are carried out in the home. All residents have consultants and some have CPNs. A 24-hour ‘crisis resolution’ service is used if a resident has acute mental health needs. This follows a referral from their GP. Some residents are registered with the NHS for chiropody services. The Manager said a few residents have had some difficulty in accessing this service, as they are reluctant to leave the home to attend the clinic. The Manager needs to address this, for example, by contacting the clinic and explaining the residents’ difficulties and seeing if a solution can be found. All staff who administer medication have had appropriate certificated training and been given a medication information pack to read. The home’s contract
Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 13 pharmacist carries out regular inspections of the home’s arrangements for medication administration. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents feel able to talk to staff about any concerns they might have. EVIDENCE: The home has a complaints procedure that is made available to residents and visitors and displayed in the entrance hall. All residents interviewed said they were happy to approach staff if they had any concerns. One said, ‘I speak out at residents meetings if I’m not happy about anything’, and another commented, ‘If I had a problem I would tell the staff.’ Appropriate adult protection policies and procedures are in place. Staff on duty confirmed that they knew what to do should an incident of abuse be reported. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in an environment that is comfortable and well maintained. EVIDENCE: The home is clean and comfortable and decorated to a good standard throughout. The Owner oversees the maintenance and upkeep of the premises. Bedrooms are homely and personalised. On the day of inspection the carpet had been taken removed from one of the steps leading to a corridor off the dining room. With it had gone the yellow alert strip. As a result there was a risk of residents and staff tripping. This was reported to the Manager who agreed to take immediate action to reduce the risk of tripping until a new carpet and yellow strip were fitted. All residents interviewed said they liked the premises. Comments included:
Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 16 ‘There’s lots of room here and it’s comfy.’ ‘It’s fairly tidy here, I like that.’ ‘We’ve all got little jobs to keep the home looking nice.’ ‘I’m a tidy person and I like to keep my room tidy. The staff help me with that.’ A new carpet has been fitted in the front lounge and further carpets are in the process of being fitted. General redecorating has been carried out. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 17 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Friendly and professional staff meets residents’ needs. EVIDENCE: There is an established staff team, some of whom have worked at the home for many years. The Manager said, ‘We try to employ people who are likely to stay long-term as residents need the continuity.’ The staff on duty were down to earth and caring and appeared to have excellent relationships with the residents who live in the home. One resident said, ‘If I feel down I can have a chat with the staff and then I feel better’, and another commented, ‘The staff are easy going which is good.’ The staff team is multicultural and consists of the Manager, Deputy Manager, three seniors, carers, a night warden, and a handyman/general assistant. Staff files were sampled and found to contain the necessary documentation including CRB checks and references. There are three staff on from 7am to 3pm, two from 3pm to 10pm, and one waking member of staff on at night, with a senior member of staff on call. The Owner is involved in all aspects of the running of the home including care, paperwork, and maintenance of the premises.
Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 18 National Vocational Qualifications in Care are established in the home. The Manager has completed Levels 2 and 3 and is now studying for her Registered Managers Award. Three carers have NVQ Level 2. Staff have undertaken accredited medication, food hygiene, and first aid training. Staff meetings are held once a month and individual appraisals every six months. This helps staff to improve their performance both as a team and individually. Staff interviewed made the following comments: ‘It’s more like a family than a care home.’ ‘Some of us have here a long time – once people come they tend to stay.’ ‘I like the atmosphere here. It’s easy going, friendly, nice, and everybody gets on.’ ‘There’s no “them and us” here. Residents and staff are equal.’ The staff team are commended. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a home that is safe and well managed. EVIDENCE: The Manager has been in post for three years, having previously worked at the home for 12 years. She said, ‘We try and maintain a family atmosphere here. It’s the residents’ home, not an institution, and we want it to be comfortable as possible for then. There are very few rules in the home, and those that exist mainly relate to health and safety. Residents meetings are held once a month and attendance is good, with the majority of residents attending. The Manager usually takes the minutes. Records showed that residents speak out and staff act of their suggestions and address any concerns they might have. In addition a residents ‘quality assurance’ questionnaire is given out every six months.
Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 20 The home’s Environmental Health Officers carried out food safety and health and safety inspections on 16.02.05 and 23.01.06 respectively. The Manager said all recommendations and requirements made have been met. The Manager also said the home’s Fire Risk Assessment (dated 31.01.02) was inspected, updated, and approved by the Fire Department last year. Staff inductions cover health and safety in the home. Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Elliott Residential Care Home DS0000006423.V292441.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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