Inspection on 01/06/06 for Elm Tree House

This inspection was carried out on 1st June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 House 27/11/07

Elm Tree House 08/01/06

Elm Tree House 29/06/05

Elm Tree House 05/11/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Elm Tree House 32 Crow Lane West Newton-le-Willows Merseyside WA12 9YG Lead Inspector Mrs Lynn Paterson Unannounced Inspection 1:00 1st June 2006 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 House DS0000061681.V295343.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 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 House DS0000061681.V295343.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm Tree House Address 32 Crow Lane West Newton-le-Willows Merseyside WA12 9YG 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) 01925 228727 01925 228727 Living Developments Ltd Mrs Beverley Steele Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The service should employ a suitably qualified and experienced manager who is registered with the CSCI Service users to include up to 20 OP The Service may accommodate up to a maximum of 5 (PD) over 55 years of age 8.01.06 Date of last inspection Brief Description of the Service: Elm Tree House is a large Victorian Detached property, which has been extended and adapted to provide residential care for a maximum of 20 older persons The home is situated on a main road location in Newton Le Willows and is close to shops and other local amenities. Accommodation is provided on the ground and first floor and a passenger lift and stair lift are in place for ease of access. The garden areas include a side patio and fish- pond with open car parking facility to the front. The fees charged are currently £343.00.per week. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of Elm Tree House was undertaken on 1st June 2006 and was carried out over a four- hour period. The inspector met with the manager, three staff members and 19 of the 20 residents in placement. . Records care files, policies procedures and other documentation was examined and a tour of the premises was carried out. Fieldwork included speaking with 2 resident’s family members and case tracking five residents, which involved reading all documentation relating to the residents daily living and speaking with the residents and staff who were associated with their care. What the service does well: The home has continued to carry out refurbishment to the premises and the work was seen to be of a high standard with quality equipment being used to modernise bathrooms and en–suite facilities. Residents spoken with said they were most happy with their surroundings and comments included “this home has everything in it to make us comfortable and make us feel very much at home”, ”We love being here the gentleman who owns it keeps on providing more things for us, we have got a wonderful new bath and the furniture and things are just great”. Staff retention and training is good with the responsible person and registered manager recognising the importance of NVQ and various specialist training to aid staff in their personal and professional. This has led to staff feeling valued in their work and enabled them to carry out effective care practices for all the residents living in the home. Staff and residents interactions were seen to be of mutual respect and the manager advised that great emphasis is placed upon the staff being afforded time to speak with residents and establish a relationship. The manager said this enabled residents to feel safe and secure and able to readily communicate their feelings. Residents spoken with said they liked the fact that staff chatted with them all the time and comments included “we find the staff will listen to you anytime and if I feel a little low the staff will comfort me by talking or simply just being there,” “The staff are kind and caring and treat us like royalty”, “If you asked for marks out of ten it would definitely be ten, you can’t get better than that”. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? Staff training continues to improve. Training is viewed as essential for the delivery of quality care and training commences with induction and is an ongoing process within the home. The home has introduced an updated policy and procedures manual and staff members are encouraged to review their knowledge of all policies and practices on an ongoing basis. Information about the home has been revised to include good quality pre admission information and clear details of all aspects of the home management systems and the service provision in the home. The home has employed a maintenance person who is on call to deal with general small maintenance work around the building. Staff advised that they all have health and safety checklist responsibilities, which, they say, has improved their knowledge and understanding of the health and safety policies and procedures in the home. Security systems have been reviewed and there are 24 hour electronic entry locks and alarms on main external doors and a closed circuit video entry system is used on the front door and peripheral areas of the grounds for added safety. Quality assurance processes are undertaken on a regular basis to include residents and their representatives being asked their views on service delivery. Residents spoken with said they were asked to comment on what they felt about the food, menus, staff, activities and entertainment and the general environment of the home. They said that their views were listened to and acted upon to ensure “they felt at home in Elmtree House”. It was noted that the home continues to update the premises to ensure that the building is equipped with the modifications necessary to support all the residents who reside therein. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 7 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 House DS0000061681.V295343.R01.S.doc Version 5.2 Page 8 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 House DS0000061681.V295343.R01.S.doc Version 5.2 Page 9 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): 1.3. