Inspection on 18/10/05 for Elms House

This inspection was carried out on 18th October 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elms House 26/04/05

Elms House 27/10/04

Elms House 15/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Elms House 24/26 Woone Lane Clitheroe Lancashire BB7 1BG Lead Inspector Jane Craig Announced Inspection 18th October 2005 09:00 Elms House DS0000009450.V254182.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 Elms House DS0000009450.V254182.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. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elms House Address 24/26 Woone Lane Clitheroe Lancashire BB7 1BG 01200 424263 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) Mrs Joanne Brown Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2005 Brief Description of the Service: Elms House provides care for up to six adults with a learning disability. The home is privately owned by Mrs Joanne Brown, who has responsibility for managing the service on a day to day basis. Elms House is a terraced property in a residential area close to Clitheroe town centre. A bus stop is located near to the home and there are small shops, a church and swimming baths within walking distance. The house has a small front garden with a bench seat, shrubs and flowers. The garden leads directly on to the street at the front of the house, where there is roadside parking. There are two small yards at the rear, with some garden furniture. Access for people using wheelchairs is at the rear of the house. There are four single bedrooms and one shared room. None of the rooms have en-suite facilities but there is a bathroom and WC on both floors. There is a steep staircase to the upper floor. Communal areas on the ground floor include two lounges, a dining room, a domestic sized kitchen and a utility room. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which meant that the residents and staff were told beforehand when the inspector would be arriving. The inspection took place over one day. At the time there were 6 residents accommodated in the home. Elms House is one of two homes in a scheme owned by the registered person. Staff are employed to work in both homes and residents spend time together on organised trips and holidays. The inspector met with all of the residents. Some were able to engage in discussions and talk about their experiences of living in the home. Their views and comments are included in this report. Four residents also completed comment cards before the inspection. Discussions were held with the owner (registered person) and two other members of staff. One relative had returned a comment card, indicating a positive experience of the home. A number of documents and records were viewed during the course of the inspection. Detailed notes were taken, which have been retained as evidence of the inspection findings. What the service does well: Residents living at the home were satisfied with their care. One said, “it’s the best place I’ve ever been in.” They got on well with the registered person and staff. One said, “the staff are brilliant, kind and very caring, they have time to talk to you.” Residents had no complaints. They said that if they did they could go to the staff or the registered person and they would sort them out. Each of the residents had an individual plan so that staff knew what to do to support them. Residents were asked about things that were important to them so that they could be put in the plan. Residents were able to make decisions about what they wanted to do with their time. Staff talked to residents about important things like their health to help them make choices. Residents were very happy with their lifestyle. They said they had lots of chances to go out. Staff made sure that residents who couldn’t go out on their own had the same opportunities. Residents were pleased that they could go on holiday at least twice a year. Most of the staff had been at the home for a long time. They were very experienced and knew the residents well. They had all attended training courses to make sure that they could provide the right care. One resident said, “staff are good at their jobs, they help me if I need it.” Staff said they felt supported by the registered person. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 6 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. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 7 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 Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 8 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): 2 The admission procedure included a full assessment to ensure that residents’ needs were understood and could be met before they moved into the home. EVIDENCE: Although there had been no new admissions to the home over the past year there was an admission procedure in place. The registered person discussed how any prospective residents would be assessed to make sure that their needs could be met at the home. The assessment would include information from the resident, their relatives and any professionals involved in their care. Prospective residents would also be invited to come to the home for a series of visits and short stays to ensure the home was suitable for them and they got along with the other residents. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 9 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 and 7 The person centred care planning process enabled residents to be involved in goal setting and care planning in accordance with their wishes. Inadequate directions for staff may result in resident’s needs not being met. Residents were supported to make decisions about all aspects of their lives. Decisions made on behalf of residents were based on prior knowledge of their likes and preferences. EVIDENCE: Person Centred Plans had been developed for all residents. The plans were drawn up following a review meeting with the resident, their key worker and other professionals involved in their care. Relatives were also invited to attend. The plans included the resident’s perspective of their strengths, likes and dislikes, issues of importance, their needs and how these were to be met. Plans were reviewed every 6 months. Residents said they kept their own plans. One said, “they are good because you can look back on things.” Each resident also had a set of care plans and risk assessments which provided staff with directions on the actions to take to meet the resident’s needs. However, one plan, completed after a serious incident, did not provide staff with adequate instructions should the situation arise again. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 10 Some of the residents were able to make decisions about all aspects of their daily lives. One resident said, “staff ask me things, they don’t tell me.” Another said that he could do what he wanted he just had to let staff know. The weekly men’s group was used as a forum to discuss issues and help residents come to a decision. Recent discussions included flu vaccinations and giving up smoking. Outside professionals were sometimes invited to the group to give further information. Staff and residents from the men’s group were working on a “communication passport” for one resident to help him to communicate his choices. The person centred plans also provided staff with information to assist them to make choices on behalf of residents who could not make their own decisions. