Inspection on 08/03/07 for Elm House

This inspection was carried out on 8th March 2007.

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 01/11/05

Elm House 21/06/05

Elm House 11/01/05

Elm House 06/07/04

Elm House 30/03/04

Similar services:

Coopers Mill Ltd

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Paradise Lodge

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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 Eynesbury, St Neots Cambridgeshire PE19 2JA Lead Inspector Andy Green Key Unannounced Inspection 8th March 2007 10:00 Elm House DS0000015199.V333146.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 DS0000015199.V333146.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 DS0000015199.V333146.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm House Address Howitts Lane Eynesbury, St Neots Cambridgeshire PE19 2JA 01480 471166 01480 471177 elmhouse@brookdalecare.co.uk 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) Brookdale Healthcare Mrs Sarah Tracey Carbery Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Elm House DS0000015199.V333146.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of six service users under the age of 18 years, but not less than 16 years, in the category LD, to be accommodated in side one of the home No service users over the age of 25 years to be accommodated in side one of the home. No services users under the age of 18 to be accommodated in side two of the home. 1st November 2005 Date of last inspection Brief Description of the Service: Elm House is a registered home, provided by Brookdale Healthcare, for 12 people with Autistic Spectrum Disorders (ASD). Accommodation is provided in a large 3-storey house set in its own grounds. The home is divided into two six bed-roomed units each with their own kitchen, dining room and lounges. 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 facilities close by. There are nearby bus and national train services. The fees range from £2084 to £4150 per week. Copies of CSCI inspection reports are available to service users and their relatives upon request. Elm House DS0000015199.V333146.R01.S.doc Version 5.2 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 8th March 2007. The inspector met with the manager, members of staff and service users. A variety of records were also inspected including care plans, medication records, fire records, training records and staff files. A tour of the premises was also undertaken. What the service does well: What has improved since the last inspection? What they could do better: No requirements or recommendations were during this inspection. Elm House DS0000015199.V333146.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Elm House DS0000015199.V333146.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 DS0000015199.V333146.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): 1,2,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have access to good information, and can make an informed choice regarding the home’s services. EVIDENCE: The registered manager has updated the Statement of Purpose to include her details as required. There have been no further changes to the Statement of Purpose or the Service User Guide since the last inspection. The organisations multi disciplinary team remains involved in the assessment process of prospective users. However the manager of the home and the regional manager undertake a follow up assessment to ensure that the home can fully meet assessed needs. There were 8 service users in residence and the manager stated that a number of referrals are being considered. Elm House DS0000015199.V333146.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): 6,7,8,9,10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. 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: Elm House DS0000015199.V333146.R01.S.doc Version 5.2 Page 10 Service users continue to be fully involved in the care planning process including regular reviews. Key workers and link workers meet regularly with service users to ensure that individual choices, needs and preferences continue to be monitored are met. Two service user plans were inspected and they contained current information and guidelines to meet the individual’s need including activities, and communication guidelines, challenging behaviour guidance and health and safety issues. The care plans are presented in a ‘Person Centred Approach’. There is also a document entitled ‘Essential Lifestyle’ plans in each service file, which clearly demonstrates the individual’s involvement in the care planning process. Information is creatively presented with photographs and clear statements detailing likes and dislikes. All records are kept in a clear and accessible format and are reviewed on a monthly basis. Activity Plans are also regularly reviewed with the service user involvement. The multi disciplinary team provide a monthly report detailing progress and developments that individual service users have made. A document entitled ‘Autistic Spectrum Disorder (ASD) Profile’ has recently been added to care plans which gives clear guidance how ASD effects the individual Risk assessments were included in individual service users files. Service users are consulted about these assessments. Risk assessments are reviewed monthly, and as required, with input from the multi disciplinary team. Service users relatives can be actively involved in the review process if the individual service user wishes. Copies of reviews are also sent to relatives. The health care of service user is regularly monitored and staff assist service users with GP and out patient appointments where necessary. Elm House DS0000015199.V333146.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): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff provide appropriate support to ensure that service users have access to a wide range activities in both the home and the community to meet their needs. EVIDENCE: Service users continue to be involved in a wide range of activities including contact with various sporting venues, colleges a local Arts Centre. A new contact has also been made with a local college. A wide range of community contacts are available to service users and staff offer support and encouragement. There are regular shopping and day trips to local towns and places of interest. Holidays to Florida and Centre Parcs were enjoyed by a number of service users and holidays. There are regular trips to theatres and music events throughout the year at venues in Cambridge and London. Staff are actively involved with service users both in and outside the home and individual preferences are recorded in the service users plan. A number of service users access the the organisations day centre at Milton Park which provides art sessions, computer, sports events, discos and karoake nights. A number of service users will be involved in the forthcoming ‘Red Nose Day’ to raise money for charities. Elm House DS0000015199.V333146.R01.S.doc Version 5.2 Page 12 Service users are assisted, where required, with daily living routines/ living skills including laundry, cleaning, planning meals and food preparation. Individual dietary preferences are recorded in care plans. Service users have access to television, video, DVD and music facilities in the communal lounges. Service users have regular contact with relatives and friends and visitors are welcome at any time according to individual service user preferences. The home continues to promote individual choice and independence and staff interact with service users in a friendly and sensitive manner. Communication is proactively and creatively addressed through a variety of methods, which includes pictorial aids where appropriate to the individuals need. Two service users were met during the inspection and they indicated that they were complimentary about the support and services that they received in the home. Service users have access to the gardens and are able to choose to spend time alone if they wish to do so. The service users help with daily living tasks including menu planning, shopping and food preparation. There are two service users currently budgeting and preparing their own meals during the week. Elm House DS0000015199.V333146.