Inspection on 15/12/06 for Elm House

This inspection was carried out on 15th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elm House 06/11/09

Elm House 14/12/07

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 Mr Berwyn Babb Key Unannounced Inspection 15 December 2006 15:00 Elm House DS0000067793.V326657.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.V326657.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.V326657.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 F/P 01782 201837 elmhousesjp@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) Learning Disability Care Group Mrs. Christine Jones. Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th December 2005 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.V326657.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This 1st. key inspection for these providers, took place during the afternoon and early evening of Friday the 15th of December 2006. All residents were present at various times throughout, as was the care manager and two members of staff. A third member of staff who had been rostered for the afternoon had already left the home and she was unwell. The newly Registered Person, Mr Sahail Butt made the journey from his base in the West Midlands to take part, and engaged in discussion regarding future plans of his organisation, including a welcome commitment to involve social services in carrying out statutory reviews of the care needs of each of the residents, to ensure both of these would be adequately met, and that appropriate resources were being channelled into maintaining their well-being. Discussion also took place with both the care manager and members of staff, with a formal interview being undertaken with the most recently appointed member of staff on duty. Conversations were held with most of the residents, some of whom took the opportunity to conduct the inspector around their rooms, and display their possessions, memorabilia, and trappings of their hobbies or interests. No resident expressed any concerns about their situation at Elm House, and the comments made by them were all positive. The observation of the dynamics between residents and staff caring for them confirmed the high regard for their privacy and dignity, and demonstrated the sensitive support they were receiving to enable them to live as normally as is possible. The home had been decorated for Christmas (with the residents party taking place that evening) and was comfortable, tidy, and warm, with no malodours. Current charges at Elm House range from £325 per week to £345 per week, though at the date of this report those charges were currently under review. What the service does well: Elm house continues to provide accommodation for 12 people both male and female, and who have a learning disability as the primary diagnosis. It does this in the centre of a vibrant local community in the most domestic style possible, and without any stigmatising signs to identify the home as a care institution. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 6 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. Elm House DS0000067793.V326657.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.V326657.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. The quality outcome for this group of residents was good. This judgment was made using all available evidence including a visit to the service. It is based upon sufficient information been available about whether the home was suitable to their needs and choices, and on a proper assessment of these having been made using the appropriate statutory tools so that the provider was able to make an equally informed choice about the capacity of the home to care for the resident. EVIDENCE: The care plan of the person most recently admitted to the home was examined in depth as part of the case tracking exercise. This showed that a proper care management assessment had taken place prior to the individual been admitted to the home, and that she and/or her supporters had been furnished with sufficient information about the services available in the home for them to make an informed decision as to whether her assessed needs and individual choices would be met by moving there. This assessment together with the observations made by the then Care Manager had been used as a basis for a detailed plan of care covering social, physical, and psychological needs, and recording the likes and dislikes and personal choices of the resident. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 9 Where these personal choices were thought to constitute any level of risk, then a further assessment had been taken for that individual task, and where possible training, monitoring, assistance, or agreed modification of the original choice had taken place, to allow for an activity without undue risk of harm to the resident. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 10 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, and 9. Quality outcome for this group of residents in this area was good. This judgment was made using all the available evidence including that gathered during a visit to the service. It is founded upon residents being able to make decisions for themselves, and to be assisted to take risks within the boundaries of the duty of care, and have this and all the other care needs and personal choices duly recorded in a the properly constructed and appropriately reviewed care plan. EVIDENCE: Minute examination of one care plan and less detailed reference to others, demonstrated that these had been founded on the appropriate statutory instruments (in each case the single care management assessment) and recorded the various social and health needs of the resident, together with those things that they liked and disliked, and things that they wanted to do. Clear instructions were contained as to how staff should support them in the various tasks that were necessary, and a key worker system was in place for the benefit of each resident. Plans had been reviewed appropriately, either as when necessary, or within the relevant recommended time frames. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 11 Risk assessments had been undertaken for various actions chosen by, or necessary to, the residents, and rather than restrictions being placed upon them, it was evidence that ways had been found to assist them to undertake activities through the use of education, monitoring, and practical assistance. Resident x stated she was able to live her life and that where she found a decision difficult to make, she could always rely on a key worker or other members of staff for helpful advice. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 12 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, and 17. The quality outcome for this group of residents in this area was good. This judgment was made using all the available evidence including a visit to the service. It reflects residents having a nutritious and healthy diet, being able to maintain family and close personal friendships, having access to the local community in a meaningful way, and being appropriately occupied every day. EVIDENCE: From conversations with residents and members of staff, and from the details given in care plans, it was established that whilst no resident was in paid employment, they were all fully occupied, either undertaking agreed tasks around the home, or in college, day service, or similar voluntary facilities. Similarly they confirmed their links with the local community, detailing visits to shops, clubs, public houses and other eating places, the cinema, and in the case of one lady, by exercising her religious leanings in attending the local Anglican Church. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 13 She and others maintained contact with members of the family either by letter, telephone, or personal visit and there was anecdotal evidence of individual personal relationships being maintain, especially with former colleagues who lived elsewhere. Those residents asked said how much they enjoyed the food, and this included healthy eating options that have been introduced some years previously, and being supported in a dietary plan with input from the appropriate health professional, whether this was to maintain and increase body mass, or to help reduce it. Observation of the dynamics between the residents and staff demonstrated a sensitive respect that never challenged their integrity, and always maintained their privacy and dignity. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 14 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, and 20. The quality outcome for this group of residents in this area was good. This judgment was reached using all the available evidence including a visit to the service. It is founded upon seeing that residents received proper health care, including monitoring of appointments and assistance to keep these, appropriate and sensitive personal care especially for intimate tasks, sound advice in areas of the health, and the intervention of the most appropriate professional to any identified problem. EVIDENCE: In the course of the inspections several care plans were examined, and the following comments are not taken from any one particular plan. In the plan of a person with a long-standing depressive illness running in tandem with the learning disability, there were many references to insuring that staff treated her with a sensitivity that would protect her dignity and privacy at all times. Discussion and consideration had taken place about any time was that she needed to be physically assisted and how these could be managed in the best interest of the resident, without exposing her to embarrassment and distress. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 15 This included ensuring continuity in her presentation and grooming, to assist in supporting her personality and self-esteem. Another plan contained details of regular visits to tertiary health care practitioners such as dentists, chiropodist, opticians, the annual Well Woman Clinics that were designed to be proactive in promoting good health, rather than responding to incidents of ill-health. The care plan showed how residents had been assisted to keep appointments with GPs, other health clinics, nurses, and any hospital consultants that they may be seeing for the various conditions. It was clear that the least restrictive practices have been undertaken in respect of such appointments, but that where people needed an advocate or supporter, staff had been made available to support them. The administration of the afternoon medications was observed, as were the storage and recording procedures, and no areas of concern were raised in relation to these. Care plans show that regular reviews of medications was being undertaken through the GP or hospital consultant as was most appropriate. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 16 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 and 23. The quality outcome for this group of residents in this area was good. This judgment was made using all the available evidence, including a visit to the service. It is founded upon staff having received adequate training in the protection of vulnerable adults, and on responses received during a formal staff interview. EVIDENCE: A formal interview was undertaken with a member of care staff, and discussion took place with her about the complaints procedure, and about the protection of vulnerable adults living at Elm house. From her answers it was possible to determine that she was aware of a wide variety of actions or omissions that could constitute abuse, and that she also knew the proper procedure to undertake if she ever suspected that anyone in her charge was being abused. She was also fully aware that the perpetrators of abuse do not fall into any particular category, and that her residents were vulnerable to anybody, however good their credentials may seem to be. The complaints procedure was seen on the wall, and in the files of those residents whose care plans were examined, and his member of staff was able to talk knowledgeably about the individuals within the home, to the extent of have being able to consider how much, and what type of help they might need in order to articulate any concerns they may have had. The Commission for Social Care Inspection have not been approached with any complaints and concerns during the last inspection period, and the respondent was not aware of any issues were being investigated within the home. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 17 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, 26, 27, 28, and 30. The quality outcome for this group of residents in this area was adequate. This judgment is founded upon all the available evidence including that taken during a visit to the service. Whilst the evidence reflects the home meeting national minimum standards in the majority of the areas covered, concern about possible danger to residents from excessively hot surfaces has been reflected in the more conservative final score. EVIDENCE: A full tour of the internal environment was undertaken, including visits to residents rooms, some by their permission, and some accompanied by them. The responsible individual discussed future plans to upgrade parts of the home, especially in the area of the downstairs shower and toilets. Exploratory consideration was also being given to the possibilities of providing an en- suite shower to one of the downstairs rooms. Changes were also being planned to the administrative areas of the home to do away with the top floor office of the previous proprietor/care manager. It was hoped to refurbish the former garage (which for many years has been Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 18 used as a store), to make the location of the office more convenient to residents. In one bedroom the temperature of the radiator was felt to be excessive, and it will be a requirement of this report that measures are put in place to ensure that the maximum temperature reached is in line with the advice in Health and Safety in Care Homes, namely, not more than 43 C when the system is operating at maximum capacity”. Both the smoking lounge and the smoke-free lounge were fitted out with a good-quality furniture, and all bedrooms reflected the individual choices of those people resident in them. This was noticeable were some residents wanted their windows leaving open, whilst others, less addicted to fresh air, han their windows closed and the radiator is switched on. Measures designed to ensure that the home remains free from Odour were discussed, as was the cessation of separate cleaning staff, the care manager reporting that this task now undertaken by care staff assisting the residents, where they had agreed to undertake domestic tasks as part of their normal daily living. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 19 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, and 35. The quality outcome in this area for this group of residents was good. This judgment was reached using all the available evidence including a visit to the service. It is based on there been adequate numbers of staff, and sufficient training for them to enable them to carry out the task of caring for the assessed needs and personal choices of the residents. EVIDENCE: On the day of the inspection one member of staff who had been rostered for duty during the afternoon had had to go home unwell, and the care manager was being supported by two members of care staff. It is understood that only one member of staff is on duty during the night, which had to be achieved through transferring a male carer previously on nights to daytime duty where he would always have a female working with him. In the formal interview, a member of staff enumerated the training that she had received at her induction and since commencing her employment, and this demonstrated a commitment to ensuring that all mandatory training had been given a timely fashion. Her answers further confirmed that a equal Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 20 opportunities practices had been followed during the recruitment, as had measures to ensure the protection of vulnerable adults. Written references had been taken, and a clear C R B had been required before she was able to have contact with residents. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 21 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, and 42. The quality outcome for residents in this area was adequate. This judgment was founded upon all the available evidence including a visit to the service. It takes into account the challenge to the health and safety perceived from the temperature of the radiator in the room of one of the residents. EVIDENCE: The care manager had recently been appointed and discussion took place with responsible individual about plans for the future management of the home, though at this time it is unclear whether this will result in a further change of manager entailing possible further disruption in the lives of residents, or extra support for the existing manager to allow her the necessary time to become comfortable, familiar, and proficient in her role. Members of staff spokehighly about home willingness to support them in their task of caring for the residents. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 22 A quality assurance audit has recently taken place among the residents, and responses are in process of being action with them to establish their full current needs and choices, and to monitor the appropriateness of the tool being used, to their needs and understanding. Once this work has been undertaken it is planned to extend the scope of the survey to families, friends of residents, and people with whom the home works in partnership in providing for their assessed needs and personal choices. There is a commitment in the service development plan to introduce a new operational manual including regular essential audits. As commented on in the environment section of this report it was felt that the temperature of one radiator was in excess of that recommended in Health and Safety in Care Homes, which will result in both a requirement of this report, and in a reduced scoring under the heading of Safe Working Practices. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 23 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 2 25 X 26 3 27 3 28 4 29 X 30 3 STAFFING Standard No Score 31 X 32 3 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 X 12 3 13 3 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 3 X X 2 X Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 24 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. 1 Standard YA24 and YA42 Regulation 23 [1]a & 23 [2]p Requirement The Registered Person shall ensure that all radiators and exposed pipes are controlled so as to be no hotter than 43 degrees C. when the system is operating at maximum capacity. Timescale for action 12/03/07 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 YA24 Good Practice Recommendations That the downstairs W. C’s and shower upgrade work is progressed as soon as possible. Elm House DS0000067793.V326657.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 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.V326657.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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