Inspection on 19/02/08 for Elm Cottage

This inspection was carried out on 19th February 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

Elm Cottage 16/11/06

Elm Cottage 08/02/06

Elm Cottage 02/08/05

Elm Cottage 01/12/04

Elm Cottage 05/05/04

Elm Cottage 08/03/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Elm Cottage 108 Harepath Road Seaton Devon EX12 2AX Lead Inspector Teresa Anderson Unannounced Inspection 19th February 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm Cottage Address 108 Harepath Road Seaton Devon EX12 2AX 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) 01297 23658 Mrs Shirley Ann Copp Mrs Shirley Ann Copp Care Home 3 Category(ies) of Old age, not falling within any other category registration, with number (3) of places Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2006 Brief Description of the Service: Elm Cottage is a small family run residential home situated on the outskirts of Seaton. It provides personal care and accommodation for up to three older people. The communal space is made up of a large lounge and a kitchen/dining room. Outside there is a level, private and enclosed garden with seating and a summerhouse. Each person living here has their own bedroom, one of which is on the ground floor which has en suite facilities. The other two rooms are on the first floor and have wash hand basins. Floors are linked by a staircase that has a stair lift. The home is on one of the main roads leading into Seaton. It is close to the town centre and the sea front. The staff team is made up of the owners (who also live in the home), two carers and a cleaner. The fees charged by this home at the time of this inspection are £410.00 per week. The only additional charge is for outdoor clothing. Further information about this home, together with past reports, is available direct from the home. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This unannounced inspection took place as part of the normal programme of inspection. One inspector carried out the site visit starting at 10.00am and finishing at 2.30pm. During the time spent at the home we (the commission) looked closely at the care and services offered to the people living here and spoke with one person living here. We looked at care assessments and care plans, and spoke with staff about their knowledge and understanding of the plans and people’s needs. We looked at one person’s bedroom and we looked at the overall environment from their perspective. We looked at records relating to medication, care planning, staffing, training, fire safety and at some policies. Prior to the visit to the home we sent surveys to all the people living here and one was returned. We sent surveys to health and social care professionals who visit the home and none were returned. We also spoke with the relative of one person living here. Before we visited the home, the owner/manager provided information about the management of the home and an assessment of what the home does well and what they plan to improve upon. What the service does well: People who consider coming to live here undergo thorough assessments of their needs and consideration is given ensuring the person will ‘fit in’ with the people who already live in this small family style home. People visit the home at different times and on numerous occasions. They are given information about the home so that they can make an informed choice about whether or not to live here. When people choose to live here their care is planned in a way that suits them. Peoples health and welfare needs are met in such a way that their health tends to improve. Their medications are well managed and some people have been able to reduce the numbers and amount they take. One person said that the home as been ‘the saving’ of one person living here. People living here have their privacy and dignity protected and promoted. They are treated as individuals with rights and the ability to make choices about how Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 6 they live. Each person living here spends their days how they choose and each has a routine which staff follow. Food is cooked by staff and people’s preferences, likes and dislikes are known by all the staff who cook what each person wants. This includes fresh organic vegetables that the owner grows. People say they never have complaints and have never been unhappy because the staff always listen and act on what they say. People feel safe and well cared for and staff are familiar with what abuse is and demonstrate a zero tolerance to it. The home is very informal and relaxed. It is clean and homely throughout. Staff are well trained and have the skills needed to care for older people in a way that meets their physical needs and which is respectful yet relaxed. There are always at least 2 members of staff on duty. At night the owners, who live in the home with people, act as the sleeping night staff. The home is well managed and run in the best interests of and for the people who live here. 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. The summary of this inspection report can be made available in other formats on request. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 and 5. This home does not provide intermediate care. Quality in this outcome area is excellent. People who consider coming to live here are able to make an informed choice and can be sure that the service can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live here say they were visited by the owner/manager and that they visited the home before they decided to move in. Some people visited on numerous occasions and at different times. People say that they had enough information about the home and that their expectations were met and exceeded. The visit by the owner/manager and visits to the home help the staff determine if this service can meet the person’s needs. As this is such a small home, the owner/manager says she wants to ensure that not only can each Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 9 person’s needs be met but also that they will enjoy living with the other people living here. People come to live here on a four-week trial basis. If, after this time, the person wishes to stay they sign a contract. We looked at one contract. This clearly sets out the bedroom to be occupied, the cost per week and the conditions of occupancy. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is excellent. People living here have their healthcare and welfare needs planned for and met in a way that suits each person and in way that helps their health to improve. Their medicines are well managed and their privacy and dignity is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In discussions and surveys people say their healthcare needs are well met. They say the doctor or nurse is called when needed or when they ask for them. Records show this to be the case and that people with medical needs see the appropriate specialists. People say their health has improved since coming to live here and that despite their old age they remain well and healthy. They say this is because of the lifestyle they live and the care they get. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 11 Everyone living here is assessed to determine for example if they are at risk of developing pressure sores, of falling or of poor nutrition or losing weight. Appropriate actions are taken to reduce these risks in a way that suits each person. No one living here has a pressure sore and the owner/manager reports that no one has fallen or been involved in any untoward incident since the last inspection. Equipment such as a hoist, stand aid and a bath hoist are available to help people to move if needed. Staff receive training in how to use these. We looked at the way medicines are managed and found them to be stored safely and securely. Records show that some people have been able to reduce the number of medicines they receive as their health improves. We talked to the owner/manager about what would happen if someone needed to have a medicine that falls under ‘Controlled drug’ legislation as the home do not have facilities to store this. As this is a ‘home for life’ the owner/manager is going to find out how this could be managed, if needed. People say that staff treat them with respect and ensure that their dignity is preserved. Staff told us how they do this. They describe seeing each person as an individual, they say that they get to know each person really well and come to value them almost as a member of their family. We saw interactions that were relaxed and respectful. