CARE HOME ADULTS 18-65
Elmcroft Elmcroft 75 Washington Crescent Newton Aycliffe Durham DL5 4BE Lead Inspector
Mr Leonard Hird Unannounced Inspection 6th December 2005 09:30 Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 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.V257850.R01.S.doc Version 5.1 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.V257850.R01.S.doc Version 5.1 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.V257850.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 17th February 2005 Brief Description of the Service: Elmcroft is a family owned and run home that aims to provide care in a friendly and homely atmosphere. The home is registered to provide residential care services for up to 3 persons in the category of learning disability. The home is located in the residential part of Newton Aycliffe and is within walking distance of the towns amenities. Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Elmcroft is a family owned and run home that aims to provide care in a friendly and homely atmosphere. The home is registered to provide residential care services for up to 3 persons in the category of learning disability. The home is located in the residential part of Newton Aycliffe and is within walking distance of the towns amenities. What the service does well: What has improved since the last inspection?
The registered manager had completed the appropriate training to national qualification level 4 in care and undertaken other training in residential care. The home had developed in conjunction with other members of the group a new care planning system that is more user friendly for both staff and residents. Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 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.V257850.R01.S.doc Version 5.1 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.V257850.R01.S.doc Version 5.1 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): 1, 2 and 3 The systems used by Elmcroft for admission to the home are clear and easy to understand. They also provide prospective residents and their relatives with clear information that enables them to make an informed decision as to whether the prospective resident wished to move in. EVIDENCE: The home had a comprehensive and up-to-date Statement of Purpose and Service User Guide. This documentation was found to be both user-friendly and readily available for both residents and their relatives. Those care plans examined contained information to show that residents admitted to the home had, had a full pre- assessment carried out by persons trained to do so prior to their admission. The registered provider confirmed that any admission made to the home was done so on a gradual basis to allow the resident and their family to make an informed decision as to whether the resident wished to come and live at the home. The resident and their relatives were encouraged to spend time in the home to get to know both the residents and the staff living and working there before they moved in as well as seeing how the prospective resident interacted with the other residents. The registered provider confirmed that the home did not admit residents if the home did not have the capacity to meet the individual needs of residents as identified in the pre-assessment process. Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 9 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): 6, 7 and 8 The system for care planning in the home was found to be adequate in providing staff of the information required to meet the individual needs of the service users. EVIDENCE: Care plans examined had been compiled from assessments carried out prior to admission and re-assessments had been undertaken on those residents who had lived in the home for many years. The information contained in these care plans enabled staff to meet the needs of the resident. Regular internal reviews were being undertaken by the home on the individual resident and care plans examined contained information to show that residents had been consulted with in this process. Care plans also contained risk management strategies and plans to ensure that the resident had the opportunity to partake of an independent lifestyle. Staff confirmed during discussions that they had received training in how to deal with both confidentiality and the other personal information that they had knowledge of that related to the individual resident. Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 10 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): 11, 12, 13, 14, 16 and 17 The links and contacts established by the home within the local community were found to be supporting and enriching the residents educational and social opportunity. The meals in the home were found to offer both choice and variety as well as catering for residents with special dietary needs. EVIDENCE: There was evidence available to show that residents took part in a wide range of leisure, social and cultural activities and these activities were being well supported by staff. The home has its own transport available to enable residents to visit facilities and events in the wider community. Records of all activities attended by individual service users were being maintained by the home. It was confirmed by residents, staff and management that the home supported residents in maintaining contact with their friends, relatives and acquaintances. Residents were being encouraged to visit their families and friends on a regular basis and wherever possible to stay with them.
Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 11 Dining arrangements were both comfortable and homely in nature. The residents were encouraged wherever possible to help in the preparation of their meals. Records were being maintained of menus that were being used by the home. Residents were being encouraged to assist in the choice of meals available on the menus and records of these different choices of food were being kept. Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 12 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): 18, 19 and 20 The health needs of residents were being well met with evidence of good multidisciplinary working taking place on a regular basis. The home manages medication in a positive manner and encourages good health. EVIDENCE: Evidence was available to to show that both the physical and emotional needs of the individual residents were being met. Records were being maintained of regular visits to the local GPs , opticians and other healthcare professionals on the individual residents care plan. A policy and procedure was in place for the safe handling and administration of medication that took account of the individual residents capacity to self medicate both at the home and when attending their individual placements or employment. Staff had undergone appropriate training in the safe handling and administration of medication and records of this training were being maintained on their personnel file. Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 13 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): EVIDENCE: This section was not assessed at this inspection. Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 14 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): EVIDENCE: This section was not assessed at this inspection. Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: This section was not assessed at this inspection. Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 16 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): 41 and 42 The policies and procedures being used in the home were safeguarding the rights and interests of the individual resident as well as ensuring their health , safety and welfare. EVIDENCE: Records were being maintained in the kitchen of the temperatures of food, the purchase of food and the temperatures of both cooking and refrigerated storage areas. Accidents records to both residents and staff were being maintained appropriately. The home sent in the Regulation 37 notifications of death, illness and other events occurring within the home as required by the Commission for Social Care Inspection The registered provider and manager were ensuring so far as is reasonably practicable, the health, safety and welfare of both service users and staff was being met. There were policies and procedures in place for staff to act on to ensure that they were aware of how to deal with issues when residents went missing from the home, fire drills and practices and the protection of vulnerable adults.
Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 17 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 3 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 3 12 4 13 4 14 4 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X X X 3 3 X Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 18 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. 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 Elmcroft DS0000007596.V257850.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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