Inspection on 17/11/05 for Elmhurst

This inspection was carried out on 17th November 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 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

Elmhurst 03/03/08

Elmhurst 27/09/07

Elmhurst 17/08/06

Elmhurst 09/03/06

Elmhurst 10/02/05

Elmhurst 17/08/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Elmhurst Priory Road Ulverston Cumbria LA12 9HU Lead Inspector Jenny Donnelly Unannounced Inspection 17 November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Elmhurst DS0000036576.V259067.R01.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. Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elmhurst Address Priory Road Ulverston Cumbria LA12 9HU 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) 01229 894115 Cumbria Care Mrs Jayne Allonby Care Home 40 Category(ies) of Dementia - over 65 years of age (30), Old age, registration, with number not falling within any other category (40) of places Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 40 service users to include: up to 40 service users in the category of OP (Old age, not falling within any other category) up to 30 service users in the category of DE(E) (Dementia over 65 years of age) When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 10th February 2005 3. Date of last inspection Brief Description of the Service: Elmhurst is a purpose built locally authority care home. Cumbria County Council own the home, which is operated by Cumbria Care. Mrs Jayne Allonby is the registered manager. Elmhurst is a single storey building situated 15 minutes walk from the centre of Ulverston town. It is divided into four units of 10 bedrooms. Each unit has its’ own dining lounge, two bathrooms and a toilet. There are four bedrooms with an en-suite bathroom, and two with adjoining doors for married couples or siblings. Three of the units cater for people with dementia, and the other unit is for the physically frail. The three dementia units have open access within the home, but no free external access. Elmhurst has a small smoking room, and a pleasant secure garden. Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and over the lunchtime period. I spent time on each of the four units, talking to residents and staff, and viewing care plans. On each unit one care plan was studied in detailed, and others briefly looked at. I saw lunch being served on three of the units. I spent time with the manager looking at staff files, policies and discussing the management of medicines. What the service does well: What has improved since the last inspection? There were four requirements made at the last inspection. These related to the information for visitors about the home, residents’ care plans, quality assurance audits and formal staff supervision. The manager has addressed all these issues, and brought the home up to the required standard in each of these areas. There was good information about the home on display in the foyer. Residents’ care plans were detailed and up to date. Quality surveys had been sent out to relatives, and the results of these had been acted on. The latest survey showed an improvement in the number of positive responses. Formal staff supervision was programmed to take place at regular intervals, following a set format. Senior staff had received training in how to do this. As detailed above, general communications with relatives and other visitors had improved. This has reduced the previous high level of complaints to nil. Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 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. Elmhurst DS0000036576.V259067.R01.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 Elmhurst DS0000036576.V259067.R01.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 and 3 There was good information about the home available for visitors and prospective residents. Assessments had been carried out for all new residents, to ensure Elmhurst would be suitable for their needs. EVIDENCE: Cumbria Care had produced a corporate Statement of Purpose, which was on display in the foyer. This had been made individual to Elmhurst, having all the relevant details inserted by the manager. This was now an informative and easy to read document. There were assessments on file showing what each resident’s needs were. These had been completed prior to the person being admitted to Elmhurst, to ensure only people the home was suitable for, were offered a place. Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 9 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 and 9 The health and personal care needs of residents had been assessed and clearly recorded. There was evidence that people were receiving good personal and health care. The management of medicines needs to be monitored, as problems with overstocking could lead to mistakes being made. EVIDENCE: Residents all looked care for and nicely presented, having been assisted to wash/bath, shave and do their hair. Residents were dressed in the clothes they liked, whether this was a shirt and tie or something more casual. Care plans followed a corporate style, which staff had received training on. The plans listed the supervisor and named carer responsible for each resident. Care plans had been checked and updated at least monthly. They contained detailed information on what care each resident required and when. They were individual to each resident, and recorded the things important to that person. Staff had started making “life histories” for residents, which families were helping with. These included important life events and photographs, and were being enjoyed by the residents. This is important in helping staff see beyond Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 10 the dementia, to the person, who they were and what they have achieved in their life. There was evidence of good liaison with health professionals, such as doctors, the intermediate support team and community nurses. Where residents required any nursing input, the community nurse was involved. The nurse arranged for any special equipment needed, to be loaned to the home. Several residents saw the community nurse regularly for general monitoring, and some for wound care. Inspection of the medicines storage showed problems with overstocking. This means too much medicine was being ordered or supplied for residents. Some of these medicines were returned to the pharmacy, and therefore wasted. Some medicines in use had been issued months ago. This made it difficult for staff to check if the medicine was being used up at the correct rate. It could also create problems if the dose had been altered, and an old bottle with different instructions on the label was being used. The manager was aware of this problem and had held meetings with the pharmacist and doctor to try and resolve it. The manager is required to monitor and prevent overstocking, as it could lead to mistakes, which will adversely affect residents. Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 11 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 and 15 Residents were enabled to spend their days as they liked, and there were opportunities for social stimulation and activity. Residents said there was a good choice of meals and that the quality of the food was good. EVIDENCE: This inspection took place during the late morning, and although the majority of residents were up and dressed, some had chosen to have a lie in. Staff knew those residents who enjoyed lying in bed in the morning, and left them to do so. Another resident was staying in bed due to having had poor nights’ sleep, and two others because they were poorly. A late breakfast was available. Residents in the three dementia care units had free access round those units, were known by all staff and able to come and go as they pleased. There was a keypad lock on the physically frail unit to prevent the dementia clients going in there, where there was access outside. Staff on all units said they organised their own activities during the morning depending on what residents fancied. Today was hairdressing day, so there was no other planned activity. Many residents said they enjoyed going to the hairdresser, and looked forward to it each week. Organised activities were discussed and planned at the residents meetings. There was a weekly bus trip, a monthly visiting entertainer and periodic trips Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 12 to shows in Barrow in Furness. One lady had talking books supplied through the post by the blind association. Menu changes and food preferences were also discussed at residents meetings. Residents said they liked this meeting as it made them feel important and listened to. Lunch was seen being served on three units. Meals were taken to the units from the kitchen in hot trolleys, and plated by the unit staff. Residents chose from the menu each day. There were two main choices, and other alternatives were available as requested. Special diets and personal preferences were well catered for. Residents said, “the food is very good”, “there’s lots of choice”, and “diabetics get special meals”. One resident liked to help set and clear the dining tables and staff encouraged her take part as she enjoyed doing it. Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 13 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 and 18 The complaint system was easy to use, and the manager made herself available to residents and visitors. Staff were aware of their responsibility to protect residents from abuse. EVIDENCE: The homes’ complaints procedure was on display. The manager said she had not received any complaints since she came into post in January 2005. Prior to this the home had received frequent complaints. The manager thinks this reduction is due to better communication with residents’ families, which she has promoted. The manager had completed a full Protection of Vulnerable Adults training course (abuse). The seniors had covered an element of this, and carers attended abuse awareness training. All staff had been issued with a copy of the multi-agency guidelines on adult abuse. Elmhurst had experienced one adult protection case this year, where a resident was harming another resident. The manager had worked with social services department, and the relevant health professionals, to seek a speedy resolution to this. Since then, staff have been more aware of adult protection issues. Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 14 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, 20, 21 and 26 Residents live in safe, comfortable, clean and well-maintained home, with adequate communal facilities and space. EVIDENCE: The home is well laid out in four units on ground level, allowing those residents with dementia, free movement around the home. Other residents had free access out of the building. The building was in a good state of repair and décor. There was no permanent maintenance person based at the home. All repairs and maintenance was done through a contracted company. The manager said this worked well and urgent matters were attended to on the same day. The dining lounges were comfortable and cosy on this cold day. Music or television was playing, as the residents requested. There was a separate smoking room. Each unit had two bathrooms and a separate toilet. Two cleaners were on duty. There were normally three, but one was ill. One of the cleaners said they would do what they could between them, and felt Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 15 they would get round all the units. The home appeared clean and fresh smelling. The carpet-shampooing machine was out of order, and awaiting a new part. In the meantime arrangements had been made to borrow equipment from another home. Although not ideal this was working in the short term. Elmhurst DS0000036576.V259067.R01.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 and 30 There were sufficient numbers of motivated staff on duty to meet the needs of residents. Staff had received training to enable them to do their jobs. EVIDENCE: When the new manager started, recruitment and retention of staff was very difficult. At that time the home had 11 staff vacancies. There were no vacancies at this time. The home was staffed with two carers on each of the three dementia care units, and one carer on the unit for the physically frail. There was one other staff member who helped where needed, and acted as quality checker for the medication rounds. In addition to these were, the manager and supervisor, plus kitchen and domestic staff. The morning ran smoothly on all units, and staff felt they had adequate time to spend with people. The units were calm, and there was friendly conversation between staff and residents. Residents said that staff were “very nice”, “they come if you ring the bell, which I do by accident, but they never mind”. Some staff had attended a two-day dementia-training course. This had led to the work being done on creating “life history” books with the residents. Nine of the 40 care staff had achieved an NVQ in care at level 2. A further 11 care staff were registered to undertake an NVQ, through the college or local training organisation. Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 17 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 and 36 The manager was competent to run this home, and the staff group were well supervised. Through the quality assurance system, the manager constantly seeks residents’ views about the way the home is operated. This ensured that Elmhurst was run in a way that benefited residents. EVIDENCE: The manager, Jayne Allonby, is registered with CSCI, and is suitably experienced and competent to run the home. She is currently undertaking a Registered Managers award as recommended for care home managers. Elmhurst had good quality assurance systems in place. These comprised of residents meetings, satisfaction surveys and management audits. Through these the manager could pick up any areas of concern and address them. Not many residents were able to complete satisfaction surveys, so these were mostly aimed at relatives. The most recent survey showed very positive Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 18 responses, which was a marked improvement from last year. Residents were able to express their views through conversation with staff, and through the residents meetings. Residents knew the manager by name, and said she was “excellent”. Management audits were used to quality check standards in the kitchen and the general cleanliness of the home. Formal staff supervision was taking place through a set structure. Each staff member received a full appraisal twice a year, with supervision sessions in between. These sessions concentrated on certain of the homes’ policies in turn, and on any particular training needs. Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 19 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 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X X Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 20 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 manager must ensure that medicine stocks match residents requirements, and that the home does not hold excess medicines stock. Timescale for action 31/12/05 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 Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Elmhurst DS0000036576.V259067.R01.S.doc Version 5.0 Page 22 - 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. 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