Inspection on 21/03/06 for Elm View Nursing Home

This inspection was carried out on 21st March 2006.

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 View Nursing Home 15/05/07

Elm View Nursing Home 18/09/06

Elm View Nursing Home 30/09/05

Elm View Nursing Home 04/03/05

Elm View Nursing Home 04/11/04

Elm View Nursing Home 02/02/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Elm View Nursing Home Moor Lane Clevedon North Somerset BS21 6EU Lead Inspector Stephen Humphreys Unannounced Inspection 09:30 21st March 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 View Nursing Home DS0000020304.V272290.R02.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 View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elm View Nursing Home Address Moor Lane Clevedon North Somerset BS21 6EU 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) 01275 872088 01275 872088 Belmont Care Limited Mrs Dawn Marie Higley Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate 45 persons aged 50 years and over who require nursing care of whom up to 3 persons may be aged 65 years and over and in need of personal care only. Manager must be a RN on Part 1 or 12 of the NMC register 2. Date of last inspection 30th September 2005 Brief Description of the Service: Elm View is a purpose built home providing 45 beds for residents requiring nursing care. It is situated in an urban area and surrounded by well-maintained gardens. The accommodation comprises 41 single and 2 double rooms, all with ensuite facilities, and situated on two floors. There is a large open dining area and two comfortable lounges. Part of one lounge is designated as a quiet area and can be used for receiving visitors or for family celebrations. A minibus is available to take residents to the local shops or for trips to Weston-Super-Mare or the surrounding countryside. Elm View Nursing Home DS0000020304.V272290.R02.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 carried out by two regulation inspectors. The inspectors met with four residents in their own rooms and ten residents in the lounge / dining areas. Elm View care home has been open for six years, there is a warm and friendly atmosphere throughout the home which is noticeable as soon as you walk into the reception. Visitors are given a warm welcome by the registered manager Mrs Dawn Higley and her staff. The inspectors concluded after discussions with residents, one relative and members of staff that Elm View is a well managed care home promoting the well being of the residents through a high standard of personal and nursing care. Residents also confirm that the social activities are suitable to their needs. The inspectors toured the home and reviewed statutory records and seven care plans. What the service does well: There is a pleasant, relaxed and friendly atmosphere at Elm view. The house keeping team are complemented on their commitment and hard work in keeping the home exceptionally clean and tidy. The interaction between residents and all the staff is representative of a family based community. Every member of staff actively participates in delivering a high standard of care. The registered manager, Dawn Higley, has been involved with the development of staff training and induction, which has resulted in Elm View’s successful application to be recognised as a placement for Student Nurses Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 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 View Nursing Home DS0000020304.V272290.R02.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 View Nursing Home DS0000020304.V272290.R02.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): 1,3,4,5 Residents and their families receive sufficient information to make an informed choice on residing at Elm View. All Prospective residents have an assessment of need carried out before admission. EVIDENCE: The home has a statement of purpose and service user guide in place. These documents are respectively known as The Residents Guide and The elm View Information Brochure. Both documents and other information about receiving care in care homes and supportive agencies are on display in the reception. One relative confirmed that she reads the inspection reports and the other documents. The prospective residents are invited to visit the home. Most of the residents who now live at Elm View had been in hospital or quite frail when decisions regarding the choice of home had been necessary to make. Many said that they had let their families ‘deal with these matters’ but were happy living at Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 9 the home. One relative said that she had heard of the home’s good reputation from a friend. A care needs assessment based on the activities of daily living model of care is undertaken by either the registered person or her deputies. The care needs assessment was evidenced in each residents care plan. Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 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 the following standard(s): 7,8,9,10 Each resident has a detailed plan of care that has evidence of resident / representative involvement. Residents confirmed that they felt well cared for and were happy with the service delivery. Medicine procedure follows the professional code of administration however further attention is needed in recording the administration or nonadministration of some medicines. EVIDENCE: Seven care plans were case tracked of residents with complex nursing and care needs. Each care plan was detailed and contained adequate information and evaluations of the care delivered. To move forward and to improve the care plan so that it becomes a fully working tool and part of the service contract the care needs should be person centred and identify what the resident identifies as their care need. This will enable a fully achievable outcome that can be measured through the care delivery. Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 11 All the residents and relative confirmed they were happy with the care and service delivered. Two residents identified a slight communication problem. This was conveyed to the registered person who will improve this area. The storage, administration, recording and disposal of medicines were reviewed. The medicine administration records were not fully completed to signify the administration or non-administration of the prescribed medicine in every case. Gaps were left where a code or the administrator’s initials should be recorded. Controlled drugs were counted and reconciled with the controlled drug register. All where correct and the register complete. Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 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 the following standard(s): 12,13,14,15 Residents continue to make their own life choices whilst living at the home. EVIDENCE: Residents enjoy the company of their families and friends at times of their own choosing. Residents’ visitors are welcomed into the home by the staff and their visitors are shown to the resident’s private rooms or the communal areas if they wish. The home has an open visiting policy in place. Residents who are able are encouraged to maintain their local links with the community such as church groups they previously attended. One resident said that they had met with former acquaintances that had also moved into the home. The residents felt that they had maintained control of their day to day lives, choosing the time they wish to retire of an evening, rise in the morning and where to take their meals. Some residents said they had found it difficult at times in establishing whom they readily chat with. These residents found it useful talking to the staff and the social activities organisers to assist them in meeting up with other residents. There were several residents who were very frail and remained in their private rooms. The inspectors noted that staff maintained regular contact with these Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 13 residents during the course of the inspection. Residents all had access to the nurse call bell system. Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 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 the following standard(s): 16,17,18 Relative and residents confirmed they would have any concerns acted upon. Resident’s legal right to vote is protected. A robust abuse policy and procedure is in place. EVIDENCE: Residents are registered to postal vote should they wish to according to the registered manager. Applications for postal voting are available on the display shelf at reception. The residents met said that if they wanted to vote they would complete the postal vote forms which the home sorts out for them. Residents said they had no concerns but would convey them to Dawn who would sort them out immediately. One resident said he had no reason to put in written concern Carers and house keeping staff spoken to are aware of the whistle blowing and abuse procedures in the home. All were able to say what action they would take if they were concerned for the safety of a resident. Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 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 the following standard(s): 19,26 The home provides a comfortable and well-maintained environment for the resident’s. It offers appropriate aids and equipment to enable independence and meet the needs of the current residents. EVIDENCE: The home is purpose built, light, airy and furnished to a good quality, arranged over two floors with a passenger lift to enable access. On the ground floor there are fifteen bedrooms, three with patio doors onto the garden area. The top floor has thirty bedrooms, two of which are doubles. All rooms are provided with ensuite facilities. The décor, fixtures and fittings are in excellent order. Elm View Nursing Home DS0000020304.V272290.R02.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): 27,28,29,30 Resident’s needs are met by staff who are appropriately trained. The levels of staff are maintained or exceeded at times. Recruitment procedures are not always followed correctly to ensure protection. EVIDENCE: On the day of this visit there were two registered nurses and 10 carers plus catering and housekeeping staff on duty. In the office was an administrator and finance officer. Carers and housekeepers confirmed that there is always adequate staff on duty. New staff have an induction program that includes observation, monitoring and supervision to ensure safe practice. This training takes place over several sessions and the time taken to complete is dependant on the learning of the new employee. The registered manager is introducing a new induction programme based on the skills for life standards. This will be done for all new staff. The training program details were clear and easy to follow demonstrating excellent practice. There are currently fourteen staff members who are qualified at NVQ level two or three, with four staff members currently on the Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 17 course. Three at level 2 and one at level 3. The registered manager is expecting to complete her registered managers award within the next two months. Staff receive regular updates for their mandatory training, such as manual handling and food hygiene with certificates of the training held on the staff training files. Catering and house keeping staff also confirmed that they had adequate training opportunities. Courses completed included Health & safety, first aid and COSHH. The recruitment files of two new employees and two established employees were checked. In the new employees files no evidence was available to support that CRB checks had been carried out by the registered provider and only one written reference was obtained for each employee. One file also had employment gaps which the registered person should have investigated and recorded the findings as part of the interview process. The registered provider must ensure that no new employees are commenced until all required CRB disclosures and two written references are received. Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 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 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): 31,33,38 Residents benefit from the clear management structures within the home. Staff supervision is formalised and carried out using a cascade format and recorded. EVIDENCE: Dawn Higley is the registered manager of Elm View and is an experienced qualified nurse. She has nearly completed the Registered Managers Award. Belmont Care Limited send out questionnaires to relatives and residents to measure satisfaction of the care and service. Comments received from the questionnaire included: Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 19 “We find the whole set up excellent especially the meals and staff friendship received”. “I believe the staff at Elm View are hard working and caring”. Residents appear to appreciate the management structure of the home referring to Matron as their point of contact should they need to discus any issues they had about the home, or one of the other qualified nursing staff. Staff supervision is carried out using a cascade system. Dawn supervises the qualified nursing staff, who then take responsibility for the senior care assistants supervision and so on. Fire log book included test records for the fire alarm system at weekly intervals and emergency lighting. Fire risk assessments are in place. Records kept regarding fire drill recorded who attended. Bed rails on resident’s beds were mainly integral as the beds were new profile type variable height beds. Consent for use was filed in each care plan record. Other records checked included the accident records and hot water temperature records. All were completed satisfactorily. Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 20 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 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 21 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 OP9 Regulation 13(2) Requirement The registered manager must ensure that all prescribed medicines are administered and the administration or nonadministration is recorded on the medicine administration record with a code or initial of the registered nurse administering the medicines. The registered person must obtain two written references and a clear CRB disclosure for every new employee. Timescale for action 30/03/06 2. OP29 19(2)(b) Schedule 2 30/03/06 Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 22 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 OP7 Good Practice Recommendations The registered manager should ensure care plans are person centred and identify achievable outcomes that can be measured as part of the quality assurance system. Elm View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 View Nursing Home DS0000020304.V272290.R02.S.doc Version 5.0 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!