Inspection on 13/11/09 for Elmslea

This inspection was carried out on 13th November 2009.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 17/09/09

Elmslea 27/08/09

Elmslea 02/03/09

Elmslea 17/03/08

Elmslea 13/06/07

Elmslea 11/07/06

Elmslea 04/01/06

Elmslea 22/06/05

Elmslea 22/09/04

Elmslea 23/06/04

Elmslea 19/05/04

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Bolealler House

Claremont Nursing Home

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Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Random inspection report Care homes for adults (18-65 years) Name: Address: Elmslea 34 Dunheved Road Launceston Cornwall PL15 9JQ zero star poor service 02/03/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Helen Tworkowski Date: 1 3 1 1 2 0 0 9 Information about the care home Name of care home: Address: Elmslea 34 Dunheved Road Launceston Cornwall PL15 9JQ 01566777661 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Irene Stanbury,Mr Henry Stanbury care home 15 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Conditions of registration: 15 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 Brief description of the care home Elmslea provides accommodation and personal care for up to 15 adults with a mental health needs. 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. Details of the cost of care are available from Mr and Mrs Stanbury. 0 2 0 3 2 0 0 9 Care Homes for Adults (18-65 years) Page 2 of 19 What we found: This inspection was carried out by two inspectors between 9.40 a.m. and 5 p.m. on 13th December 09. The purpose of this visit was to follow up a Statutory Requirement Notice regarding the recruitment and employment of staff and volunteers at the home. This notice required that Mr and Mrs Stanbury must have arrangements to ensure that the information specified in the regulations is obtained prior to new care workers or volunteers is obtained, before they are employed. It also required that all such documents be obtained for people currently in employment, and that arrangements are put in place to ensure that staff do not begin work without a Protection of Vulnerable Adults (POVA) First Check, and that they are then to be supervised until a satisfactory Enhanced Criminal Records Bureau check had been received. We spoke with Mrs Stanbury and she confirmed that she had not employed any new staff, and that a number of staff who were employed at the time of the last inspection are no longer working at the home. We looked at the recruitment, employment and training records for the ten staff and volunteers currently working at Elmslea. We found that none of the people currently working at the home have two appropriate written references. Where individuals did have references they were not dated, it was not clear how the reference related to their employment history. Six of the ten people had either unexplained gaps in their employment history or in one case no employment history. Where individuals were expected to drive we found that there were no current drivers licenses on file, to show that this had been checked. Mrs Stanbury told us that some of the people at Elmslea use various therapists who visit the home. We discussed with Mrs Stanbury that she has a duty of care to ensure that she has carried out appropriate checks on these therapists to ensure that they are suitable. The use of therapists should also be discussed and agreed through the Care Plan, with the individual and relevant professionals. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 3 of 19 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 1 4 The Registered Provider must 01/06/2009 have a Statement of Purpose that contains all the information that is required in the regulations and standards. A copy of this document must be sent to the Commission. The Commission and other interested parties need to know what services are provided in the home. 2 1 5 The Registered Provider must 01/06/2009 provide a Service User Guide to everyone who lives in the home. This document must contain all the elements specified in the regulations and standards. A copy must be provided to the Commission. People who live at Elmslea or who are thinking about such a move need to know what sort of service is provided. 3 1 4 The Registered Provider must 07/11/2009 have a Statement of Purpose that contains all the information that is required in the regulations and standards. A copy of this document must be sent to Page 4 of 19 Care Homes for Adults (18-65 years) Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action the Commission. The Commission and other interested parties need to know what services are provided in the home. 4 1 5 The Registered Provider must 07/11/2009 provide a Service User Guide to everyone who lives in the home. This document must contain all the elements specified in the regulations and standards. A copy must be provided to the Commission. People who live at Elmslea or who are thinking about such a move need to know what sort of service is to be provided, and any rules with which they may reasonably be asked to comply. 5 2 14 The Registered Provider must 01/06/2009 have a copy of a comprehensive written needs assessment of a person, before any stay Elmslea, including a trial visit. People must be confident that their needs will be known and can be met if they move to Elmslea. 6 2 14 The Registered Provider must 07/11/2009 have a copy of a comprehensive written needs assessment of a person before they come to stay at Elmslea, including for a trial visit. Page 5 of 19 Care Homes for Adults (18-65 years) Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action People must be confident that their needs will be known and can be met if they move to Elmslea. 