Inspection on 19/02/07 for Elm Tree House

This inspection was carried out on 19th February 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 Tree House 03/11/08

Elm Tree House 30/11/07

Elm Tree House 11/05/06

Elm Tree House 17/11/05

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE Elm Tree House 37a Ogle Street Hucknall Nottingham NG15 7FQ Lead Inspector Rob Cooper & Michael Williams Key Unannounced Inspection 19th February 2007 10:00 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 DS0000064368.V329312.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 DS0000064368.V329312.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm Tree House Address 37a Ogle Street Hucknall Nottingham NG15 7FQ 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) 0115 963 3573 Carisbrooke Healthcare Ltd Elizabeth Pasik Care Home 17 Category(ies) of Dementia - over 65 years of age (17), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (2), Old age, not falling within any other category (17) Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Within the total number of beds, a maximum of 17 may be used for the category OP Within the total number of beds, a maximum of 17 may be used for the category DE(E) Within the total number of beds, a maximum of 2 may be used for the category MD (E) 15th March 2006 Date of last inspection Brief Description of the Service: Elm Tree House is a converted family house providing residential care for up to seventeen (17) older people. The home is situated in a residential area near the heart of Hucknall, within walking distance of shops and local amenities. The home is comfortable and homely and has pleasant gardens to the rear. There is a car park available at the front of the building. The home has recently been registered to provide services for people with Dementia and Mental Health Needs. Fees range up to £336.92 depending on dependency levels. Service users are expected to fund additional costs for newspapers, hairdressing and chiropody. Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection – so that no one at Elm Tree House knew that the inspection was going to take place before hand. The inspection took approximately three and a half hours through the middle of the day, with two inspectors – Rob Cooper and Michael Williams present. The method used to carry out the inspection was to send out a questionnaire, which asked questions about the service, to gather statistics, such as how many service users there are, the numbers of staff etc. This was followed with a visit to Elm Tree House, where a method called case tracking was used; this involved identifying three residents and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was done by a partial tour of Elm Tree House, looking at the activities on offer, and talking to residents, staff and one relative who was visiting. On the day of the inspection there were residents living at Elm Tree House. Elizabeth Pasik who is the manager facilitated the inspection, and the Registered provider Mr Sohawon also called in. What the service does well: What has improved since the last inspection? At the last key inspection a number of requirements and recommendations were made, and these have all now been met. Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 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 House DS0000064368.V329312.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. No resident moves into Elm Tree House without having had their needs assessed, and been assured that these will be met. Elm Tree House does not offer intermediate care. EVIDENCE: As part of the case tracking process three residents files were seen in respect of the assessments within them. Each file contained a completed assessment form, and the dates on the assessments showed that these had been completed before the residents moved into Elm Tree House. Among the different types of assessment tool seen were an Extended Community Care Assessment, completed by the resident’s social worker, and three Shared Nottinghamshire Assessment Process forms (SNAP’s) This is the latest assessment form for older people used within Nottinghamshire. There were also examples of in-house assessments completed by Elm Tree House staff to Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 9 follow on from the formal social worker assessments. At the last inspection a requirement was made in relation to resident’s assessments, and the evidence seen shows that this requirement has now been met. In January 2007 a thematic inspection was carried out which looked in some depth at the Statement of Purpose, Services User Guide and contracts for residents at Elm Tree House. All of these were found to be fit for purpose. Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 & 10 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Resident’s health, personal and social needs are set out in an individual plan of care at Elm Tree House. Resident’s health care needs are fully met. Residents at Elm Tree House where appropriate are responsible for their own medication, and are protected by the policies and procedures in place for dealing with medicines. Residents at Elm Tree House feel they are treated with respect and their right to privacy is respected. EVIDENCE: The case tracking process showed that the three resident’s identified had an individual plan of care within their file, and this plan is being reviewed on a regular basis. The files were seen to be stored securely, and to be set out in a logical format. The resident’s files contained details of health care needs, and health care appointments attended. Two residents were asked about visits to the doctor, and both said that they were able to see a doctor when they wanted to. Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 11 A local chemist provides medication to Elm Tree House for use by the residents. A check of the documentation relating to medication showed no obvious errors, and the storage of medication was secure. There was evidence in the staff training files of staff being trained to administer medication, and evidence of them being monitored by the manager. One resident at Elm Tree House currently self-medicates, and there was a care plan and risk assessment within their personal file concerning medication. At the last inspection a requirement was made relating to the handling of medicines, evidence showed that this requirement had now been met, and that medication is administered in a safe and appropriate manner at Elm Tree House. During the course of the inspection a number of staff to resident interactions were observed. These were seen to be polite and respectful, and staff were observed knocking on resident’s doors before entering. Three residents were spoken with during the inspection, and each one said that they thought they were well treated by the staff. One resident said: “The staff are always very nice, always kind.” Another resident said that: “The staff are very friendly, and they treat us very well.” At the last inspection a requirement was made in respect of privacy and dignity, and the issues raised have been addressed. Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 & 15 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents find that the lifestyle experienced at Elm Tree House matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Residents at Elm Tree House maintain contact with family/ friends and representatives and the local community as they wish. Residents are helped to exercise choice and control over their lives. Residents receive a wholesome appealing balanced diet in pleasing surroundings at times that are convenient to them. EVIDENCE: During the inspection there was a game of bingo taking place in the lounge. This was a planned activity, and the majority of the residents within Elm Tree House were involved, and were observed to be taking an active part in the game. There was a positive relaxed atmosphere with plenty of ‘banter’. Four residents were spoken with, three said that they were quite happy with the level of activity within Elm Tree House, and that there were also occasional trips out into Nottingham shopping, or sometimes out for lunch. The fourth Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 13 said they preferred their own company, and avoided the ‘organised activities’ in the lounge. One relative was spoken with during the inspection, and they said that they were quite happy with the arrangements for visiting, and that they were always made to feel welcome. The relative said that they had a good relationship with the staff, and that there was good communication, in that the staff kept them (the relative) informed about their relatives health and events within their life. Three residents when asked said that they had visits from their relatives, and that they were quite happy with the family contact and visits they received. Four residents were asked about control and choice within Elm Tree House, each resident said that they had a choice with regard to meals, and could spend their day how they wished. One resident said that there were occasional residents meetings where among other things activities were discussed and resident’s views were sought. Three residents who were asked said that they had a bedroom key, and that they felt they had some control over when they got up, went to bed, or had a bath. During the inspection the residents were observed having lunch, at the last key inspection a requirement was made with regard to the size of the portions being given to residents, although observations showed the size of the portions to be alright. Three residents were asked about the food at Elm Tree House and each one said that the food was good, and that they got enough to eat, and that there was always a choice. An inspection of the kitchen found it to be well organised, and all of the documentation relating to cooking and food storage was found to be complete and correct. There was a supply of fresh vegetables available, and the food on offer appeared to be of a good quality. Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon at Elm Tree House. Residents at Elm Tree House are protected from abuse. EVIDENCE: Since the last key inspection in April 2006 there have been two recorded complaints. A review of the complaints records and documentation showed that the complaints were dealt with in line with Elm Tree House’s complaints policy and procedure. The complaints policy is displayed in the foyer, and two residents who were asked said that they knew who to complain to, should they need to complain. The relative who was spoken with was also aware of the complaints procedure, and said that usually it was little things that needed addressing, and that these things were sorted on an informal basis by the staff, before becoming an issue. At the last key inspection a requirement was set in relation to record keeping in relation to complaints. A review of the documentation showed that this requirement had been met. Two members of staff were asked about safeguarding adults training, and both said that they had received training. Discussions with the staff showed that they were aware of safeguarding adults procedures. A review of Elm Tree House’s training records showed that some staff had received safeguarding adults training, and that there were plans in place to provide similar training to Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 15 those staff who needed it. Two residents were asked if they felt safe living at Elm Tree House, and both said yes they did. Elm Tree House DS0000064368.V329312.