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The home provides clear information to enable people to make an informed choice about living in the home. Staff; ensure that all prospective residents are subject to a thorough assessment of need to ensure that the home has the facilities to meet all assessed need prior to admission. EVIDENCE: Pre admission documentation looked at was clear and detailed information about the home and its service provision and the home statement of purpose held details to include staffing levels and the ethos of the home. Information recorded in the statement of purpose included “Elmtree House exists for the benefit of its residents” and residents spoken with advised that they felt the place was very much their home. Residents said they were able to read about the home before they visited to look around. Three residents spoken with said when they had decided they wished to live at Elmtree House they received a home visit to assess their Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 10 needs before being offered a place there. One resident said “I visited the home before I came with my daughter. I knew straight away that it was the right place for me”. Assessment documentation seen confirmed that pre admission assessments were carried out prior to residents being admitted to the home. Assessment procedures included utilising information from the prospective resident, their representatives and any other professional to enable full details about choices, preferences and abilities to be noted and used as the basis for a plan of continuing care. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 11 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): 7.8.9.10. Quality in this outcome area is generally good. This judgement has been made using available evidence including a visit to the service. Health and personal care needs are met, however care plans do not include full information as to how the care is carried out. Care plans should hold full details of care planning; care delivery to ensure all assessed needs are met. EVIDENCE: Care plans were looked in general and five care plans were examined in detail to gain information as to how and when health and personal care practices were carried out. The care plans had been changed since the previous inspection and it was noted that the care records were maintained in a booklet format, which included health records, a general overview of the residents needs, pre admission assessment details and other information which identified that care needs were recorded. However the care plans did not hold sufficient detail to show how the assessed needs were met. An example of this was that one resident had been assessed as needing assistance with mobility and the care plan said “assistance needed with mobility” but did not record what this Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 12 assistance consisted of. Another example was “resident needs assistance with bathing and toileting” again no information was recorded as to how this care` and support would be carried out. In discussion the manager agreed that the care plans did not hold sufficient detail but she said that because the staff had been working in the home a long time they knew what the residents wanted. Staff observed carrying out their care practices and the reactions of the residents to this indicated that the practices were carried out by mutual agreement and residents spoken with confirmed that all care and support was carried out to their wishes. However care plans should detail what care is needed and how this care will be provided. Care plans should also have signatures of all who were involved in drawing up the plan. It was noted that health care needs were clearly identified on the plans and any health care treatment was recorded. Medication records had greatly improved since the last inspection and staff records showed all staff that held the responsibility for medication had received full refresher training in all aspects of medication management. Staff spoken with and observed interacting and supporting residents revealed they had received training to ensure they treated each resident with respect and maintained their dignity at all times. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 13 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): 12.15 Quality in this outcome area is excellent. The judgement has been made using available evidence including a visit to the service. Residents are provided with a varied lifestyle that meets their expectations and satisfies their needs. Meals are wholesome, menus offer choice and residents enjoy their meals, which are served in pleasant surroundings. EVIDENCE: Menus were viewed. A discussion was held with the cook. A tour of the environment was undertaken. Brief discussions were held with three residents. A menu board was completed on a daily basis stating what the choice of meals will be for that day. Residents said staff visited all residents each morning to offer the choice to each resident. Staff confirmed this to be true. The diet on offer is wholesome and nutritious. Five residents confirmed that they enjoyed the food on offer. The manager and cook agreed that monthly food satisfaction surveys are carried out to ensure that the residents are happy with the standard and choice of food available. The home has two dining rooms, a main dinging room with a small adjourning annex. Both were viewed and were set with tablecloths and condiments. Both had a relaxed atmosphere. Staff were observed to support residents appropriately. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 14 Residents advised that they were able to enjoy activities and interests if they wished. Residents comments included” activities are arranged but you are not made to do anything you are not happy about, which is nice”, ”we take part in activities if we want, if not we just watch”. Staff said daily activities were arranged and outings and social events took place on a regular basis. At the time of the visit it was noted that a clothing party was taking place in which all residents were seen to participate. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 15 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): 16.18 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Staff, receive clear ongoing training in respect of adult protection. Residents know the complaints procedures used by the home and are confident that any complaints made will be listened to, acted upon and quickly resolved. EVIDENCE: The home had a complaints policy. This was displayed in a prominent area of the home. The complaints book was viewed. No complaints had been made against the service, to the service or CSCI since the last inspection. Viewing this book showed that any complaints made were recorded, dated, and actions taken recorded with outcomes. Residents spoken with said they knew about the complaints procedures and felt the staff would deal with any complaints quickly. Residents revealed that staff spoke with them on a daily basis to ensure that they were happy with everything. Staff advised that the had received training in all aspects of adult protection and discussions held with staff revealed they had full knowledge and understanding of all the processes involved with the protection of vulnerable adults. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 16 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. Quality in this outcome area is excellent. The judgement has been made using available evidence including a visit to the service. The manger has systems in place to ensure that residents live in a clean, hygienic safe and well maintained environment. EVIDENCE: A tour of the building revealed that the home was clean, hygienic and well maintained and the general appearance of the premises was good. Residents spoken with said they liked being the home, which they felt was a very pleasant place to live in. The home has commenced a refurbishment programme to modernise the premises and to ensure the equipment used and in house services provide a safe and well-maintained environment for all the people living in the home. Documentation viewed showed that all essential services are tested and serviced and a tour of the premises revealed that exit and entry doors had Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 17 ramped access, the lift was in full working order, fire doors were used as appropriate and all windows held opening restrictors. Staff, spoken with identified that they had full awareness of the necessity to maintain a safe wellmaintained environment for the protection of all who used the home. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 18 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): 27.30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. Staff, are employed in sufficient numbers and receive ongoing relevant training to ensure that are able to meet the needs of all individuals who live in the home. EVIDENCE: Staff rosters showed that staff, were employed in sufficient numbers and skill mix to meet the assessed need of the current residents of the home. Records showed that training topics are offered on an almost monthly basis and that a great variety is available. The training records showed that the training offered is designed to meet the needs of older people. Other training is also offered to enable qualified staff to maintain their professional status. Staff spoken with and observed carrying out their care practices identified they were skilled and confident in their caring role. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 19 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): 31.33.35.38 Quality in this outcome area is excellent. The judgement has been made using available evidence including a visit to the service. The manager runs the home in the best possible interests of the residents and is totally supported in her task by the homes registered provider. EVIDENCE: The managers file was viewed which showed that she maintained her professional status by undertaking further training in management. The manager is registered as “ fit” to manage with the CSCI. Staff and residents spoken with said the manager was admired for her ability to run the home “without fuss”. Resident’s comments included “the manager talks to us everyday about what is going on, she is always helpful and kind”, ”we know what is happening here because staff include us in everything”. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 20 Discussions with the manager and reviewing documentation showed that the provider requests the views of residents (where appropriate) and relatives on a regular basis to gain their opinion of what the home offers. This is then produced in a report format and made available for viewing. A copy of this was viewed in the Homes Statement Of Purpose. The manager confirmed that staff are included in the survey. The home utilise several quality assurance monitoring systems to ensure that it is run in the best interest of the people living in the home. This includes monthly visits by the registered provider who tours the premises and speaks with residents to make sure they are content with the services and the manner in which they are provided. The home manager completes daily building risk assessments and an environmental audit is carried out six monthly. Customer surveys are used to monitor the quality of the staff and services provided and resident and family meetings are arranged to ensure all views can be aired and full information about the running of the home shared. In additional the home manager and staff have effective communication systems in place to ensure all residents are fully included in the running of the home. Records show that residents finances are dealt with in a manner to ensure that then people living in the home are encouraged to manage their finances for as long as possible with support being provided as appropriate. Safe storage systems are available to enable residents to keep money and/or valuables under lock and key. Health and safety documentation revealed that the home undertakes regular fire practice with fire instructions being placed by each alarm. A fire log- book is held centrally and details all evacuation points and staff spoken with identified they had full understanding of all fire safety procedures. The home visitors book is also fully utilised to ensue that all people arriving and departing from the home are recorded. Staff, are given responsibility for the checking and testing of various health and safety procedures and staff spoken with said that they felt this enabled them to gain better understanding of the full health and safety policies utilised in the home. The home uses a maintenance and housekeeping book to identify any health and safety issues or necessary repairs and employs a maintenance person who is available on site to carry out testing and emergency repairs. Elm Tree House DS0000061681.V295343.R01.S.doc Version 5.2 Page 21 Building risk assessments are an ongoing process in the home and accidents and incidents are recorded, followed up analysed and action taken as per the policies and procedures in the home. Records show that all essential services are tested and serviced on a regular basis and all staff receives ongoing updated training in all aspects of health and safety. Elm Tree House DS0000061681.V295343.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 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 3 X 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Elm Tree House DS0000061681.V295343.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. 1. Standard OP7 Regulation 15 Requirement Care plans must detail assessed need and how care practices are planned and carried out. They must also hold signatures of all people responsible for the compilation of the plan Timescale for action 01/08/06 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 House DS0000061681.V295343.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Tree House DS0000061681.V295343.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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