Inspection on 23/05/05 for Elmglade

This inspection was carried out on 23rd May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Elmglade 19/06/07

Elmglade 03/04/06

Elmglade 15/11/05

Elmglade 06/07/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Elmglade 399 London Road North Cheam Surrey SM3 8JH Lead Inspector Deborah Yapicioz Announced 23 May 2005 09:30 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 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. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Elmglade Address 399 London Road North Cheam Surrey SM3 8JH 020 8393 5593 Telephone number Fax number Email 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 Tissa Nihal Atapattu & Mrs Nelum Vijayanthi Atapattu Mr Tissa Nihal Atapattu Care Home 10 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (10) of places Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19/01/05 Brief Description of the Service: Mr and Mrs Atapattu own Elmglade. The home is registered with the Commission to provide personal care and support for up to ten older people, not falling within any other category, and ten older people with associated dementia/cognitive impairments. The home currently has eighteen service users. The home itself is a large detached property (formally two houses joined together) situated in a residential area of North Cheam. Built over two floors it comprises of sixteen single and two double bedrooms. There are two separate dinning areas/open plan lounges on the ground floor and sufficient numbers of bathroom and toilet facilities are conveniently located throughout the home. The home also has a well-maintained garden with a fishpond. There is ample space for parking vehicles in the front drive. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was Announced and started at 9.30 a.m. The inspection took place over one day and the registered manager was present. The home was inspected under the National Minimum Standards Care Homes for Older People. The home is registered to provide care to twenty service users. On the day of the inspection there were eighteen service users in residence. There is one vacancy and one service user in hospital. The inspection was spent meeting with the home manager, examining records, talking to the service users and members of the staff team and a tour of the premises. Over the past twelve months the homes insurance company has being monitoring the home for subsidence. Underpinning to part of the home is due to start in the early June. Since the last inspection, there has been one complaint, which was investigated by the Commission For Social Care Inspection. This resulted in a number of requirements and recommendations being set. What the service does well: What has improved since the last inspection? The home has introduced a quality Assurance survey since the last inspection and the manager is now looking at ways of implementing the suggestions from the survey. The manager has started the process of redecorating the home. This will be completed when the underpinning is complete. Three members of the staff team have completed medication training. Three other staff have applied to do the course later in the year. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 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 standard(s) 1,2,3,4 The home provides good information and introduction opportunities for prospective service users and their families to make an informed choice about moving to the home. EVIDENCE: The home has a statement of purpose and a Service users guide in place. Service users are only admitted to the home once a full assessment of their needs is completed. The service users files looked at during the inspection all contained assessments completed before the service users moved into the home. The home manager stated that any new service user would only be admitted once a full needs assessment and a care plan are completed by an appropriate person. The service user and their family (if it is appropriate) are involved and consulted in each stage of the admission. The home has compiled their own Preadmission procedure for new service users, which they would complete alongside the care managers assessment. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 9 The home manager would usually visit the prospective service user in his or her own home or hospital in order to carry out an assessment before a ‘trial’ period of residence would be offered. The homes assessment covers areas such as medical history, contact details, personal preferences and food (likes and dislikes). The home has a contract in place, which includes rooms to be occupied, who is liable for breech of contract, fees, complaints and the trial period. This home does not offer intermediate care therefore standard six does not apply. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 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 standard(s) 7,8,9,10,11 The service users have individual care plans, which are regularly updated and detailed their care needs and personal goals. EVIDENCE: Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 11 The home uses an “Assessment for Good Care Planning” format in conjunction with the existing ‘Cardex’ system. The format has ample space to set out in detail action that needs to be taken by staff to ensure the health, personal and social care needs of the service users are being met. The inspector noted that the care plans can also be updated on a monthly basis to reflect changing needs, and includes a section for carry out risk assessments, preventing falls and pressure sores. Since the last inspection three senior members of staff have completed “Opus” medication training. Three more staff members are due to attend the course. The care plan format contains a section for recording appointments with General Practitioners and other health care professionals, including district nurses, opticians, dentists etc. There were some gaps in the Medicine Administration Record sheets on the day of the inspection. The home has a returned drugs book and entries were signed. The service users preferred term of address is also recorded on their file and used by the staff team. There are curtains in shared bedrooms for screening when personal care is being given. The manager stated that all new members of staff receive as part of their structured induction training in how to treat service users with respect and dignity at all times Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 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 standard(s) 12,13,15 The daily routines and house rules promote residents’ rights and take into account their social and cultural needs and encourage independence. Dietary needs are catered for with meals that are nutritionally well balanced, nicely presented, and based on the service users food and drink preferences, providing them with daily variation and healthy eating options. EVIDENCE: There is an activities programme in the home, which includes activities such as gentle exercise and bingo. The home occasionally provides outside entertainers. The service users at Elmglade are offered three meals a day as well as morning and afternoon tea’s. The day’s menu is written up on the notice board. An alternative to the main meal on offer is also provided. Having examined a random sample of menus it was clear that a wide variety of well-balanced, nutritional food was available in plentiful supply. The service users can choose where they want to eat and many choose to have breakfast in bed. The manager stated that the menus are changed on a regular basis. Any dietary needs are recorded in the service users care plan. The home keeps a record of all food consumed by the service users. Service users are encouraged to remain in contact with family and friends who can visit regularly. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 13 Family and friends are made aware of the home’s visiting policy and there are few restrictions about when people can visit. