Inspection on 14/12/07 for Elm House

This inspection was carried out on 14th December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 House 06/11/09

Elm House 15/12/06

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Elm House 201 Waterloo Road Cobridge Stoke-on-trent Staffordshire ST6 2HS Lead Inspector Mike Moloney Unannounced Inspection 14th December 2007 08:45 Elm House DS0000067793.V352697.R01.S.doc Version 5.2 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 House DS0000067793.V352697.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 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. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm House Address 201 Waterloo Road Cobridge Stoke-on-trent Staffordshire ST6 2HS 01782 201837 01782 201837 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) LDCG Limited Christine Marion Jones Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2006 Brief Description of the Service: Elm House is a large Victorian building on three floors. It is located on a busy road which connects the towns of Hanley and Burslem. There is good access to both via a main bus route. There are also local services within easy walking distance, and a large entertainment complex including a swimming pool, and a multi screen cinema within a mile of the home. The surrounding area is heavily populated, and since its inception, Elm House has fitted in well with the local community. It is registered care for 12 adults with learning disability. Accommodation is in 10 single rooms, and one shared room. There is a walk in shower on the ground floor and two WCs together with the shared bedroom and one single bedroom. The first floor has two bathrooms, one of which is assisted, and seven further single bedrooms. There is also a separate WC. The second floor has domestic bathrooms/WC, and the remaining two single bedrooms. Communal space comprises of a large lounge/dining room, and a large lounge, which is the designated smoking area within the home. The house has a large garden at the rear that contains adequate seating for use in good weather. Residents are able to take ownership of various areas of the garden. The ethos of this house is to provide a safe and secure living environment where a persons abilities/individualities can be maximised through a wide range of educational, recreational and social opportunities. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service What the service does well: What has improved since the last inspection? What they could do better: Finding out what activities each of the people living in the home took part in was difficult and, as they clearly do have quite active social lives it would be easier for people who are looking at these things if the way activities were recorded were clearer. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 6 The condition of the building could be improved, particularly the bath and shower rooms, the number of electric sockets in some of the room and the overall décor of the home. 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 House DS0000067793.V352697.R01.S.doc Version 5.2 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 Elm House DS0000067793.V352697.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): No new service users have been admitted to this home for some time. EVIDENCE: Elm House DS0000067793.V352697.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. Individuals are involved in decisions about their lives and play an active role in planning the care and support they receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of two of the service users were looked at and these were seen to contain care plans which were seen to have been recently reviewed by the home. The manager and the staff said and the records confirmed that the needs of the service users had been reviewed by a number of different healthcare professionals since the last inspection. Talking with a number of the service users showed that they are able to make decisions about their lifestyle and are supported to do so by the people working at the home. For example, one of the service users talked about issues he had raised about who he could invite into his room and how he had been supported to be assertive about what he wanted. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 10 Another service user talked about how he is able go car washing, an activity which he has enjoyed for many years. One of the service users also talked about how, when he had gone Christmas shopping with the support of one of the staff, he had chosen make-up as a present for one of his relatives. He was definite that he had made the choice of colour and type for himself. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. People who use services are able to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of the activities that two of the service users are involved in were looked at. A number of the service users were also spoken to on the same subject. One of the service users whose records were looked at attends a day centre five days a week. She described what she does when she goes there with enthusiasm. When not at the centre she has a number of activities that she undertakes regularly. The second set of records looked at also showed that the person concerned undertakes a number of activities that he enjoys doing. Talking to him showed Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 12 that his likes and dislikes as recorded in his file correctly reflected what he does and doesn’t like doing. The way the records are maintained made it difficult to establish the timetable and frequency of activities for each person. To assist in both an inspection and any review of activities carried out by the home summaries of activities written up on a regular basis would help to identify any change in needs and preferences. On the day of the inspection the service users and the staff were preparing for the Christmas party that was to take place later in the day. Groups of staff and service users were observed going out to make necessary purchase in the home’s vehicle. A number of the service users spoken to confirmed that this type of ad hoc activity happened regularly and they enjoyed taking part. Within the home itself it was seen that the two main rooms each had a television in them and a number of the bedrooms also contained televisions as well as music centres. Each room was equipped with a lock. The occupants of some of the rooms had chosen to lock their door when they were not in it. On the day of the visit staff were seen knocking on the doors to bedrooms and bathrooms before going in. The menus were seen in the kitchen and the meals looked to be both nutritionally balanced as well as varied. Their accuracy was confirmed by the diary of the service user who keeps her own diary. Talking with a number of the service users showed that the food was to their liking and that they helped to choose the food when they helped with the shopping. Talking with the staff confirmed that they can cater for special diets that are necessary for medical reasons and try to do so without there being two much of a distinction between what is served. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records showed and talking with the manager, the staff and the service users confirmed that care plans identify any health needs that the service users may have. The records also showed how those needs should be met with the daily logs showing where and when this took place. Talking to staff and looking at the records also showed that staff had received the training necessary to effectively support people with such things as diabetes. The same was true of the training given to the staff around the management and administration of medication generally. Looking at the medication records showed that they are appropriately maintained so that I could be seen that the right person got the right medication at the right time. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 14 Medication storage was also seen to be appropriate ensuring that people who may not understand the significance of medication did not have access to it. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the home had made one referral into the local procedures for the protection of vulnerable adults. This had not related to anything about the functioning of the home or it’s staff. Staff confirmed that they had received training about those procedures. No complaints had been recorded since the last inspection although there had been one issue raised by one of the service users about access to his room that could have been considered as a one. However, talking to him established that he feels that the issue had been appropriately addressed by the manager. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27 and 30 Quality in this outcome area is adequate. The décor and flooring and some aspects of the fabric of the home need improving to meet the needs of the people who live in the home and to ensure that it is a pleasant for them to live in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Elm House is a large Victorian building on three floors. It is located on a busy road which connects the towns of Hanley and Burslem. There is good access to both via a main bus route. There are also local services within easy walking distance, and a large entertainment complex including a swimming pool, and a multi screen cinema within a mile of the home. Looking around the building it could be seen that damage to the décor from work that had been carried out installing radiator guards had not been put right. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 17 There was no programme of renewal and maintenance available at the home but the senior manager present at the time of the inspection was asked to forward one to the Commission for Social Care Inspection. The garden was seen to be of a reasonable size and looked pleasant and well maintained. All but one room was for a single occupant with that other being a double. All bedrooms were seen to be fitted with appropriate locks and some service users have their own keys. The home was seen to have three bath/shower rooms. The ground floor shower room is off the main lounge. The flooring is stained, the wall tiles were in poor condition, pipe-work was not painted, and the décor was in poor condition. The manager explained and other staff confirmed that a plumber was due the Monday after this inspection to rectify the temperature control for the third floor bathroom. This bath was situated under the slope of the roof and looked difficult to access. The manager did say that the two occupants of that floor do prefer to have showers in the downstairs shower room. A number of bedrooms were looked at and some were seen to have only one double electric socket. The presence of a number of extension leads showed that they were inadequate for the needs of the rooms’ occupants. The home was seen to have two large communal rooms, one being the dining room although both rooms contained lounge furniture and televisions. A washing-up area for the service users to use was seen to be situated outside the kitchen. The sink used was an industrial rather than domestic type. The home was seen to have an appropriately equipped laundry. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is good. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the staff were observed interacting with the service users in a positive manner. Records that showed that the staff receive appropriate training were seen and the staff confirmed that these were accurate. The records also showed that five of the ten staff employed at the home have achieved level two National Vocational Qualification in care. One of the staff said that she had achieved her qualification in less than twelve months after starting at the home with no previous experience in the care industry The staffing levels during the inspection were enough to meet the needs of the service users and looking at the rota showed that these levels were the norm for the home and the diary kept by on of the service users confirmed that the rota was accurate. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 19 The rota showed that there was only ever one member of staff on duty at night and the managers stated that there had not been any issues because of this. It is recommended that a risk assessment is carried out in relation to this practice. The records of staff recently recruited to the home were looked at and these showed that appropriate background checks had been carried out before they were allowed to work with the vulnerable people living at the home. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager confirmed that she has finished her Registered Managers Award and hopes to complete her National Vocational Qualification 4 in care in the near future. Both of these are qualifications that are considered appropriate for people who manage services such as these. The records showed and staff and service users confirmed that the provider’s senior managers visit the company on a regular basis in order to establish how well the home is functioning. The results of satisfaction surveys were also seen and these had been carried out by the home in order to find out whether or not the service users thought that their needs were being met. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 21 Various record were looked at that showed that safety tests for things like electrical equipment, gas appliances and fire detection equipment were carried out at regular intervals. One of the service users confirmed that the fire tests were, in fact, carried out and was able to show where the records were kept. As mentioned elsewhere in this report, records were seen that confirmed that the staff receive training in such things as infection control, medication administration and food hygiene. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 22 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 x 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 2 27 2 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 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 x 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 Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 23 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. 2 3 Refer to Standard YA24 YA26 YA33 Good Practice Recommendations That the downstairs W. C’s and shower upgrade work is progressed as soon as possible. Enough power sockets must be installed in each bedroom to avoid the need for trailing wires around the room. The home should carry out a formal risk assessment to establish whether or not only having one person on duty throughout the night is a safe practice. Elm House DS0000067793.V352697.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 House DS0000067793.V352697.R01.S.doc Version 5.2 Page 25 - 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!