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 11 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): 13, 15 and 17 Residents were provided with good opportunities to engage in a wide range of appropriate activities within the local community. Residents were supported to maintain relationships with family and friends. Residents received a well balanced diet. They were satisfied with the choice and quality of the meals served. EVIDENCE: All residents had busy weekly programmes and made full use of community facilities, either independently or with staff support. Residents talked about going to luncheon clubs, social clubs, bingo, the local library, swimming, bowling and church. One resident said he liked to be able to go off on his own into town. Another talked about using public transport to visit his family. Staff provided transport for residents who needed it. The registered person provided one to one support for two residents to enable them to go out regularly. Residents said that they had already had two holidays this year and were looking forward to going away again next month. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 12 There was an open visiting policy at the home. Residents were encouraged to maintain contact with their families and friends and staff helped residents with transport arrangements to make visits. Staff assisted other residents to keep in touch with phone calls and letters. Residents comments about meals included, “good grub,” “the food’s brilliant,” and “good meals, no grumbles.” Residents planned menus. They had also suggested a change to the time of the main meal to fit in with those who attended day centres and luncheon clubs. Menus showed that residents received a varied and well balanced diet, with fresh vegetables and fruit. Special diets were catered for. One resident had been referred to a dietician following a period of weight loss. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 13 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 Personal care was provided in a way that suited residents and promoted their independence. EVIDENCE: Care plans outlined the type and level of support the resident required to meet their personal care needs. Staff were aware of individual needs and preferences, for example times for bathing and which staff residents preferred to assist them. Residents said that staff only gave them the help they asked for and let them do things for themselves. One resident said, “they help me in and when I’ve finished they help me out.” Residents who returned comment cards said that their privacy was respected. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 14 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): 22 Residents knew who to make a complaint to and they were confident it would be dealt with. EVIDENCE: The complaints procedure met the standard in full. There was a summarised procedure in a suitable format accessible to residents. ‘How to make a complaint’ had been discussed recently in the men’s group and it was regularly on the agenda of residents’ meetings. Residents spoken with said they had no complaints but they could go to their key worker or to the registered person if they were unhappy about anything. One resident said, “I would go to Joanne, she would do something about it.” There had been no complaints to the home or to the Commission for Social Care Inspection. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 15 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): 24 Further improvements had been made to the environment, which enhanced residents’ comfort. EVIDENCE: There had been some improvements to the overall standard of the environment since the last inspection. The upper floor was being painted at the time of the inspection. A utility room had been added to provide separate laundry facilities. All residents had new bed linen they had chosen themselves. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 16 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 and 35 The lack of adequate pre-employment checks may place residents at risk of harm. Residents’ benefit from a competent and qualified staff team. EVIDENCE: There was a small staff team, many of whom had several years experience of working with the resident group. Staff were knowledgeable about residents individual and collective needs. Residents were happy with the staff, who they said were kind and friendly. One resident said, “I get on with all of them, they are alright to talk to.” Another said, “the staff are good, they see to you straight away if you’re ill.” Staff contracts and some employment policies had been updated. Residents had drawn up a list of questions to be asked at staff interviews. They met with prospective employees and had some input into the selection process. The files of two new staff were inspected. One did not contain adequate preemployment checks and a CRB disclosure had not been returned before they commenced employment. Recruitment practices must improve. Staff said there were good opportunities for training and development. Training in safe working practice topics was up to date. Other training included; adult abuse, person centred plans and management of challenging behaviour. New staff completed a very thorough in-house induction-training programme before being enrolled on the LDAF induction-training course. New Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 17 staff were mentored for at least 4 weeks. The registered person had introduced a staff handbook that provided or directed staff towards essential information. Training records had improved and there was a training plan for all staff. 62.5 of the combined Elms House and West View staff team had achieved NVQ level 2 and a further 2 staff were awaiting their results. Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 18 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 Residents and staff benefited from a well managed home. EVIDENCE: The registered person was in charge of the home on a day-to-day basis. She had many years experience of running the home and had attained an NVQ level 4 in care and management. In addition, she kept up to date by attending various short courses and self-study. Staff described the registered person as “supportive”, “knowledgeable” and “good at her job.” Residents said they got on very well with the registered person and one commented, “Joanne’s brilliant, she’s caring and if we have any problems she sorts them out for us.” Elms House DS0000009450.V254182.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 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 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 4 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 4 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 4 X 2 4 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elms House Score 3 X X X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X DS0000009450.V254182.R01.S.doc Version 5.0 Page 20 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 2 Standard YA6 YA34 Regulation 15 18 Requirement Strategies for managing aggressive incidents must be included in the care plan. Pre-employment checks must be carried out. Timescale for action 30/11/05 30/10/05 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 Elms House DS0000009450.V254182.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Elms House DS0000009450.V254182.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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