Inspection on 03/04/07 for Elmhurst Private Nursing & Residential Home

This inspection was carried out on 3rd April 2007.

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 Private Nursing &... 22/03/10

Elmhurst Private Nursing &... 17/03/09

Elmhurst Private Nursing &... 17/01/07

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Elmhurst Private Nursing & Residential Home Prees Whitchurch Shropshire SY13 2EN Lead Inspector Mike Moloney Key Unannounced Inspection 3rd April 2007 09:00 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 Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 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 Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elmhurst Private Nursing & Residential Home Address Prees Whitchurch Shropshire SY13 2EN 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) 01948 841140 01948 841113 LDCG Limited vacant post Care Home 28 Category(ies) of Past or present drug dependence over 65 years registration, with number of age (6), Old age, not falling within any other of places category (17), Physical disability over 65 years of age (2), Terminally ill over 65 years of age (3) Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The home may accommodate a maximum of 28 older persons, of these a maximum of 6 may be suffering from dementia and a maximum of 3 may have a terminal illness. The home may accommodate up to 2 persons with a physical disability under 65 years of age. There must be at least 1 Registered Mental Nurse employed within the staff team. An application to register a manager must be submitted within 3 months of this certificate. Bedrooms must not accommodate more than 2 persons by end April 2007. 17th January 2007 Date of last inspection Brief Description of the Service: Elmhurst is a privately owned care home, situated on the outskirts of the village of Prees in a very rural location with extensive views over farm land. It is registered to provide both personal and nursing care, for a maximum of 28 older people in single, double or four bedded rooms. Many rooms have direct access to the extensive lawned gardens and views of open countryside. The registered managers position is currently vacant but the home is being run by Jane Platt. Fees currently range from £440 a week to £520 a week Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. What the service does well: What has improved since the last inspection? What they could do better: Since the last inspection a lot of work has been carried out on the care planning systems. This will be further enhanced when the social needs have been more fully identified and ways of meeting them developed. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 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 Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. Prospective residents have their needs assessed and recorded in a way that enables the development of a plan of how these are to met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection there have been new residents admitted to this home. Their records were looked and these were discussed with the staff. Nursing assessments were seen to have been carried out. The records also contained assessments carried out by the home staff which they confirmed had been carried out prior to admission. The documents used by the home for the assessment were seen to contain information about the individuals needs and included enough to ensure that a care plan could be developed that met that persons needs. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 9 A ‘History’ sheet was also seen that had been filled in by family members that gave the background of that resident and some idea of how the family saw their needs being met. Risk assessments had also been carried out at this point and these included those about moving and handling. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. The health and personal care that a resident receives is based on their individual needs. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records for a number of the service users were looked at. The home has now adopted the use of a proprietary care planning system which it has fully implemented but has modified the risk assessment section to more suit their situation. This process had been carried out in the month prior to this inspection. The manager in charge stated that each care plan will be formally reviewed at least six weeks after admission to the home and then every six months or more often if necessary. She also said that the care staff will review them on at least a monthly basis. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 11 Looking at the care plans it could be seen that consideration had been given to cultural and religious issues although given the ethnicity of the service user group this was mainly about religion. Talking with a number of the staff it was also clear that they had a good understanding of the contents of the individuals care plans. During the inspection it was seen that at a GP visited the home. The records showed when any health care professionals were consulted or visited and included any comments, instructions or decisions that made by them. Medication storage and management systems were also looked at. Storage was seen to be appropriate and the senior nurse explained that a new medication fridge had been delivered the day before the inspection. She also explained that the home was expecting to adopt a ‘blister pack’ system of storage and administration and that the nurses felt that this would be safer. Throughout the inspection staff were observed being polite to the service users, always respectful in their manner and knocking on doors before entering bedrooms and bathrooms. Catering staff were heard knocking on bedroom doors and asking if people wanted and early morning cup of tea in a very appropriate manner. