Inspection on 09/03/06 for Elmhurst

This inspection was carried out on 9th March 2006.

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 17/11/05

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 9th March 2006 12:30 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.V282906.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 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.V282906.R01.S.doc Version 5.1 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 www.cumbriacare.org.uk 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.V282906.R01.S.doc Version 5.1 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. 17th November 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.V282906.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place throughout the afternoon. I spent time on each of the four units, talking to residents, visitors and staff. I spoke with the manager, and looked at staff files, policies and procedures, residents’ finances and the home’s maintenance records. I checked through the medicines records and stock, and spoke with the cook. Some residents were attending the hairdresser; others were enjoying time with their visitors, listening to music or watching television. Staff were evident on each unit, chatting with residents and making them drinks. The home had one resident vacancy. Any key standards not inspected at this time, were checked and found satisfactory at the last inspection of November 2005. What the service does well: What has improved since the last inspection? One requirement was made at the last inspection about the home overstocking with medicines. This was not solely the homes’ fault, and the manager had tried to rectify the matter with the prescribing doctors and supplying pharmacist. Since the last inspection the manager had continued to monitor this and immediately return any medicines, which they had not ordered. This has greatly reduced the amount of unnecessary stock in the home, which reduces the risk of staff making medication errors. The requirement has been met and is removed from this report. Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 Page 6 The home had purchased some new equipment, including a new hoist and a specialist bed. 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.V282906.R01.S.doc Version 5.1 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.V282906.R01.S.doc Version 5.1 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): EVIDENCE: No standards in this section were inspected. Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 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): 9 and 10 The management of medicine stock in the home had improved since the last inspection. Residents received their prescribed medication in a safe and timely manner. Residents’ rights to privacy were being upheld, and residents felt they were treated with care and respect. EVIDENCE: The medicines stock and records were inspected. At the last inspection a requirement was made about the home overstocking medicines. This was due to the prescribing doctor issuing prescriptions for items not requested by the home, as they already had sufficient. This resulted in stock cupboards being overfull, which could lead to staff making errors. The manager had addressed this through meetings with the prescribing doctors and supplying pharmacist. Medicines were also being checked into the home at the time of delivery, with any unwanted items being immediately returned to the pharmacy for re-use. Previously these items were held in the home for some time before being returned to the pharmacy, where they had to be destroyed, which was wasteful. At this time the medicines stock consisted of items required for this months use, making the storage much easier and less confusing for staff. Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 Page 10 The home had information for staff on the importance of maintaining residents’ privacy and dignity. This was included in the homes’ polices and procedures, induction and ongoing training. Staff had been instructed to knock on residents’ doors before entering their bedroom, and residents were asked by which name they liked to be called. Residents confirmed that staff “treat us well”, and were sensitive when providing personal care. Bathrooms and toilets had door locks fitted, and personal care was carried out in private. Residents said they had their own clothes to wear and the manager said she frequently reminded relatives to name mark any new clothing. Staff were heard to speak to residents in a polite and friendly manner. All bedrooms were single, although two had an adjoining door for use by married couples or siblings. Residents were smartly dressed, with care given to their appearance, the hairdresser was in the home, and the men had been helped to shave. Two ladies had bare legs, but stated they did not like to wear stockings and were not going outside. Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 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): 13 and 14 Residents were helped to keep close links with their friends, family and local community as they wished whilst living at Elmhurst. They were also enabled to make daily choices and maintain control over their lives as much as possible. EVIDENCE: The home operated an open visiting policy, so residents could receive visitors when they liked. There was close liaison with residents’ friends and family. There were arrangements in place for staff to telephone relatives when certain residents were bright and responsive, so that visiting could be more rewarding for both. Relatives were invited to the residents meetings, to act as the residents representative should they need one. The manager felt this had been most successful, with some relatives making very good suggestions and becoming involved with projects in the home. One recent idea was to produce a “hot tips” information sheet for new relatives, giving advice on where to buy nametapes, and to check that clothes such as jumpers are suitable for machine washing. One of the relatives is collating these ideas, which is really good. The home maintained links with the local churches and had regular visits from different religious denominations. Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 Page 12 The ethos of the home encouraged residents to have control and make choices in their daily lives. Their ability to do so differed according to the residents’ level of dementia, but relatives were able to assist with this. Residents’, who were able to express an opinion, said they could go to bed and get up at a time which suited them, and that they were offered a choice of a bath or shower, as they preferred. Residents said they were offered a choice at meal times, and could spend the day where they liked, and opt in or out of activities as they chose. Residents who were able, managed their own money, and made their own plans and appointments. Residents were seen to have freedom to wander around the building, spend time in their bedrooms or in the lounges. In two units music was playing, in the other the television was on, so residents could choose which they liked. Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 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): EVIDENCE: No standards in this section were inspected. The manager said she had not received any complaints since the last inspection, and none had been made directly to the inspector. Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 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): EVIDENCE: No standards in this section were inspected. The home had purchased some new equipment since the last inspection, including a profiling bed and a hoist. Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 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 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): 29 The homes recruitment procedures were sound, and protected residents from having unsuitable people working in the home. EVIDENCE: The home had thorough procedures in place for the recruitment of new staff. Inspection of new staff files showed these had been adhered to. There was evidence that staff had completed an application form, attended for interview, and had satisfactory references and a criminal records bureau check completed. Staff had been issued with a job description and a contract of employment. There was a formal induction programme for new staff, which covered principles of care, and health and safety issues. There were currently vacancies for two care staff, and relief staff were adequately covering these shifts, until new appointments are made. Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 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 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): 35 and 38 The home had safe systems for handling residents’ money. The health and safety of residents and staff were protected and promoted by the homes procedures. EVIDENCE: The home held money for safekeeping on behalf of some residents. Each resident had an individual record book and money wallet for this purpose, which were held in the safe. The records and money of four residents were checked and found correct. Maintenance records were inspected. The fire log was up to date, with regular checks of the alarms and other fire safety equipment. Fire safety training for staff was up to date. The service records for electrical equipment and gas installations and hoists were also up to date. Elmhurst DS0000036576.V282906.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 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 Page 18 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. 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 Elmhurst DS0000036576.V282906.R01.S.doc Version 5.1 Page 19 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. 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