Inspection on 24/07/06 for Elmcroft

This inspection was carried out on 24th July 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elmcroft 22/02/06

Elmcroft 06/12/05

Elmcroft 17/02/05

Elmcroft 22/12/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Elmcroft Elmcroft 75 Washington Crescent Newton Aycliffe Durham DL5 4BE Lead Inspector Mr Leonard Hird Unannounced Inspection 24th July 2006 16:00 Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 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 Elmcroft DS0000007596.V304534.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 Adults 18-65. 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. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elmcroft Address Elmcroft 75 Washington Crescent Newton Aycliffe Durham DL5 4BE 01325 307479 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) Mr Ian Thomas Patterson Mrs Nicola Jayne Morgan Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: Elmcroft is a Residential Care Home providing residential care services for up to 3 adults in the Category of Learning Disability (LD). Elmcroft is part of a small group of homes owned by the Registered Provider Mr Ian Patterson. Elmcroft is located in a residential part of Newton Aycliffe and within walking distance of the town centre and its amenities. Elmcroft is a small terraced house providing suitable living accommodation for its residents. The accommodation at Elmcroft comprises of 3 single bedrooms, a communal bathroom, a kitchenette and a lounge/ dining area. There are small garden areas to the front and rear of the house, but there are no dedicated car parking spaces. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection of Elmcroft took place on the 24th July between 16.30 hrs and 19.30 hrs and the 21st August between 16.00 hrs and 19.00hrs. The inspection process considered all of the Key standard areas as identified by the Commission for Social Care Inspection within the Care Homes for Younger Adults National Minimum Standards. These Key standards are: Choice of Home (NMS2), Individual Needs and Choices (NMS 6,7 and 9), Lifestyle (NMS 12, 13, 15,16 and 17) Personal and Healthcare Support (NMS 18,19 and 20), Concerns Complaints and Protection (NMS 22 and 23), Environment (NMS24 and 30) Staffing (NMS 32, 34, 35) Conduct and Management of the Home (NMS 37,39 and 42). Comments were received from residents, the registered manager and members of the care staff team. What the service does well: What has improved since the last inspection? The home continues to provide a good standard of residential care and support to its residents. Elmcroft DS0000007596.V304534.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. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS2 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The Registered Manager at Elmcroft had ensured that prior to the admission of a resident to the home both the local authorities social care and health team and the home had carried out a full assessment of needs. EVIDENCE: From a review of individual residents care plans and files it was noted that a full assessment of needs had been carried out prior to admission. The local authorities social care and health team as well as the home had carried out these assessments of need separately before admission to the home. From these agreed assessments of needs, the home had in conjunction with the resident been able to develop an individual care plan that took account of the needs and aspirations of the resident. From a review of individual residents care plans and files it was noted that a full assessment of needs had been carried out prior to admission. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 9 The local authorities social care and health team as well as the home had carried out these assessments of need separately before admission to the home. Residents and where appropriate their representatives had signed the assessment documentation. From these agreed assessments of needs, the home had in conjunction with the resident been able to develop an individual care plan that took account of the needs and aspirations of the resident. This information was being maintained on the individual residents personal file. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 6 NMS 7 and NMS 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The system for care planning in the home is adequate and provides staff with enough information to assist them in meeting the needs of the individual resident. Residents were actively encouraged and supported to participate in the decision-making and risk taking process affecting their lives. Residents were being well supported by the home in their chosen areas of employment and day placement. EVIDENCE: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 11 The system for care planning in the home is adequate and provides staff with the information required to assist them in meeting the needs of the individual resident. Some of the care plans were not being kept fully up-to-date with an odd signature missing from the documentation. Residents were being actively encouraged and supported to participate in the decision-making and risk taking process affecting their lives. Regular house and group meetings were occurring, where residents could influence what went on in their lives e.g. the type of holiday, the activities they wanted to do and what they wanted to have on the menu. Records were being kept of these meetings. Daily informal meetings were also occurring where residents could make decisions as to what to watch on television and other events that occurred in the home The residents living at Elmcroft were being well supported by the care staff in their chosen areas of employment, education and day placements. One resident made comment that, ‘they were looking forward to changing their course at college’, another commented that, they enjoyed going out to work each day from the home. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 12 NMS 13 NMS 15 NMS 16 and NMS 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The routines of daily living and activities occurring at Elmcroft were varied, flexible and meeting the needs of the residents. The independence and personal choices of residents at Elmcroft were being actively promoted by the home. The dietary needs of residents were catered for with a balanced selection of home prepared food being made available. EVIDENCE: Residents had individually planned programs of activities that had been developed to take account of their interests. Activities ranged from visits to the local gym, visits to the Wishing Well Club, swimming, the gym and watching TV. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 13 During the inspection the Inspector went to see the residents take part in a swimming session at the local leisure centre. Residents were seen to be thoroughly enjoying themselves in a safe and controlled environment. If residents didnt want to take part any activity they didnt need to and flexible staffing levels enabled this to be accommodated. A resident commented that, they enjoyed going to the leisure centre to swim with their friends’. Another commented that, ‘it was good going to the baths, and having some fun . The residents of Elmcroft were going on a holiday cruise and coach trip arranged by themselves and the other homes in the group to Spain and France during September. A resident said that, ‘they were looking forward to the holiday and going on a large boat’ another commented that, ‘Disneyland was what they were looking forward to going to’. Residents attended a day or work placement where they engaged in activities with their peer groups. Families were encouraged by the home to visit their relatives either at the parental home or by taking them out. Records were being maintained appropriately of family contacts. Elmcroft had an open visitors policy in place. There were regular residents meetings being held enabling residents to influence decisions being made in the home e.g. choice of menus and choice of activity, as well as regular group meetings with the other homes. Records were being maintained of these meetings. A resident spoken with commented that, ‘the food was what they liked to eat’ All of the residents spoken with were aware of the need for healthy eating. The homes menus took account of the likes and dislikes of the residents but kept to a healthy eating programme, wherever possible. