Inspection on 14/06/05 for Elm Tree Court

This inspection was carried out on 14th June 2005.

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 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 12/10/05

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 Kingston upon Hull East Yorkshire HU9 5HH Lead Inspector George Skinn Unannounced 14 June 2005 9:30 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 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 J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Elm Tree Court Address 344 Preston Road Kingston upon Hull East Yorkshire HU9 5HH 01482 788447 01482 788448 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) Humberside Independent Care Association 1 Anchor Court, Francis Street, Kingston upon Hull, HU9 5HH Mrs Audrey Clark Care Home 72 Category(ies) of OP Old Age (72) registration, with number DE(E) Dementia - over 65 (72) of places Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 13/01/05 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 service users 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 J54 s846 Elm Tree Court v276097 140605 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 undertaken over 6 hours. The building was looked at and some records were inspected. The majority of the residents and seven of the staff group were spoken with. This included the manager. This is the first visit to the home since the last inspection in January. All those minimum standards inspected were met and in some cases exceeded. What the service does well: The home has a very welcoming and friendly feel to it. The staff are very conscientious with a relative saying that “the staff go that extra mile to make the residents feel wanted and cared for”. Residents, or relatives where appropriate, are always involved with the compiling of care plans. These are very detailed and reflect the things that are important to the residents. The time is taken to ensure that what may seem like small things are recorded as these are very important for the quality of life of the residents and ensuring that the staff give the care which the resident chooses and needs. Residents benefit from the staff being well trained and they were more than satisfied with the quality of care provided residents commented on the staff being “very caring and kind” one said “I can always count on my key worker if I was in any difficulty. The home provide basic induction training which is given to all new staff when they start working this provides the staff with the skills to care for the residents properly. The home also provides more specialised training in dementia etc to enable them to meet the more personal needs of individual residents. Residents live in a safe environment as staff are trained in all aspects of health and safety Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 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 Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 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 standard(s) 3 All residents have their needs assessed prior to moving into the home, this ensures their needs can be met. EVIDENCE: 7 files were looked at these indicted that residents are admitted to the home having undergone an assessment by either the Local Authority or senior staff from the home. The format of the homes needs assessment covers all required areas; copies of completed assessments were detailed and appropriate. Copies of the Local Authority assessment and care plan are obtained prior to admission for those residents referred through the local Social Services care management teams. In addition to the pre admission assessment the home undertakes a further assessment of strengths and needs once the resident has arrived. It is on the basis of both these assessments that the residents plan of care is formalised. Some of those residents interviewed knew the home kept information about them and said that they were involved in their care plans some commented on being involved with the reviews one relative said “I’m always invited and it’s nice to think that the home take my mums care seriously”; however due to the Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 9 dependency levels of the majority of the residents many were unaware of this. The care plans did demonstrate that all the residents are involved in the process of care planning, or have someone acting on their behalf. Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 7 & 8 Residents care records ensure personal care needs are well met by the staff group. EVIDENCE: Each resident has a plan of care, which has been devised from the assessments; the resident or next of kin is involved in the formulation of these and subsequent reviews. The way in which the care plan recorded likes, dislikes, preferred routines demonstrated the residents had been consulted. A form has been devised which asks the resident where appropriate, or their relatives to acknowledge that they are aware and agree with the contents of the care plan a signed copy was seen on all those files inspected. Care plans set out in detail the action to be taken by staff; these are linked to individual risk assessments. Each care plan is reviewed on a daily, weekly and monthly basis. Risk assessments relating to falling, moving and handling are available. The documentation used is under review and some of the formatting has been changed and new documents introduced. Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 11 Residents’ health care needs are met and staff ensure they have access to health care services to meet their assessed needs. Equipment is available for the promotion of tissue viability and the prevention of pressure sores. Dispite the frailty of some of the residents none have pressure sores, this is a credit to the staff and their high standard of practise in this area. The home has obtained the Heartbeat award for the provision of healthy meals, residents’ dietary intake is monitored on both an informal and formal basis dependant on need, and concerns are referred to the local dietician for advice. The organisation has developed a nutritional screening form in consultation with the National Association of Care Catering and the CSCI. Residents confirmed that they are enabled to access specialist-nursing services, dental, chiropody and ophthalmology. The management has developed positive relationships with a consultant Psychiatrist who now visits the home on a weekly basis to discuss and advise staff on any concerns regarding residents. Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 14 & 15 The residents are enabled to exercise choice and control over their daily lives. Residents are provided with a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. EVIDENCE: The manager and staff conduct the home in a manner, which aims to maximise residents’ autonomy and choice. Individual likes and dislikes are recorded. Where possible residents are encouraged to manage their own finances. Residents confirmed this. The personalisation of residents’ bedrooms is encouraged and was seen in varying degrees. Residents or their representatives are informed in writing about their ability to access personal information kept in the home. Residents upon admission to the home are made aware of local advocacy services by information provided in the Service user Guide. The home provides residents with a varied, appealing, wholesome and nutritious diet and as a result has obtained the Heartbeat Award. The quality of the meal was very good and the way in which it had been cooked had taken into account residents needs. The staff who are responsible Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 13 for serving the meals know residents likes and dislikes. Residents spoke positively about the quality of the meals comments were: “the food is always nice” “You always get a good choice at every meal time”. Assistance is offered to residents with individual needs. Residents are offered a choice at each mealtime; the menu indicates that cooked alternatives are available at both lunchtime and teatime. Tables are set appropriately with clean tablecloths, serviettes, condiments etc. Once the meal is finished staff seek the views of residents about their meal. Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 16 & 18 Both relatives and resident knew whom to complaint to and had confidence that their complaints would be taken seriously. The residents are protected from abuse. EVIDENCE: A complaints procedure is available which encourages residents and relatives to express their dissatisfaction without fear of repercussion. This procedure includes contact details for CSCI. Complaints are seen as an opportunity to improve the service as a whole or more specifically for an individual. Residents and relatives all said they felt the management style of the home encouraged them to speak out and they were satisfied that they would be listened to and issues acted on, they would not hesitate in bringing such matters to the staffs attention. In addition to the main complaints procedure each bungalow has a grumbles book, minor grumbles are recorded and the action taken identified. Residents are protected from abuse with robust procedures in place for responding to any suspicion. All staff receive formal training on abuse and the protection of vulnerable adults. The home does have a detailed system for the management of residents’ finances, which protects residents from financial abuse. The homes policies and procedures preclude staff from involvement in the making of wills or receiving gifts. Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 15 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 standard(s) EVIDENCE: Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 29 & 30 The residents are well cared for by a well trained staff group who have undergone a robust selection and recruitment process. EVIDENCE: The organisation has a detailed recruitment procedure. As part of this inspection six random staff files were seen. From these files it was evident that two references were sought. Criminal Records Bureau (CRB) checks are undertaken along with a health assessment. A copy of the General Social Care Council (GSCC) Code of Conduct is made available to staff. All staff are provided with written terms and conditions within 8 weeks of employment and copies of these are retained at headquarters. The organisations policy and procedures regarding the recruitment of volunteers outlines a thorough process, which includes the obtaining of references and a CRB check, the home does not currently have any volunteers. Those staff files seen did included a copy of passport and birth certificate. The company has a detailed induction program which meets National Training Organisation s(NTO) standards and incorporates all mandatory training this is done in a weeks block training. From staff files seen it is evident that induction is a formal process, which is allocated the appropriate amount of time and attention. Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 17 The company operates a thorough training program, which equips staff for their role and ensures they are able to meet the changing needs of residents. In addition the manager undertakes an audit of residents needs and compares this against the skills of the staff, the purpose of this is to establish if there is any shortfall in training need. Staff training is based on individual supervision; the amount of training provided was seen to exceed the three days required per year. Those staff spoken to during the inspection were knowledgeable about their role and the varying aspects of caring. Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Residents live in a home which is well managed and has effective administrative procedures to ensure that their health, safety and welfare is protected. EVIDENCE: The home has a detailed Health and Safety policy. Safe working practices are maintained by the provision of training to staff in the form of moving and handling, basic food hygiene, first aid at work, basic first aid, infection control and fire safety. Systems are in place to ensure that all the homes equipment and building maintenance is up to date. Hazard notifications are circulated to the home manager, action taken and then retained for staff to see. Hot water is regulated to control the risks of Legionella along with the risk of scalding. Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 4 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 3 Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 20 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 none 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 none Good Practice Recommendations Elm Tree Court J54 s846 Elm Tree Court v276097 140605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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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