Inspection on 12/10/05 for Elm Tree Court

This inspection was carried out on 12th October 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 Tree Court 17/05/07

Elm Tree Court 14/06/05

Elm Tree Court 17/02/05

Elm Tree Court 09/09/04

Elm Tree Court 09/03/04

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

CARE HOMES FOR OLDER PEOPLE Elm Tree Court 344 Preston Road Hull East Yorkshire HU9 5HH Lead Inspector George Skinn Unannounced Inspection 12th October 2005 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elm Tree Court Address 344 Preston Road Hull East Yorkshire HU9 5HH 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) 01482 788447 01482 788448 Humberside Independent Care Association Mrs Audrey Clark Care Home 72 Category(ies) of Dementia - over 65 years of age (72), Old age, registration, with number not falling within any other category (72) of places Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th February 2005 Brief Description of the Service: Elm Tree Court provides personal care and accommodation for a maximum of 72 older people some of who may have memory impairment. It is owned By Humberside Independent Care Association Ltd (HICA) which is a not for profit organisation. Elm Tree Court is a purpose built care home located on the eastern outskirts of Kingston upon Hull in a mainly residential area. The facilities are all on the ground floor and the home is structured into three separate bungalows Willows, Sycamore and Hawthorne. Each bungalow has twenty-four single bedrooms, however a small number of these can be made into a double facility for those wishing to share. In addition there is a variety of lounges, a dining room, toilets and bathing facilities. There is a central core to the building, which comprises administration offices, entrance, treatment room, kitchen and laundry facilities. Small shops are located on an internal street. Each bungalow has access to an enclosed courtyard where residents can walk in safety. The home was initially registered in February 1996, and has had no major changes to the layout since that time. Although in a mainly residential area, close by are two shopping areas, post office, public houses, churches and leisure facilities. Main bus routes into the City Centre stop just outside the home and there are ample car parking facilities within the grounds. Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken over 4 hours. The home was looked at as were some records, and residents were spoken with. What the service does well: What has improved since the last inspection? What they could do better: The acting manager acknowledges that they are not perfect but is always reassessing and auditing the service offered to see if there are areas for improvement. Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 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. Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 & 10 Residents are protected by the home policies and procedures for handling medication, and residents feel they are treated with respect. EVIDENCE: There is a detailed medication policy in the home about the handling of medication. Records of medication received into the home are well maintained along with their administration and disposal. The home does not routinely facilitate self-medication. Those residents whom wish to self medicate would be enabled in this process, subject to an assessment and agreement. Appropriate storage facilities for controlled medication are available. Some medication is stored in a fridge; the temperature of this is monitored and recorded on a daily basis. Senior staff that have been trained and assessed as competent administer medication in the home and sample signatures are retained. The health of residents on medication is monitored and recorded in case files regular medication reviews takes place with the GP. The organisation has Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 10 developed a medication-training package, which has extend to a formal assessment process based on competency and understanding The maintenance of residents’ privacy and dignity forms part of the staff induction programme. Residents spoken to confirmed that privacy and dignity is respected whilst personal tasks are being undertaken, assistance is always available but where possible independence is enabled. Medical examinations/ treatment is conducted in the privacy of the residents’ own room. The preferred form of address is recorded on all case files. Residents are informed in the statement of purpose about their rights to have a private phone fitted in their bedroom. Residents can use the homes payphone to make and receive calls. Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 13 The resident expectations are satisfied and their cultural and religious needs are met, and contact with families are maintained. EVIDENCE: Staff provide a variety of choice and flexibility in the daily lives of the residents, with care being given to ensure that it reflects the wishes of the resident. Care plans indicated how even small preferences were to be accommodated like the preference for putting slippers on before the residents feet touch the ground. Leisure and social activities are arranged both in house and within the local community. Notices of forthcoming social events are displayed around the home. Residents interests are recorded in their individual care plans. Through discussion with residents it was evident they choose when to get up, go to bed, spend time in company, time alone etc. Whilst mealtimes are set residents are able to make choices about where they wish to eat and there is some flexibility around the timing and what they would like to eat. Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 12 Residents are able to receive visitors at all reasonable times. The statement of purpose states that residents are able to choose whom they see and don’t see. No restrictions are placed on visiting. Relatives spoken to commented that they were made to feel welcome by staff and frequently joined in the main meal. Relatives were of the opinion that sufficient and varied social activities were organised. Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Residents live in well-maintained environment, which is clean, pleasant and hygienic EVIDENCE: The home was purpose built and is accessible, safe and well maintained. The maintenance of the building is audited by the home manager as well as the company bank to ensure environmental standards do not deteriorate. Redecoration is ongoing and subject to individual choice. Small garden areas are available and used by residents. The building complies with the requirements of the local fire and environmental health department. CCTV cameras are not used. The premises were clean and hygienic with systems in place to reduce the risk of odours. It is the organisation policy that where minor odours are identified as a problem that cannot be rectified by cleaning then new carpets are Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 15 purchased. The location of laundry facilities is suitable and ensures that dirty laundry is not carried through food storage, preparation or dinning areas. Policies and procedures for the control of infection are in place along with the provision of protective clothing. The homes laundry is fitted with industrial washers and driers. There is separate hand washing facilities in the laundry room. The covering on the laundry room floor is impermeable and easily cleaned. Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 The number and skill mix of the staff meet the needs of the residents. EVIDENCE: The National Care Standards Commission have been advised that recommended guidance should only be applied to new registrations. For homes registered prior to April 1st 2002 staffing levels must at least meet the minimum requirements of the previous regulatory authority. At the time of this inspection staffing numbers were found to meet those previous requirements. The home retains a copy of duty rosters. All staff employed by the home to care for residents are aged over 18 years and those staff left in charge are at least 21 years old. Dedicated domestic staff are employed in sufficient numbers to ensure the home is maintained in a clean and hygienic state. Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 & 35 The residents live in a home which is well managed and run in their best interest. EVIDENCE: The home currently has an acting manager in post as the permanent manager is managing a home which has been newly acquired by HICA in the west of the city. She was the deputy so is more than capable of maintaining the high standards at the home. Residents and relatives spoken with during this inspection spoke highly about the acting manager and the staff, everybody without exception praised their caring approach. From observation it was clear that positive relationships had been formed between residents, relatives, staff and the acting manager. Residents and their relatives are encouraged to make decisions about how the Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 18 home is run through day-to-day discussions, meetings and the “coffee morning” meetings. There is a statement about equal opportunities in the staff handbook and the home has a policy on Equal Opportunities. All staff have been provided with a copy of the Code of Practice published by the GSCC. Staff meetings are held on a regular basis. Minutes of these meeting were seen. Coffee morning meetings continue to be organised for friends and relatives. Residents, staff and relatives felt the acting manager was approachable and would do all she could to help. The organisation have developed a reward system for staff which is dependent on the companies annual profits, as HICA is a not for profit organisation then staff have developed a system which rewards the positive contribution that home staff have made to the running of the home, staff felt this demonstrated how their contribution was acknowledged by the organisation. Finances are managed in varying degrees dependant on individual abilities and wishes. This has resulted in a number of families taking care of personal monies whilst others ask the home to keep monies in safekeeping. The home maintains a rigorous system for the safekeeping of monies, with individual details and receipts of any monies spent on their behalf. Hard copies of this account are printed off on a daily basis. This account whilst being rigorous, does fall into the realms of a “communal non-interest account”; from discussions with families, inspection of records and having read information provided to them, it is apparent that any decision to utilise this system have been made by the resident or their representative and is based on individual choice often for convenience. On the basis of these findings this system is acceptable. The organisation ensures that financial audits take place of all monies handled by the home, following these audits a report is produced and any recommendations made are acted upon. Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x x Elm Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 20 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. 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 Tree Court DS0000000846.V258321.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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. 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