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Elm Tree House live in a safe, well-maintained environment. Elm Tree House is clean, pleasant and hygienic. EVIDENCE: A partial tour of Elm Tree House showed no obvious evidence of poor maintenance, and discussions with two residents showed that they were happy with the environment, and they thought it was comfortable. Elm Tree House has a homely feel, and has some of the ‘clutter’ that makes a home rather than an institution. Staff were seen cleaning in various areas of Elm Tree House during the inspection, and the building was found to be clean. Two residents were asked about the cleanliness of Elm Tree House, and both said that they were quite Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 17 happy, and that they thought the staff worked hard to keep the home clean and tidy. At the last inspection a requirement was made with regard to having an adequate supply of personal protective clothing (aprons, gloves etc), a inspection of the stock cupboards showed that there was good supply of these items at Elm Tree House. Elm Tree House DS0000064368.V329312.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 & 30 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff at Elm Tree house meets the residents’ needs. Residents at Elm Tree House are in safe hands at all times. Residents are supported and protected by Elm Tree House’s recruitment policy and practices. Staff at Elm Tree House are trained and competent to do their job. EVIDENCE: A review of the staffing rota and staffing levels at Elm Tree House showed that there were enough staff currently employed to meet the resident’s needs. Two residents were asked about staffing levels, and both said that they thought there were enough staff. In addition a relative who was visiting was also asked about staffing levels, and said that there did not appear to be a problem. A requirement regarding staffing levels was set at the last key inspection, but this does not appear to be an issue any longer. The care industry considers National Vocational Qualifications (NVQ) to level II in care to be the basic qualification for staff working in residential care. A review of the training records showed that currently three staff are studying for their NVQ qualification, and three other staff already have their NVQ level II in care. It is recommended that a minimum 50 of the care team are NVQ Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 19 qualified, and the staff team at Elm Tree House are currently working towards this figure. Three staff files were seen, and these contained information that showed that staff had been recruited in a safe manner – in that applicants had to fill out an application form, provide two written references and undergo a Criminal Records Bureau check. A review of the documentation showed that there were no issues raised in the recruitment process for the three staff members, and that the process had worked to protect residents. Discussions with two staff members about their recruitment evidenced that they had undergone preemployment checks, and had not started working until those checks had been completed. The staff training records at Elm Tree House were seen, and these showed that there was an ongoing staff training programme in place. Further discussions with two members of staff about their training, showed that they had attended a variety of training courses, and that they had other training booked in the near future. Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 & 38 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at Elm Tree House 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. Elm Tree House is run in the best interests of its residents. Resident’s financial interests are safeguarded. Staff at Elm Tree House are appropriately supervised. The health, safety and welfare of residents and staff at Elm Tree House are promoted and protected. EVIDENCE: The Registered manager is Elizabeth Pasik, who is suitably qualified and experienced to hold the post of registered manager. Elizabeth has undergone the Commission for Social Care Inspection’s own review process to assess her Elm Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 21 competence and suitability to be the registered manager, and been judged ‘fit’ to hold the post. Elm Tree House run resident’s meetings approximately once a month, and the minutes to several meetings were seen. Two residents were asked about resident’s meetings, the first said: “There are meetings sometimes, and I can go if I want, but I don’t always want to.” The second resident said: “I like the meetings they tell us lots of things about what’s going on.” At the last key inspection a requirement was set regarding Regulation 26 visits by the provider to the home – these are visits by the provider to ensure the quality of the service, and to discuss with residents how they are finding the experience of living at Elm Tree House. A review of the records showed that these visits are now taking place on a regular basis. Elm Tree House operates a system for resident’s personal finances. The records for four residents were checked at random, and were found to be correct, and with receipts in place to show expenditure. Two residents when asked said that they could get their money when they wanted it, and that they were quite happy for the staff to look after their money. Elm Tree House operates a supervision and appraisal system, with staff having formal supervision approximately six times a year. Records relating to the staff’s formal supervision were seen and these indicated that staff members were properly supervised. The two staff members who were spoken with said that they were having a formal supervision session approximately every eight weeks. Both members of staff said they felt they were well supported, and said that the manager was approachable, and both felt they could ask for help if they needed it. A range of health & safety records were seen, and all found to be correct and up-to-date. These included the fire safety records, the Control of Substances Hazardous to Health (COSHH) records, and the water testing records for Legionella. Elm Tree House DS0000064368.V329312.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Elm Tree House DS0000064368.V329312.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 Tree House DS0000064368.V329312.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Tree House DS0000064368.V329312.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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