Inspection on 13/06/07 for Elmslea

This inspection was carried out on 13th June 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

Elmslea 28/05/10

Elmslea 18/05/10

Elmslea 27/04/10

Elmslea 15/02/10

Elmslea 10/02/10

Elmslea 13/11/09

Elmslea 17/09/09

Elmslea 27/08/09

Elmslea 02/03/09

Elmslea 17/03/08

Elmslea 11/07/06

Elmslea 04/01/06

Elmslea 22/06/05

Elmslea 22/09/04

Elmslea 23/06/04

Elmslea 19/05/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Elmslea 34 Dunheved Road Launceston Cornwall PL15 9JQ Lead Inspector Mike Dennis Unannounced Inspection 13th June 2007 10:00 Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 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 Elmslea DS0000009018.V341946.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 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. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elmslea Address 34 Dunheved Road Launceston Cornwall PL15 9JQ 01566 777661 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) Mr Henry Stanbury Mrs Irene Stanbury Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15) of places Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 15 adults aged 18 - 65 on admission with a mental illness (MD), some of whom may have a secondary minor learning disability. Total number of service users not to exceed a maximum of 15 Date of last inspection 11th July 2006 Brief Description of the Service: Elmslea provides accommodation and personal care for up to 15 adults with a mental disorder. The care home is situated in a quiet residential area of Launceston. The recreation park and leisure centre are nearby and the town centre amenities are a short walking distance. All the bedrooms are single with en suite facilities. There are various communal spaces and garden areas for residents to use. The cost of care is currently £450 per week. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection to review the standards of care provided. We arrived at 9:30 am and left at 3.00 pm. During this time the registered person assisted me in looking at records regarding residents welfare and discussing developments at the home. I met residents, staff and observed the daily routines at the home. 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. The summary of this inspection report can be made available in other formats on request. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 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 Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are fully assessed prior to admission to the home. Written contracts are in place EVIDENCE: Four service user files were selected at random and case tracked. It is evident that Assessment packs are sent to all prospective service users/relatives to collate initial background information. Reports are also obtained from other agencies such as social services, CPN’s etc. If the prospective service user has been involved in respite care, reports from those sources are also obtained. One or more visits are then undertaken to the current place of residence for further information gathering and to give the individual and their family the opportunity to meet and question staff from the home. There then follows a planned introduction to the home, prior to full admission. The planned introduction periods will vary according to individual circumstances. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 8 On completion of this process the home will have gathered substantial information as to the persons care needs. This information then forms the initial care plan. Contracts and/or Statements of Terms and Conditions with the home were evident. This process was explained by the staff on duty and verified from the written records. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Comprehensive care plans exist, are reviewed regularly and contain personal goals and assessed needs incorporating a risk management framework. Service users are consulted and participate in all aspects of their life at the home. Confidentiality is maintained EVIDENCE: From inspection of service users files, and in discussions with staff and some service users it is evident that Elmslea House encourages service users and their representatives to express their views in the formation of their care plans. The care plan specifies what actions staff should take to ensure that the care need is approached in a consistent manner. The care plans are reviewed regularly and include appropriate risk assessments. Staff were able to give Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 10 verbally, a précis of the content of plans indicating a knowledge of care needed without reference to the care plan itself. Staff facilitate regular house meetings and one to one opportunities for service users to express their opinions. During the various conversations with staff whilst in company of service users, staff maintained confidentiality. Service users stated that they felt supported by staff at the home and staff members exhibited appropriate skills and attitudes in their interactions with residents. The registered providers and staff support residents to make decisions and consider the consequences of their behaviours. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Links with the community are good with various opportunities available for residents to access recreational and educational facilities. The menu indicated that a good standard of food is provided. EVIDENCE: The homes philosophy of care emphasises that residents participate in a programme of activity and exercise. Service users are encouraged to participate in a programme of recorded activities. Various resources are used including the Duchy College, Launceston Leisure Centre, voluntary work placements and residents occasionally assist the registered person on their farm. The home is also providing a range of in house arts and crafts. Service Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 12 users stated they are encouraged to develop their own contacts outside of the home and participate in social clubs or other community facilities. The registered person stated that relatives and friends of residents are welcome at the home and this is seen as an important part in assisting residents develop relationships. Service users were observed enjoying their midday meal. The kitchen and food storage areas are well maintained. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Physical and emotional health needs are met. Service users receive personal support that preserves their privacy and dignity. Medication is administered according to the homes policies and procedures. Staff are aware of the additional needs of some service users due to their advancing years. EVIDENCE: Records showed that service users are accessing local services independently and support from GP’s, community psychiatric nursing, social work and consultant psychiatrist as required. A consultant psychiatrist visits the home every 6 months to review the welfare of residents and care reviews are held annually or as required. The residents are self-caring and only prompting and encouragement may be required regarding personal care issues. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 14 There is a strong ethos of personal support and preservation of privacy. We observed staff interacting with service users in a caring and positive way. Details concerning service users were not discussed in front of other service users. Service users are free to choose their G.P from the Town’s health centres. Staff are pro-active in arranging a wide range of medical and therapeutic support services as and when they become necessary. Examples of the above were explained to us and borne out by the written records. One service user is terminally ill. Staff have facilitated accommodation for the next of kin and are supporting her needs. Staff were observed to be supporting and counselling other service users in this difficult time. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has appropriate policies and acts to prevent residents being placed at possible risk or abuse. EVIDENCE: The home has a complaints policy and procedure that is discussed with residents to ensure they know how and whom to complain to. The home also has ‘Adult Protection’ procedures and the registered person understands the need to report concerns to the social services under DOH guidelines detailed in ‘No Secrets’. The complaints procedure is posted throughout the home. Service users were aware of the procedures to follow. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The registered person is providing a good standard of décor and maintenance to ensure service users live in a safe and comfortable environment. EVIDENCE: The home is well maintained, with a good standard of furnishings and fittings. There are adequate toilets and bathing facilities for residents. All 15 bedrooms are for single occupancy and have en suite facilities. Various communal spaces and a large dining area are provided for residents. The large gardens have seating areas and room for activities. The home presented as being clean and tidy. Individual bedrooms displayed the personal tastes of their occupant to include pictures, ornaments and items Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 17 of personal interests. Several service users were pleased to show us their rooms and described items relating to hobbies and interests. A homely atmosphere existed throughout. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The registered person is providing a stable and suitably trained staff team in appropriate numbers to provide for the welfare of service users. EVIDENCE: On arrival at the home the providers and support staff were available to discuss the routines and developments at the home. Service users were engaged in various activities and the home was organised to provide for their welfare. The service users are self-caring and participated in daily domestic functions around the house and in the community independently. The majority of staff have worked at the home for over 12 months and have achieved NVQ at level 2 or above. A range of training opportunities has been provided that are relevant to service users welfare. Staff files show evidence of appropriate references, checks for recruitment procedures, supervision and induction procedures. The home normally provides 2 members of staff on duty throughout the day. The registered persons live on the premises and they are on call for residents that may require attention at night. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 19 The registered person is registered with the European Therapies Institute and the home offers residents a range of complementary therapies, a member of staff has also achieved a counselling skills certificate. Advice is given to ensure that the registered person monitors these activities and they are discussed as part of reviews involving relevant professionals, residents and recorded as part of the agreed care plans. Supervision is undertaken at required time intervals and recorded. We recommend that the supervision records are maintained on a separate sheet for each staff member and not combined as is the present practice. The record can then be stored on each staff members file to comply with confidentially systems. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The registered persons are experienced providers of care, maintaining a safe and pleasant environment for residents. Mr and Mrs Stanbury also live at the home and share most days with service users in activities, meals and discussion in an open and consistent approach. EVIDENCE: The registered persons both have many years experience in caring for people with mental health issues and are qualified as an Occupational Therapist and Approved Social Worker. The registered person has made appropriate Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 21 arrangements for staff training in fire precautions, first aid, food hygiene, health and safety and the maintenance of equipment. Where the address of the CSCI is listed in policy and procedural documents, this should now be changed to reflect the new address at Ashburton. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 X X 3 X Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NONE 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. 1 2 Refer to Standard YA40 YA36 Good Practice Recommendations Note the change of CSCI’s address in policies and procedures. We recommend that the supervision records are maintained on a separate sheet for each staff member and not combined as is the present practice. The record can then be stored on each staff members file to comply with confidentially systems. Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Elmslea DS0000009018.V341946.R01.S.doc Version 5.2 Page 25 - 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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