Inspection on 21/06/05 for Elm House

This inspection was carried out on 21st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 08/03/07

Elm House 01/11/05

Elm House 11/01/05

Elm House 06/07/04

Elm House 30/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Elm House Howitts Lane, St Neots Eynesbury Cambridgeshire PE19 2JA Lead Inspector Andy Green Unannounced 21 June 2005 @ 10:00 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 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 Stationary 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 I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Elm House Address Howitts Lane, Eynesbury, St Neots, Cambridgeshire, PE19 2JA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01480 471166 01480 471177 na Brookdale Healthcare Kathleen Houseago Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11/1/05 Brief Description of the Service: Elm House is a home for 12 people with Aspergers Syndrome situated in a large 3-storey house set in its own grounds. The accommodation is presented in two 6 bedroomed self-contained units each with its own kitchen, dining room and lounge. The bedrooms do not have ensuite facilities but there are 8 toilets 2 bathrooms and 3 showers available for service users. There is also a conservatory, which creates further lounge and office space. The home is within walking distance of St Neots town centre and there are shops and other facilities close by. Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by Regulation Inspector, Andy Green on 21st June 2005 and was the first inspection of the home for the year 2005/6. The inspector met with the manager and two of the team leaders in the home. What the service does well: 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 I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 7 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 standard(s) 1,2 Service users have access to good information, and can make an informed choice regarding the home’s services. EVIDENCE: There have been no additions or updates to either the Statement of Purpose or the Service Users Guide since the last inspection. The Manager stated that both of these documents are reviewed as part of an ongoing process within Brookdale management processes. Assessments prior to admission are in place to make sure that that the care needs of prospective service users can be met. The Manager stated that the Autism Services Manager, Consultant Forensic Psychologist and the Speech and Language Therapist undertake all assessments of prospective service users. The Registered Manager stated that this process continues to ensure that consistent and thorough assessments are made. The Autism Services manager was involved with a prospective service user who was visiting the home during the inspection. Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 8 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 standard(s) 6,7,8,9 The care and support provided at the home is of a high standard. Detailed care plans are in place to ensure that staff have sufficient information to satisfactorily meet the service users assessed needs. EVIDENCE: Service users are involved in care planning and reviews. Key workers meet regularly with Service user to gather individual choices and preference. Three service user plans were inspected and contained current information individually tailored to meet the individual’s need including lifestyle plan, activities, and communication guidelines, challenging behaviour guidance and health and safety issues. All records were kept in a clear and accessible format and are reviewed on a monthly basis. Activity Plans are also regularly reviewed with service user involvement. Risk assessments were observed and individual service user are consulted about these assessments. Risk assessments are reviewed monthly, and as required, with input from the lead Psychologist for autism services. Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 9 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 standard(s) 11-17 Staff provide appropriate support to ensure that service users have access to activities in the community. EVIDENCE: Service users continue to be involved in a wide range of activities and education via contact with the local college. There is also continuing contact with the sporting venues including tennis and ice-skating and the local gym. A wide range of community contacts are available to service users and staff offer support and encouragement. There have been recent beauty therapy and massage sessions arranged for a number of service users. Individual preferences are recorded in the service users plan. The staff are actively involved with service users both in and outside the home and this is detailed in individual care plans. There is a television, video, DVD and music facilities available to service users. Service users have regular contact with relatives and friends and visitors are welcome at any time according to individual service user preferences. The home promotes individual choice and independence and staff were seen to respect privacy by knocking before entering a service users rooms and assisting service users in a relaxed and social manner. Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 10 Communication is proactively and creatively addressed through a variety of methods and a “storyboard” example, which has been successfully introduced with one of the service users was shown to the inspector. Three service users were met during the inspection and they indicated that they were content with the support and services that they were receiving. There is unrestricted access to the home and gardens and service users are able to choose to spend time alone if they wish to do so. The service users help with daily living tasks and menu planning and food preparation. Individual dietary preferences are recorded in care plans. The care staff support service users in the preparation of meals in a relaxed and unhurried manner to suit service users activities and needs. Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 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 standard(s) 18,19,20 Service users receive appropriate health and personal care to meet their assessed needs together with support in taking prescribed medication. EVIDENCE: Staff support service users with personal care needs where appropriate. Each service user has a personal daily timetable regarding daily activities and living skills; these are recorded in the care plan. There is specialist input from the multi disciplinary including the Autism Services Manager, Psychologist and the Speech and Language Therapist. Input is also received from an occupational therapist, physiotherapist, CPNs and a psychiatrist. Brookdale Healthcare also employs a lead psychologist specifically for autism services. The home uses a monitored dosage system for drug administration and all staff who administer medication receive appropriate training. The records of medication administered were inspected and found to be accurate. There is a policy regarding medication kept in the home. A pharmacist is available to provide advice when required. Service users health care is detailed in their care plan and reviewed on a regular basis as part of the care planning process. Choice is given to the service users regarding G/P support. Care staff support service users to be Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 12 able to attend out patient appointments when required. Primary health checks are carried out at appropriate intervals and records confirm the use of health care needs of service users. On the day of inspection an incident had occurred in the home concerning one of the service users who had presented with challenging behaviour. The situation had been sensitively and professionally dealt with and the service user was given a high level of support. The service user, with their agreement, has temporarily been admitted to one of Brookdale Healthcare’s crisis units, to help her stabilise and receive support within a more appropriate and safer environment. The inspector was impressed with the professional and caring systems of support that were in place to deal with the needs of the service user and also taking in to consideration the needs and feelings of other service users in the home. Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 13 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 standard(s) 22,23 The home has a satisfactory complaints process to make sure that service users have their complaints or concerns listened to and acted upon properly. There are suitable arrangements for ensuring the protection of service users from neglect or harm. EVIDENCE: The home has a complaints procedure including agreed timescales to make sure that all complaints are fully investigated and actioned appropriately. The home has not received any complaints since the last inspection. The home has a satisfactory policy in place, which is in line with local authority policies, to make sure that service users are protected from abuse. Care staff receive confirmed that they receive ongoing training to ensure that they are aware of adult protection principles and procedures. It was observed that care staff spoke to service users in a friendly and respectful manner appropriate to the individual’s needs. Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 14 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 standard(s) 24-30 The environment is homely and clean and suitable for the needs of those living in the home. EVIDENCE: The premises are suitable for the stated purpose; accessible, safe and well maintained. The home is comfortable, bright, airy and clean. The furnishings and fittings are of good quality. There is maintenance and redecoration programme and service users are able to choose colours for their bedrooms. The bedrooms are decorated and furnished to meet the preferences of each service user. A television, DVD and video are available for service users to use in the communal lounge. Following a recent incident regarding a service users glass panels in three fire doors have been broken along with some damage to surrounding walls. The organisations maintenance department was made aware of the damage and repairs were being undertaken on the day of inspection. All fire doors have magnetic retaining devices to ensure fire safety. Repairs have been made to a handrail in one of the hallways. Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-36 The home’s recruitment policy and processes makes sure that service users are protected from harm. Training is provided to make sure that care staff are competent to deliver care to the service users they support. EVIDENCE: The home’s recruitment policy and processes makes sure that service users are protected from harm. Training is provided to make sure that care staff are competent to deliver care to the service users they support. All recruitment is processed through an “Assessment Centre” model. All staff receive a job description which accurately describe the staff’s role. Copies of job descriptions are kept on file. Staff training is given high priority in the home which is reflected in the individual staff files.Training in mandatory health & safety issues are organised throughout the year along with specific autism spectrum related training. Members of staff spoken to during the inspection said that they had received comprehensive training. Specialist services are sought, where required; in line with the requirements of the individual service users care plan. Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,42 The home is well managed and the manager provides supportive leadership and guidance to staff to ensure that service users receive high quality care. EVIDENCE: The manager has relevant managerial / supervisory experience and is near to completing an NVQ level 4 in Management and Care. She is commencing a BA degree in Autism Studies via Sheffield Hallam University in September 2005. She creates a supportive and positive approach and communicates a clear sense of leadership and direction to ensure that the home is well managed. Staff confirmed that they recieve recorded supervision every 4 weeks and ongoing support from the manager. Members of staff also commented that they felt able to raise issues or concerns freely and that they were encouraged by managers to actively participate in trhe developmwent of the service. Health and safety checks are made including fire safety and electrical testing. Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 17 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elm House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 18 no 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 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 Good Practice Recommendations Elm House I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 19 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 I53 I03 15199 ELM HOUSE 232863 210605 STAGE 4.doc Version 1.30 Page 20 - 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!