CARE HOME ADULTS 18-65
Elliott Residential Care Home 46-48 Highfield Street Leicester Leicestershire LE2 1AD Lead Inspector
Helen Abel Unannounced Inspection 22nd November 2005 9:30 Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 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.V265368.R01.S.doc Version 5.0 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.V265368.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Elliott Residential Care Home Address 46-48 Highfield Street Leicester Leicestershire LE2 1AD 0116 254 4458 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.V265368.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No additional conditions of registration. Date of last inspection 23rd May 2005 Brief Description of the Service: The home is situated on 46-48 Highfield Street just off London Road a short distance from Leicester city centre. The home offers care to 17 men and women with learning disability and / or mental health difficulties. The home is spread over two large houses, service users are currently all men. They are a friendly group and the atmosphere is relaxed and homely. The home is close to bus routes, mainline train station, shops and a variety of places to eat and drink. There is a quiet lounge, and a smoking lounge and a smoking area in the dining room. There is a pretty terrace paved rear garden, which the service users particularly enjoy in the summer with plants and a fountain. Elliot House is in keeping with the local community and has a style and ambience that reflects the home’s purpose. A longstanding staff team supports Elliot House service users. There is a Registered Manager, deputy, two cooks, care assistants, and domestic. The Registered Provider is present regularly in the home. Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced during a weekday morning over a three hour period. A full tour of the building took place with care records, policies and procedures inspected. There was the opportunity to talk with three residents in private. The Registered Manager and Registered Provider were briefly present. The senior staff member assisted the Inspector throughout the inspection process. What the service does well: What has improved since the last inspection? What they could do better:
Improvements around recruitment procedures and training specifically for new staff. These changes would further safe guard residents. Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 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.V265368.R01.S.doc Version 5.0 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): 1,3,4 A good standard of information is available for prospective residents. Residents are assessed prior to the admission. Residents are able to visit the home prior to living at the home. EVIDENCE: Staff confirmed the new resident leads the length of the admission and settling in period. This may include day/ weekend visits followed by a month’s trial period. Residents will complete a care plan and a likes and dislikes list with staff. A new resident confirmed with the Inspector he was consulted about food preferences, layout of furniture around his room, and his lifestyle. Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 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): 8,10 Residents are consulted about life in the home; and confidential information is handled appropriately. EVIDENCE: Staff confirmed resident meetings take place regularly and on an informal daily basis consult with residents around their needs and choices. A resident said “I asked for shelves and cupboards to put in my room and a kettle, and they have provided that.” Information is kept secure in the office area and confidentiality policies and procedures are upheld. Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 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): 11,14 Residents engage in appropriate leisure activities and have opportunities for personal development. EVIDENCE: A number of residents go to local day centres, do voluntary/part time jobs. One resident is looking to go to pottery classes. Some residents went to see the Diwali lights in Leicester. Short breaks in Skegness in a caravan have also been made available to residents. Some residents undertake tasks around the home. One resident helps to shampoo the carpets and other light housekeeping tasks. Another resident helps with clearing away after meals. Staff spoke of how popular the karaoke sessions are which are held in the dining room. One resident said, “I can’t go to the day centre today, but will go another day. I go to the barbers by myself.” Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 Page 11 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): These outcomes were inspected at the last inspection and were compliant. EVIDENCE: Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 Page 12 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): 23 Residents are protected from abuse, neglect and self-harm. EVIDENCE: The adult protection policies and procedures are comprehensive and have been recently updated and reviewed. Physical and verbal aggression by residents is understood and dealt with appropriately. Staff confirmed strategies they used to help residents. One resident said, “If I get upset, staff are very understanding and help me. I do appreciate the help.” Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 Page 13 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): 25,26,27,28 The home is homely, safe, comfortable and well maintained. EVIDENCE: Bedrooms viewed were clean and comfortable. Keys are available for bedrooms to maintain residents privacy and independence. New carpets had been in fitted in the hallway. The décor throughout is of a good standard. Staff reported the Registered Provider saw to any maintenance tasks straight away. The dining room is bright and cheerful with facilities for making drinks available with a hot water and a fridge. Upon arriving at the home residents were seen to be busy making themselves hot drinks and talking together with staff. Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 Page 14 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): 31,32,33,34,36 Residents are generally supported by the home’s recruitment policies and practices. The staff group are effective and able to meet the individual needs of the residents. EVIDENCE: Staff are working towards National Vocational Qualifications in care. Appraisals take place every six months. Staff have undertaken accredited medication training and food hygiene. Staff recruitment files were examined. Two written references relating to two staff were not in place. There is a permanent mixed staff group of women and men from different backgrounds. They have got to know and develop relationships with residents, and are able to meet particular needs. Staff were talking with residents when the local community policeman dropped by for a social visit with the residents in the dining room. A resident told the Inspector, “The staff are very nice here.” Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 Page 15 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): 37,41,42,43 The home is well run and; the health and safety and welfare of residents are generally promoted and protected. EVIDENCE: Health and safety checks are in order. The fire risk assessment has been updated following a fire officer’s inspection. Portable electrical appliances are due to be re-tested. New staff follow the Induction Training Record of Health and Safety handbook. All these aspects protect residents and staff. Day staff hold first aid training qualifications. New staff have been appointed for night cover. Night staff’s training needs should be revisited to ensure they have first aid training so as they can deal confidently with any accidents or incidences. Information was given around the structured Induction and Foundation training for new staff. Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 3 x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x 3 x 3 Standard No 24 25 26 27 28 29 30
STAFFING Score x 3 3 3 3 N/A x LIFESTYLES Standard No Score 11 3 12 x 13 x 14 3 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 3 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Elliott Residential Care Home Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 x x x 3 2 3 DS0000006423.V265368.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA34 Regulation 7 Requirement Information and documents in respect of people carrying on working at the home must include: Two written references relating to the person. Ensure the persons employed by the registered person to work at the care home receive 1) Training appropriate to the work they are to perform- First Aid Ensure the persons employed by the registered person to work at the care home receive 1) Training appropriate to the work they are to performInduction and Foundation Training to meet The Sector Skills Council for Social Care (TOPPS). Timescale for action 05/12/05 2 YA42 18 05/12/05 3 YA42 18 05/12/05 Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 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. Refer to Standard Good Practice Recommendations Elliott Residential Care Home DS0000006423.V265368.R01.S.doc Version 5.0 Page 19 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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