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Progress has been made towards ensuring that residents are able to choose their life style and social activities. Residents receive a healthy, varied diet according to their assessed requirement and choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The senior manager present during the inspection explained that an activities organiser had been appointed to work at the home and would be starting in the near future. Her role would be, along with the rest of the staff, to identify the social needs and interests of the service users and develop ways of providing a stimulating programme of activities for them. Talking with the manager and her staff established that work had already begun on this process. During the inspection a number of visitors were seen going in and out of the home. From looking at the visitors book and by talking to staff it was clear that Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 13 a number were relatives visiting residents and staff were observed talking with them in a relaxed but professional manner. Talking with the catering staff and looking at the records that they keep it could be seen that the menus that are offered to the service users are varied and nutritionally balanced. They explained that they currently cater for a number of special diets. They also explained that the home intends to review the menus in the near future and the manager explained that as part of this exercise the views of the service users will be sought and a nutritional risk assessment would be carried out. The meal seen on the day of the inspection was seen to be well presented and appealing and a number of the service users spoken to said that they always found the meals to be appetising and plentiful. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was seen to have developed a complaints procedure that contained al of the elements required by the Care Homes Regulations 2001. This was also seen to have been included in the home’s service user guide as well as staff handbook. The home had received one complaint since the last inspection and the complaints register contained details of this as well as an outline of the action taken by the home to resolve it. The manager stated that there had been no referrals to the local Adult Protection procedures since the last inspection and that a start had been made on training the staff team in such matters. Talking to the staff and looking at the training records confirmed this. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 23 and 26 Quality in this outcome area is good. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is in a very rural position. There are good views over the landscape to the rear of the building through a series of ‘french’ windows leading from the lounge. The lounge has two areas that can be kept separate by partitions. There is a separate dining room next to the kitchen. The laundry area was seen to be appropriate. Since the last inspection building work has taken place in the home and now no more that two service users share a bedroom. On the day of the inspection Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 16 it was seen that the foundations were being prepared for the next stage in the planned structural development of the home. It was also noted that most of the beds in use within the home have built in bed rails and are of such a design that the safety of both the service users who need them and the staff who care for them is improved. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Staff in the home are trained, skilled and are available in sufficient numbers to fill the aims of the home and meet the changing needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of the staff recently recruited to the home were looked at and these were seen to contain all of the checks required to ensure that people who start working at the home are fit to work with vulnerable people. The staff records also showed that safety training around such things as infection control is taking place. A training plan developed by the home was seen to identify which staff need what training. The staff themselves and the homes diary confirmed that training identified has been arranged. Looking at the records and talking to the staff confirmed that over 50 of the staff team were qualified to NVQ2 or above. The staff members spoken to said that they felt that staffing levels were right for the level of needs of the current group of service users and looking at care records and the staffing rota confirmed this. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 18 Watching and listening to interactions between the staff and the service users it could be seen that the service users felt able to approach and talk to all of the staff. Service users could be heard talking fondly to their carers and the staff were observed reacting professionally and sensitively to them. All of the staff spoken to during the inspection spoke positively about the recent changes in the management of the home. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. Although the home does not currently have a manager who is registered with the Commission for Social Care Inspection the management and administration of the home is based on openness and respect, has effective quality assurance systems developed by qualified, competent managers with appropriately supervised staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the visit the home did not have a manager registered with the Commission for Social Care Inspection. The senior manager present stated that the company was actively trying to recruit one. As a temporary solution to the problem she would be managing the home directly. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 20 An action plan relating to the requirements made at the last inspection has been received by the Commission for Social Care Inspection. Action plans relating to infection control and health and safety audits were also seen to be in place. The proprietor visits necessary under Regulation 26 of the Care Homes Regulations 2001 have been carried out at the required intervals. All those spoken to during the inspection spoke of how the senior managers and proprietor of the company visit on a very regular basis. A variety of documents showed that various levels of staff meetings had taken place as had a residents meeting. The senior manager explained that it was intended that these would continue on a monthly basis. A variety of records were seen that showed that safety issues are constantly monitored. Records of such things as fridge freezer temperatures, fire equipment tests, gas safety tests and portable appliance testing were seen to have been maintained. Staff records also showed that the mandatory training that is necessary to keep the service users safe has been taking place. This included training in such things as food hygiene, fire prevention and infection control. Staff spoken to confirmed that these records were accurate. Records were also seen that confirmed that a programme of recorded staff supervision is now in place. Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 21 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 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x 3 x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Elmhurst Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 22 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 Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Private Nursing & Residential Home DS0000068427.V334626.R01.S.doc Version 5.2 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!