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is excellent. People living here make choices about how they live their lives which staff always respect. They enjoy a healthy, varied and largely organic diet that is tailored to each person’s individual preferences and needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who come to live here are told that the home does not provide organised activities. This is clearly stated in the information about the home and is reiterated to people when speaking with the owner/manager prior to admission. People say this is one of the reasons they chose to live here. They say they want a ‘family life’ and not organised activities. People come together when they feel like it. They join in with or watch the cooking, if and when they feel like it, and generally spend their days and lives how they like. Everyone has a digital TV (supplied by the home) in his or her bedroom and each person has a routine which staff follow. Visitors are welcome at any (reasonable) time. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 13 Staff talked of how each person likes to do things and of the support they need and how they like this given and by whom. The home has a level garden and summer house which some people spend time in during the summer months. People say they enjoy the sun, birds and plants. Meals are cooked in the domestic kitchen by the staff. The male owner has an allotment where he grows organic vegetables and fruit. The home does not have a set menu but asks people what they would like to eat. Some people say they have been introduced to new tastes since coming to live here and some are being tempted with favourite foods to help them gain weight. The home caters for special diets such as vegan and diabetic diets. During this inspection one person ate fish and vegetables, and two chose to have spicy chicken with a selection of salads and bread. One person said ‘the food is excellent’ and another ‘the food is very varied’. The staff share the cooking and one of the cooks is described as ‘wonderful’. Another member of staff involved people who wished to be involved in making preserves and cakes to be judged at the local country fair. The home are very proud that they won a cup. Staff demonstrate an excellent understanding of peoples likes, dislikes and preferences. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. People are always listened to and are well protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People say they have no complaints and have ‘never had one’. We observed that people are confident in staff’s company and they say they feel completely safe. Neither the commission nor the home have received any complaints about this service. Staff demonstrate a good understanding of what different forms abuse can take and have received training in this. This training was done in 2003, and may need updating to ensure that staff are familiar with current procedures. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. People live in a home which is suited to their individual needs and which is safe, clean and well cared for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People say the home is always clean and this is how we found it during the site visit. The owner/manager tells us that she employs a part time cleaner and that people clean as they go along. Each week the cleaner ‘spring cleans’ a different bedroom. We saw one bedroom and this was very clean as was the lounge and kitchen/diner. Staff have received training in controlling infection and liquid soap and paper towels are available for staff to use. The owner/manager described how soiled linen is dealt with and this complies with good practice. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 16 The environmental health officer visited this home in May 2007. No actions for improvement were needed. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is excellent. People living here benefit from receiving support from a small committed staff group who have the skills needed and are employed in sufficient numbers to meet people’s needs. Staff recruitment is robust meaning that people are cared for by appropriate carers. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are always at least two carers on duty in this home. During the night, there are no waking night staff but the owners are available if needed. All the care staff hold a National Vocational Qualification (NVQ) in care and have additional training as needed. People describe the staff as ‘lovely’ and ‘the best’. We observed some interactions showing that staff and the people who live here clearly have relaxed yet respectful relationships. One person said that staff wait on people ‘hand and foot’. The home has not recruited any staff for a long time therefore we did not look at recruitment records. We did look at the homes policy on recruitment. This sets out what checks are undertaken prior to a member of staff being Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 18 employed. As is good practice, checks include two written references and a police check. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is excellent. People benefit from living in a home that is well managed, run in their best interests. They also benefit from a service that ensures their health and safety is always promoted and balances this with allowing people to make their own decisions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of this home is also one of the owners. She has long experience of working with older people and holds the Registered Managers Award. She has consistently demonstrated her management skills and knowledge of needs relating to older people. This inspection has resulted in a number of outcome areas being judged as excellent. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 20 Each year the manager carries out quality assurance surveys to ensure that the service being delivered is what people want and to look for improvements. People in the homes surveys, and in ours, did not make any suggestions for improvement. The home does not hold any money for people living here. Some people keep very small amounts of cash themselves. All staff receive mandatory training and have updates in training such as manual handling and handling food. The home has contracts in place to ensure that electrical, gas and fire systems are checked and maintained. In addition the home carries out weekly fire alarm testing and carried out the fire risk assessment for the building in September 2006. During this inspection the owner/manager made all the documents and records needed easily available and all records are up to date. Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 4 3 4 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 x 4 x 3 x x 3 Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 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. 1. Refer to Standard OP9 Good Practice Recommendations No one currently living here is receiving controlled drugs. However, you should consider finding into what would be needed to facilitate this if anyone living here should need them. Guidance is available on the commissions website. All staff have received training in ‘Safeguarding Adults’ However, you should consider providing updates/refresher training as this was last received in 2003. 2. OP18 Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 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 © 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 Elm Cottage DS0000021931.V358699.R01.S.doc Version 5.2 Page 24 - 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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