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Inspection on 12/12/05 for Elmridge Nursing Home

Also see our care home review for Elmridge Nursing Home for more information

This inspection was carried out on 12th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home delivers a quality standard of care to the residents. The atmosphere of the home is warm and homely, with some good quality soft furnishings. All bedrooms are personalised with the resident`s belongings such as photographs and ornaments. The staff are friendly and greet visitors in a positive helpful manner.

What has improved since the last inspection?

The central recreational area has been carpeted and the foyer has been separated with a modern wooden and glass partition. The outstanding issues from the last inspection have been addressed; the curtains in many of the bedrooms have been lined and look more suitable at the windows. Large screen televisions have been purchased for all the lounges. The management team continue to work towards achieving consistent high standards of care.

What the care home could do better:

The staff would benefit from a more structured approach to training. This is to ensure all of the staff receive the mandatory training and follow up training in care practices. The training records should reflect all of the training the staff member has received.

CARE HOME ADULTS 18-65 Elmridge Nursing Home The Pastures Coulby Newham Middlesbrough TS8 0UJ Lead Inspector Val Daly Unannounced Inspection 12th December 2005 09:30 Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 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 Elmridge Nursing Home DS0000000165.V251394.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 Adults 18-65. 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. Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elmridge Nursing Home Address The Pastures Coulby Newham Middlesbrough TS8 0UJ 01642 590028 01642 576384 dormyw@c-i-c.co.uk 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) BUPA (Goldsborough) Limited Mrs Helen Elizabeth Saunders Care Home 42 Category(ies) of Learning disability (22), Learning disability over registration, with number 65 years of age (20) of places Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home can only accommodate up to 20 elderly service users (65 ) with a learning disability LD(E). The home can accommodate one named service user under the age of 25. 1st August 2005 Date of last inspection Brief Description of the Service: Elmridge Nursing Home is a 42-bedded care home with nursing, registered under the Care Standards Act 2000 to provide care to 42 adults with learning disabilities. The home has conditions of registration in place to enable it to provide care to 22 people with learning disabilities aged between 18 and 65 and no more than 20 people with learning disabilities aged over 65. The home was first registered under the Registered Homes Act 1984 in 1993. The registered provider is BUPA (Goldsborough) Ltd. The responsible individual is Mrs L Tart and the manager is Mrs Helen Saunders. Elmridge is a single storey building divided in 4 units with each of these areas opening into a large room used for day activities. Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. What the service does well: What has improved since the last inspection? 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. Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These five standards were not assessed at this inspection. EVIDENCE: Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&7 Resident’s assessed needs are reflected within their individual plans of care. These provide the staff with the guidance for their care practices. Residents are supported to take risks within a risk management framework. This helps to ensure they remain safe and that their independence is promoted. EVIDENCE: Each of the resident’s has a 24-hour life plan written in their care records. The records are detailed and informative. Following the day-to-day living there are specific care plans to address any problems that the person has. A detailed history is obtained and a clear picture of the person’s care needs is recorded. The care plans are formulated with the resident, where possible, their key worker and the Registered Nurse. Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 9 Due to the nature of the conditions that the residents have there are risk assessments in place. These include bed rails, use of wheelchairs, skin damage, nutrition and falls. Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 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 & 17 Residents are encouraged to reach their potential. A good range of stimulating activities is available both inside and outside of the home. The food is of good quality and sufficient to meet the needs of the residents. EVIDENCE: The key workers are responsible for ensuring the resident’s rooms are tidy and the resident has the furnishings they choose in it. Staff said that they do not open resident’s mail without their agreement or their advocates agreement. During the inspection the staff were observed to be interacting well with the resident’s and were participating in activities with them. A recent review of the menus has taken place and they have been amended following advice from the community dietician. The menu offers a healthy wholesome diet with alternatives that meet the resident’s likes and dislikes. Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19 Residents receive good support from staff to ensure that their personal, physical and emotional health needs are met. EVIDENCE: Residents personal support is clearly written in the care plans, the 24-hour life plan describes what the person’s routine is from getting up to going to bed. Each resident has a key worker who spends time with the resident and his or her families or guardian. Occupational therapists and physiotherapists assess the resident’s needs and provide them with the appropriate technical aids. Other specialist support is obtained from the resident’s consultant, GP, specialist nurses and other health care professionals. Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Appropriate policies and procedures are in place, which offer protection to residents from harm or abuse and staff actively promote the protection of residents. EVIDENCE: The staff records viewed were up to date and included an application form, 2 references, photographic identification and a criminal records bureau check. All staff receives training in Adult Protection during the induction and as part of National Vocation. Each member of staff receives a handbook and a code of conduct. Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These seven standards were not assessed at this inspection. EVIDENCE: Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 & 34 Robust recruitment and selection procedures and training opportunities ensure that residents are appropriately supported and protected by a competent staff team. EVIDENCE: Each of the 4 units in the home is staffed with carers and a Registered Nurse oversees 2 units on each span of duty. A key worker system is in place to ensure continuity of care for the residents. Training opportunities are available in the home for staff to attend. However there is an inconsistent approach to training within the units and further development is needed to co ordinate staff training. The policies for recruitment are robust and clear to understand. Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 The manager demonstrates that she is a hardworking and experienced leader who has successfully developed the service and improved the health, welfare and lifestyle opportunities for the residents. EVIDENCE: The Registered Manager has achieved a National Vocational Qualification level 4 in management and has been in post for several years. The manager is specialist nurse and holds the Registered Nurses qualification in caring for people with a learning disability. The Registered Manager has an Operational Support Manager whom she can contact for help and advice, however she is responsible for managing the home’s budget and applying the aims and objectives of the home. The certificates of registration are displayed in the central area of the home. Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elmridge Nursing Home Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X DS0000000165.V251394.R01.S.doc Version 5.0 Page 17 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 YA32 Regulation 18 Requirement The training plans must be amended to ensure consistency and that all staff receive the same opportunities. Timescale for action 31/01/06 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 Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Elmridge Nursing Home DS0000000165.V251394.R01.S.doc Version 5.0 Page 19 - 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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