7 6 15(2)b People living in the home are 30/07/2008 fully involved in the planning of their care and this is regularly reviewed with them. The Registered Provider must 07/11/2009 have Care Plans that are comprehensive and include details of any goals, skills being developed or therapies used. The people at Elmslea and staff need do know what held is needed and how it should be given. 9 6 15 The Registered Provider must 01/06/2009 have Care Plans that are comprehensive and include details of any goals, skills being developed or therapies used. The people at Elmslea and staff need to know what help is needed and how it should be given. 10 7 12 The Registered Provider must 01/06/2009 ensure that any restrictions or limitations placed on people at Elmslea, are undertaken with their consent or informed by the Mental Capacity Act. Page 6 of 19 8 6 15 Care Homes for Adults (18-65 years) Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action People must be protected from unnecessary risk however they must not have their liberty restricted arbitrarily. 11 7 12 The Registered Provider must 07/11/2009 ensure that any restrictions or limitations placed on people at Elmslea are undertaken with their consent or informed by the Mental Capacity Act and are in their best interest . Such issues must be recorded in the Care Plan. This includes getting up and bed times. People must be protected from unnecessary risk howeverthey must not have their liberty and choices restricted arbitarily. 12 9 13(4)c Risk assessments must show 30/07/2008 that the safety, independence and choice has been considered and is regularly reviewed with people living in the home. Risk asessments must show 07/11/2009 that the safety, independence and choice has been considered and is regualarly reviewed with people living in the home. People need to be safe and risks minimised, whilst still able to lead active and purposeful lives. Care Homes for Adults (18-65 years) Page 7 of 19 13 9 13 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 14 10 12 Confidential care records 30/11/2009 must be kept securely and only accessed by those who have the right to view them. People have a right to have confidential information kept in an appropriate manner. 15 11 12 The people who live at 07/11/2009 Elmslea must be given the opportunity and supported to make choices. This must include choices around relationships, religious beliefs, and having snacks and drinks at times that suit their needs. People who live in a care home must be given the opportunity to make their own choices, as far as possible. 16 18 12 The use of behavioural 07/11/2009 techniques, must be based on a proper assessement. Goals must be agreed with the indivdiuals, or be in their best interests if they lack the capacity. The mangement of rewards and feedback to the indivdual must be approriate and reflect good practice. If people wish to change their behaviours then they must be given appropriate support to do this. 17 19 13 The Registered Provider must 01/06/2009 ensure that risk assessments are drawn up in relation to Page 8 of 19 Care Homes for Adults (18-65 years) Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action people who look after their own medication. People need to be able exercise their independence, however must also have the support they need. 18 19 13 Invasive procedures must only be carried out where there has been written delegation and training by the primary health care team. This is to ensure that no one is harmed by untrained people carrying out procedures that are the duty of health care practitioners. 19 20 13 Make sure that when people 07/11/2009 living in the home look after and administer any of their medicines themselves there is a full written risk assessment process in place with actions taken to reflect best practice guidance and to make sure this is safe for everyone in the home. Make accurate and compete records when medicines are given to people to look after, as well as regular checks that they are using their medication correctly. This to help make sure that people are taking the correct amounts of medication and that the arrangements are safe for everyone in the Care Homes for Adults (18-65 years) Page 9 of 19 20/09/2009 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action home. 20 20 13 Make arrangements so that 07/11/2009 any medicine that needs refrigerated storage is always kept securely within the correct temperature range indicated by the manufacturer. Use a maximum and minimum thermometer to keep daily records of the temperature in the medicine fridge. This will help to make sure medicines are kept at the right temperature to retain their potency. 21 20 13 Review medicine records and 07/11/2009 care plans for people living in the home to make sure that for all medicines prescribed with a direction when required or with a variable dose there is clear, up to date and detailed written guidance on how to reach decisions to administer the medicine and at a particular dose, taking into account the provisions of the Mental Capacity Act 2005. This will help to make sure people living in the home receive the correct amounts of medication in a consistent way in line with planned actions. 22 20 13 Make sure and demonstrate 07/11/2009 that all the arrangements for recording, handling, Page 10 of 19 Care Homes for Adults (18-65 years) Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action safekeeping, safe administration and disposal of medicines received into the care home are safe for everyone in the home by having clear, safe procedures in place that follow accepted best practice guidance and with robust checking and auditing at a frequency to demonstrate that people are consistently having their medication correctly and all medicines are accounted for. This is to help make sure that people living in the home receive the correct levels of medication and are not put at unnecessary risk because of poor practices or recording. 