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): 18,19,20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users receive appropriate health and personal care to meet their assessed needs together with support in taking prescribed medication. EVIDENCE: The staff continue to support service users with personal care needs when required. Each service user has a personal daily timetable regarding daily activities which is recorded in their care plan. Service users are assisted to access GP and outpatient appointments where necessary. Specialist input continues to be provided on a regular basis from members of the multi disciplinary team. This includes regular meetings with occupational therapist, physiotherapist, psychologist, CPN’s and a psychiatrist. The home benefits from access to the hospital services provided by the organisation at Milton Park. This has been invaluable especially when service users needs have changed and more intensive input is required. The home continues to accommodate up to six service users from the ages of 16–25 years in side one of the home. This has proved to be a successful development for the home and staff confirmed that they enjoyed working with a younger age group. Elm House DS0000015199.V333146.R01.S.doc Version 5.2 Page 14 A monitored dosage system for drug administration is in place and all staff that administer medication receive appropriate training. The records of medication administered were accurate. A local pharmacist continues to provide advice/guidance 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. The manager stated that the home continues to have a good relationship with the local surgery and stated that they are responsive to service user’s needs. Primary health checks including dental and optician appointments as required are carried out at appropriate intervals and recorded in individual care plans. Elm House DS0000015199.V333146.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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 full complaints procedure which includes timescales to ensure that all complaints are fully investigated and actioned appropriately. The manager stated that one complaint had been received since the last inspection which has been satisfactorily resolved. CSCI has not received any complaints/concerns regarding the service. The home has a robust policy in place to ensure that service users are protected from abuse. The manager stated that there had been no changes to the procedure since the last inspection. Care staff confirmed that they receive ongoing POVA training to ensure that they are aware of adult protection principles and procedures. Feedback through service users and relatives comment cards, received by CSCI, did not raise any concerns regarding the home. Elm House DS0000015199.V333146.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): 24,25,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is homely and clean and suitable for the needs of those living in the home. EVIDENCE: The premises remain suitable for the service user’s needs and are accessible, safe and regularly maintained. The home is comfortable, bright, airy and clean. The furnishings and fittings are of good quality. A complete redecoration of all communal areas, kitchens, hallways and bathrooms is in progress including new flooring where required. Service users are able to choose colours for their bedrooms which are decorated and furnished to meet the preferences of each service user. Service users are encouraged to personalise their rooms to reflect their individual tastes and interests. Appropriate door closing devices and an additional smoke detectors have been installed following fire safety advice. The maintenance department are aware of these requirements and will action them accordingly. Elm House DS0000015199.V333146.R01.S.doc Version 5.2 Page 17 Four new beds have been purchased and three wardrobes and a new cooker has been installed in the kitchen in side two of the home. Since the last inspection the manager has reviewed the office space for staff. She stated that she is relocating to the underused meeting room in the home. This will create more storage possibilities and give increased space in the current office for staff to comfortably work in. The meeting room will continue to be accessible for meetings etc. The manager also stated that any confidential material stored in the meeting room would be kept locked at all times. Elm House DS0000015199.V333146.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): 31,32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s recruitment policy and processes makes sure that service users are protected from harm. Training and supervision is provided to ensure that all staff are competent to deliver care to the service users they support. EVIDENCE: The home’s recruitment policy and processes ensure that service users are protected from harm. A full training and induction programme is provided to ensure that all staff are competent in providing care and support to service users. All recruitment continues to be processed through an “Assessment Centre” model. Staff receive a job description to accurately describe their roles and responsibilities. Copies of job descriptions are kept on file. Two Staff files were seen and they contained all the required documentation. The manager stated that the home is fully staffed at present. Training continues to be given high priority in the home and which is evidenced in individual staff files and in the training matrix kept by the manager. Training in mandatory health & safety issues are organised throughout the year along with specific autism spectrum related training. The manager Elm House DS0000015199.V333146.R01.S.doc Version 5.2 Page 19 provided copies of the detailed training programmes that have been undertaken and that are planned. Two staff spoken to during the inspection stated that they they receive a comprehensive training package. Specialist advice/input is also received through sessions with members of the multi disciplinary team specific relating to individual service users care. Staff also confirmed that they received regular monthly supervision sessions. Elm House DS0000015199.V333146.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): 37,38,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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: Since the last inspection an application to register the manager with CSCI has been successfully completed. She has completed the Registered Managers Award and she has recently received training regarding ‘Selection and Recruitment’ and ‘Managing the Team’. She also receives the required mandatory training. She also provides training for the organisation in ASD approaches e.g. challenging behaviour, professional boundaries and an introduction to working with service users with ASD. She creates a supportive and positive approach and communicates a clear Elm House DS0000015199.V333146.R01.S.doc Version 5.2 Page 21 sense of leadership and direction to ensure that the home is well managed. Staff confirmed this to be the case and they stated that they are encouraged to participate fully in the development of the service. Staff also commented that they felt able to raise issues or concerns freely. Adequate health and safety checks are made and fire safety records were accurate. Elm House DS0000015199.V333146.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 3 2 3 3 X 4 3 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 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 4 13 3 14 3 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X Elm House DS0000015199.V333146.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. Refer to Standard Good Practice Recommendations Elm House DS0000015199.V333146.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 DS0000015199.V333146.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. 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