Inspection on 19/07/05 for Elmhurst

This inspection was carried out on 19th July 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 14/04/08

Elmhurst 04/04/07

Elmhurst 06/02/07

Elmhurst 21/02/06

Elmhurst 15/03/05

Elmhurst 25/05/04

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

CARE HOMES FOR OLDER PEOPLE Elmhurst Windhill Bishops Stortford Hertfordshire CM23 6NF Lead Inspector Alison Jessop Unannounced 19 July 2005 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. Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Elmhurst Address Windhill, Bishops Stortford, Hertfordshire, CM23 6NF 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) 01279 713100 01279 713161 Quantum Care Limited Mr Peter Meredith CRH Care Home 61 Category(ies) of DE(E)-61, LD(E)-61, OP-61 registration, with number of places Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are none. Date of last inspection 15 March 2005 Brief Description of the Service: Elmhurst is a residential care home providng accomodation for up to 61 service users. The home is purpose built and offers single occupancy with en-suite facilities and is divided into four units, one of which is a specialist Dementia Care Unit. Elmhurst is situated close to Bishop Stortford town centre and easily accessible using public transport services. It is run by Quantum Care Ltd. Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over half a day by one Regulation Inspector. A lot of feedback was gained from service users, staff and visitors, all of which was very positive. The manager of the home was available to answer questions. On the day of the inspection a small gas leak had been identified in the main kitchen area and was being rectified. There appeared to be little disruption and lunch continued to be served at it’s usual time with small implementations made to the menu. The home currently holds a waiting list. What the service does well: What has improved since the last inspection? The manager has implemented new care plans on the dementia care unit which will soon be implemented on the other units. They are very detailed and particular attention is paid to the service users personal history and their individual preferences. Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 6 Two of the kitchenettes have undergone complete refurbishment and the new beech units offer a bright spacious area for staff to prepare light snacks and drinks. Two further kitchens are due to be replaced in the near future. The cook has been given a list of specialist dietry requirements and conditions that may be affected by certain foods. 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 I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 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 Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 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) 1,2,3,4,5 & 6 The atmosphere in the home is relaxed offering a welcoming environment to prospective service users. A comprehensive assessment along with information from other professionals ensures that the service is appropriate to their assessed needs. EVIDENCE: Service users confirmed that they were given the opportunity to visit the home before making a decision. One gentleman stated that his daughter came to look around on his behalf. One resident has completed his trial period, a review has been held and he has made a decision to move into the home permanently. His daughter stated that she has been involved in the process and said that she has also felt supported by the staff team at the home. The service said user said ‘I have settled in very quickly here, the carers are very supportive, especially my keyworker.’ The home does not provide Intermediate Care. Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 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 standard(s) 7, 8, & 10 New Care Plans introduced on the Dementia Care Unit offer more detailed and comprehensive information. This ensures that specialist, individualised care can be provided to service users. Care staff are unobtrusive and sensitive in their approach. EVIDENCE: The new care plan format which has been introduced on the dementia care unit provides in depth detail of a service users social history. It also provides detailed descriptions of individual preferences. This is due to be introduced on all units in the near future. Some risk assessments in relation to specific areas such as the use of chair straps were unavailable however the manager stated that these have been completed. Care practice observed in the home was dignified and sensitive. Care staff have a relaxed approach and service users, particularly those who have dementia appeared to be relaxed and content. One new service user has stayed at several other residential care homes but has not been able to live there permanently as she has been very unsettled and the previous homes have not been able to manage her behaviour. She has settled in very well at Elmhurst and although spends most of her day walking Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 10 around the home, she appears not to be agitated. She has through individual care and attention, spent time reading a book, this was a pleasing sight to her husband who said that she has not done this for a long time. Various systems have been implemented to protect her safety and the other service users privacy. On arrival at the home a service user was sitting near to the front door, saying he would like to get a taxi to the bank as he has not been able to go for three years. The manager explained that they try to discourage him from going out alone as he has mobility problems and has fallen in the past. The manager stated that staff could go with him but advance notice is required as staffing arrangements would need to be made. Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 & 15 Staff appear to have difficulties in motivating service users to join in with planned activities, thus creating the impression that activities are inappropriate. More individual activities could ensure that appropriate levels of stimulation are offered. EVIDENCE: A three-day activity programme is displayed in each unit. The activities planned for the three days ahead were sewing and knitting group, a film day and cards and dominoes. A cream tea afternoon is planned for August and several service users had been on a trip to Hatfield Forrest. On the afternoon of the inspection the activity co-ordinator was observed assisting a service user on the dementia care unit to do a jigsaw puzzle. Another service user sat with them as they chatted to each other. The activity co-ordinator stated that its difficult to motivate the service users to do activities however she has planned to do more individualised activities in the future. One service user said ‘there is a lack of activities’. I asked whether they had been consulted with about activities, they stated that they don’t have the opportunity to make suggestions as they do not have residents meetings. The manager has attempted to set up a committee in the home, this would enable residents meetings to be more focussed and beneficial however no Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 12 interest has been shown from service users. The ‘Friends of Elmhurst’ is currently being set up. Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 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 standard(s) None of the above standards were inspected on this occasion. EVIDENCE: Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 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 standard(s) 19,20,21,22,23,24 & 25. The home and its surroundings offer a pleasant, comfortable and safe environment to its service users. The home is extremely clean and well maintained and bedrooms are personalised offering a homely, lived in feel. EVIDENCE: The home is very well maintained and a dedicated and enthusiastic team of domestic staff and a handy man clearly work hard to maintain high standards. The lounge areas look warm and inviting and individual ornaments and pieces of furniture belonging to the service users offer a really homely feel. The specialist equipment around the home has been maintained and is adequately stored. Service users bedrooms are personalised and a large number of service users were observed enjoying the privacy of their own space in the afternoon. Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 15 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) None of the above standards were inspected on this occasion. EVIDENCE: Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 16 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, 32, 33 & 38 The manager who has worked at the home for a number of years continues to have a positive impact on the home, he has an open relationship with his team creating a positive ethos. He continues to implement new systems improving standards and adapting to service users changing needs. EVIDENCE: The home is very well maintained and provides a safe and secure environment to its service users staff and visitors. One service user stated ‘The manager is very approachable, I can talk to him like I am talking to you’. Staff spoken to confirmed they have received on going health and safety training and supplies of gloves, aprons, and clinical waste facilities were plentiful. Although fridge/freezer temperatures were being monitored in the kitchenettes, some of the fridge freezers contained opened perishable items that had not been dated on opening. Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 17 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 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 4 3 3 3 3 3 3 x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 3 x x x x 2 Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 18 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 38 Regulation 13(4)(c) Requirement All refidgerated food items must be dated on opening. Timescale for action From 19/7/05 and henceforth. 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. 2. Refer to Standard 21 12 Good Practice Recommendations Review storage facilities and remove excess equipment from shower rooms and the main lounge so that these areas are fully available to service users. More creative ways to motivate and involve service users in activites should continued to be sought. Elmhurst I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City, Herts AL7 3BQ 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 I52 s19335 Elmhurst v238795 190705 Stage 4.doc Version 1.40 Page 20 - 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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