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 18 NMS 19 and NMS 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health needs of residents were being well met with evidence of good multidisciplinary working regularly taking place. No resident currently self-administers medication. EVIDENCE: A review of care plans confirmed that residents were receiving support and advice from appropriate health professionals when necessary. Individual care plans included detailed information about the involvement of doctors, dentists and other healthcare professionals. Elmcroft had appropriate policies and procedures on how to safely administer medication to residents for staff to refer to. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 15 Staff involved in the administration of medication had undergone an appropriate course in the Safe Handling and Administration of Medication. Records of this training and first aid training were been maintained on the individual members of staffs personnel file. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 22 and NMS 23 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to the service. There was an easy to read and suitable complaints procedure in place at Elmcroft and residents indicated that they felt confident that they could approach staff at any time with any problem they had. Elmcroft had an appropriate procedure for handling suspected cases of abuse available in the home and staff had received appropriate training in how to handle allegations of abuse. EVIDENCE: Elmcroft is part of a small group of family owned homes and there is a simple companies complaints policy and procedure in place. As a result of this complaints are handled according to the companies complaints procedure. A copy of this easily read document was available, at the home. No recent complaints had been made. Discussions with residents confirmed that if small problems arose then staff dealt these with quite quickly. One resident spoken with commented, ‘if they wanted to complain about anything then they would speak to the manager or a member of staff’. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 17 The company’s procedures on how to deal with suspected cases of adult abuse were available in the home. Staff had received training on how to deal with the Protection of Vulnerable Adults and records were being maintained of this training. In discussions with staff they confirmed that they were fully aware of the importance of acting quickly in cases of suspected abuse and that they would follow the homes policy and procedures if necessary. There had been no recent adult protection issues in the home. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 24 and NMS 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Elmcroft is clean, pleasant and hygienic and provides a very safe, homely comfortable environment for its residents to live in. EVIDENCE: Elmcroft was clean, tidy and free from unpleasant odours. Individual residents rooms had been decorated and furnished in a pleasant and homely manner and to the taste of the resident. Elmcroft was well decorated, furnished to a high standard and well maintained. Maintenance work undertaken on the homes equipment and facilities had been recorded appropriately. There were appropriate systems in place for infection control. and Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 19 The homes infection control policies and procedures were written in accordance with relevant legislation and professional guidance. It was confirmed by staff that they had received appropriate training in infection control and a record of this had been kept on their personnel file. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Elmcroft through its recruitment, employment and training procedures had ensured that only suitably qualified staff were employed the home. Staffing levels at the home were sufficient to meet the current assessed needs of the residents. EVIDENCE: The Registered Manager, had the required qualifications and experience to run the home. From a review of the staff rota provided it was noted that staff were being deployed in sufficient numbers as to ensure the current needs of the residents were being met. There was a commitment to training for all staff at the home and currently over 50 of the homes care staff had qualified at NVQ level 2 or above. The home tried wherever possible for staffing stability to ensure that the residents knew the members of staff, who worked in their home. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 21 Staff who had recently been employed had received appropriate induction training. There was a training programme operating in the home that provided training for staff in moving and handling, first aid training and the Protection of Vulnerable Adults. The home’s management through courses organised by the Durham Employers Care and Health Alliance had provided the training programme for staff and the home provided a copy of the training programme that staff could take part in. Records of training undertaken and completed by staff were maintained on individual members of staffs personnel file. All staff employed at the home had being recruited in accordance with the homes policies procedures. All of the appropriate employment checks prior to starting to work at the home had been undertaken and recorded accordingly. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS and 37 NMS 39 and NMS 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Elmcroft had in place, a variety of quality assurance systems, including resident meetings to enable residents to express their views. Elmcroft actively promotes the health, safety, protection and welfare residents EVIDENCE: Records of individual staff and management supervision sessions were being maintained securely and staff confirmed that they had received copies. There were also regular staff meetings and group supervisions being held to enable the staff group to develop their own individual roles. of the Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 23 From discussions with staff it was confirmed that they were aware of the management structure within the home. Records were being maintained of the regular health and safety checks when they had been completed. There are monthly monitoring visits carried out by the senior manager in the group and records are maintained of these visits. Elmcroft does not currently undertake in-depth surveys of residents, visitors or visiting professionals to find out their views of the home and the care provided. Elmcroft DS0000007596.V304534.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000007596.V304534.R01.S.doc 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elmcroft Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 25 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 YA6 Regulation 15(2)(b) Requirement The Registered Manager must ensure that residents care plans are kept up to date. Timescale for action 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA39 Good Practice Recommendations It is recommended that the home undertake surveys of residents, visitors of visiting professionals to find out their views of the home and the care provided. 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