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 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 standard(s) 16,18 There is complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: Elmglade has a complaints procedure, which outlines how a complaint is dealt with and timescales for action. The complaints procedure is included in the service uses guide. The home keeps a record of any comments or complaints made about the service. There have been eight complaints since the last announced inspection. There has been one complaint referred directly to the Commission for Social Care Inspection. The home has a vulnerable adults policy and any concerns would be referred in line with the Vulnerable Adults Procedure. The home has a copy of the local authority Adult Protection Policy on site. Staff have all received appropriate training. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 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 standard(s) 19,20,21,24,25,26 Generally the home is homely and bright, and provides the service users with comfortable surroundings that they say meets their needs. A locked door policy needs to be developed based on risk assessment to give the service users greater freedom. Attention needs to be paid to both the cleaning of the home and general décor to ensure a safe environment. EVIDENCE: Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 16 The home was originally two semi-detached houses that have been joined together. The home is built over two floors and there is no lift. Access to the second floor for service users unable to use the stairs is via a stair lift fitted to the staircase nearest the kitchen. The home has two large lounge/dinning areas on the ground floor, which are suitable for the range of interests and activities preferred by service users. Communal areas appeared comfortable, and furnished appropriately to a satisfactory standard with adequate facilities for service users and their visitors to meet in private. There is also a large garden with seating to meet the service user needs. On the whole furnishings and fittings were of a satisfactory quality. In the morning of the inspection the smell of urine was noticeable on the ground floor of the home. The homeowner is aware of the issue and is investigating the cause. The homes insurance company has monitored the home for subsidence. Underpinning to part of the home is due to start in the early June. The home manager is reminded that risk assessments should be completed for the area that is being underpinned. Some areas of the home have been redecorated since the last inspection and the home manager stated that the remaining areas would be done once the underpinning is complete. The home has sixteen single rooms and two doubles. At previous inspection the home the home manager has been asked to develop a “localised” locked door policy to protect individual service users rights to choice of freedom and movement. The policy is not yet in place and needs to be actioned. The home manager must also ensure the homes radiators are appropriately guarded. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The staff team at the home have a range of skills and abilities, which enable them to meet the needs of the service users living at the home. The appropriate Criminal Records Checks for all staff are not all in place and this may put residents at risk from employees who are unsuitable to work with vulnerable adults. EVIDENCE: Six members of staff at the home have completed or are in the process of completing National Vocational Qualification at level two or three. The home manager is also in the process of completing National Vocational Qualification level four. All new staff completes an induction when they begin working at the home. The home manager has previously gone through an “Umbrella organisation” to get Criminal Records Check checks for all staff. The home manager explained that he has recently had some problems with the organisation and the home is now able to apply directly for staff Criminal Records Check checks. All staff members have had Criminal Records Checks applied for, although they have not all been received back at the home. The home manager must follow this up as a matter of urgency. The home has a rolling programme of staff training in place including issues such as dementia care, moving and handling and medication training. Three staff ate on duty at the home during the day as well as the home manager. At night two staff are on duty. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,34,36,38 Although the management style appears open with clear lines of accountability, which is aimed at ensuring the well being of the service users., Staff supervision is spasmodic and appears on an ad hoc bases which could have an adverse effect on service users care. EVIDENCE: Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 19 Mr Atapattu, the registered manager, is a psychiatric nurse (RMH) and has substantial experience in a care setting. Mr Atapattu has completed a business plan for the year. The home has introduced a quality Assurance system since the last inspection and the manager is now looking at ways of implementing the suggestions from the survey. Records held at the home confirm that the staff supervisions are not being carried out as often as required. The recorded supervision sessions should be kept in greater detail and cover all aspects of practice; philosophy of care in the home, and career development needs of the staff. It was suggested at the previous inspection that it would be easier to keep the level of supervisions up to date if other senior staff were trained to carry out supervisions. All the homes baths have been fitted with thermostatic mixer valves to ensure the temperature of the hot water is constantly close to a safe 43 Degrees Celsius. The home has completed a fire risk assessment and fire drills are up to date. Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x x 2 2 2 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 Standard No 16 17 18 Score 3 x 3 3 x 3 3 x 2 x 3 Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 21 yes 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 36 Regulation 18(2) Requirement The registered person must ensure that recorded supervisions are kept in greater detail and cover all aspects of practice; philosophy of care in the home, and career development needs of the staff Carried ober from previous inspection. The registered person must ensure the home develops a ‘localised’ locked door policy that protects individual service users rights to choice and freedom of movement. In addition, all the homes service users who are willing and able to access the keypad system must be provided with a key and/or the code, unless a risk assessment suggests otherwise Carried over from previous inspection The home manager must ensure the homes radiators are appropriately guarded in bedrooms as well as bathrooms Carried over from previous inspection The registered provider must ensure the home is kept free of offensive odours Carried over Timescale for action 31/07/05 2. 24 13(4), 15(1) & 17(1)(a), Sch 3.3(q) 24(1,2& 3) 31/07/05 3. 25 13. -(4) (a) 30/08/05 4. 26 16. -(2) (k) 31/07/05 Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 22 from complaint investigation. 5. 6. 7. 36 29 9 18(1) 7 Sch 2.1, 2.2, & 2.3 17 (1)(a) Sch 33. (I) recorded supervisions must 31/07/05 occur at least six times a year. Criminal Record Bureau checks 31/07/05 must be held on site and made available for inspection. The registered person must 31/07/05 ensure medication administration records are correctly filled in at all times. 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 36 Good Practice Recommendations The inspector recommends that the registered person should consider training sufficient numbers of the senior staff team carry out supervisions to ensure each member of staff receives at least six a year Carried over from previous inspection The inspector recommends that the registered provider keeps a more detailed record of maintenance and repairs which will include the date equipment is reported out of order and the date of repair. Carried over from complaint investigation 2. 26 Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor, Grosvenor House 125 High Street, Croydon CR0 9XP 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 Elmglade G53-G53 S07141 Elmglade V186680 230505 Stage 4.doc Version 1.20 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. 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