23 20 18 Make sure that any staff who 30/11/2009 administer or deal with medication for people who live at this home have completed and passed a proper formal course about the safe handling of medicines are assessed as competent to handle medication. This will help to make sure that staff are competent to manage medication safely and people living in the home are not at unnecessary risk from mistakes with their medicines. 24 20 13 For each person living in this 31/08/2009 home you must always keep Page 11 of 19 Care Homes for Adults (18-65 years) Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action accurate, clear and complete records for all medicines received, administered and disposed of. This is to help make sure all medicines are accounted for, that people receive their prescribed medication correctly and are not at risk of mistakes with medication because of poor recording arrangements. 25 20 13 Make arrangements to have in place effective stock control arrangements for medication so that all medicines are always within their expiry date, only those medicines in current use for people in the home are kept and that all medicines can always be accounted for. (This is particularly to address the issues raised in the report.) This will help to make sure that all medication can be accounted for and that people in the home at not at risk of receiving the wrong medicines or medication that is out of date. 26 20 13 (2) Arrangements must be made to record any verbal dose changes safely. This is to make sure that people receive their medicines safely and as the Care Homes for Adults (18-65 years) Page 12 of 19 07/11/2009 30/11/2009 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action prescriber intended 27 23 13 Any allegation of abuse must 31/10/2009 be referred to the Social Services, the homes policy must reflect this strategy. Elmsleas safeguarding policy must recognise Social Services lead role in coordinating any investigation of alleged abuse. Vulnerable people must be protected and any allegations appropriately investigated. 28 23 12 The Registered Person must implement the Mental Capacity Act. Restrictions and limitations may only be placed on people in line with this legislation and the relevant guidance. People who live in care homes have the same rights as any other person. 29 33 17 The Registered Provider must 07/11/2009 have an accurate record of staff who are rostered to work in the home. This must be amended to reflect any changes where necessary. This rota must include who is on call or sleeping in. The Registered Provider must review the level of staffing to ensure that there are always adequate numbers of staff on duty. The provider and the staff Care Homes for Adults (18-65 years) Page 13 of 19 01/06/2009 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action must be accountable for the work they carry out. 30 33 17 The Registered Provider must 01/06/2009 have a record of staff who are rostered to work in the home. The provider and staff must be accountable for the work they carry out. 31 33 17(2)Sch 4.7 Duty rosters must be kept to 31/05/2008 demonstrate that there is always sufficient staff in such numbers as to meet the needs of people living in the home. The Registered Provider must 01/06/2009 have a suitable system for the recruitment of staff, including receiving two appropriate written references, and a POVA check, prior to working in a supervised capacity. A CRB check must be completed before any person may work unsupervised. Only people who are suited to the work may be employed in care homes. 33 34 19 The Registered must ensure 07/11/2009 that arrangements are in place to ensure that they have obtained the necessary information, as specified in the regulations, for all new volunteers, before they start work at the home. Page 14 of 19 32 34 18 Care Homes for Adults (18-65 years) Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action This is to ensure only people suited to the work, volunteer. 34 34 19 The Registered Providers 07/11/2009 must put in place arrangements to ensure that when staff are employed at the home with a POVA First check that they are appropriately supervised in accordance with the regulations, until a CRB clearance is received by the home. This is to ensure that people are supervised until all the relevant checks have been completed. 35 34 19 The Registered Provider must 07/11/2009 ensure that every care worker currently employed at the home has the documents required by the regulations. This is to ensure that only people who are suited to the work are employed. 36 34 19 The Regsitered Provider must 07/11/2009 ensure that full and satisfactory information, as specified in the regulations, is obtained in relation to all new care workers, before they are employed by the care home. This is to ensure only people suited to the work are employed. Care Homes for Adults (18-65 years) Page 15 of 19 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 37 35 18 New staff must be provided with a comprehensive, structured induction to the work. New staff need to be made aware of their role, and good practice. 07/11/2009 38 38 12 The Registered Provider must 01/06/2009 act in a professional manner and facilitate contact with health and social care professionals. This is so that the people who live at Elmslea can receive the services to which they are entitled. 39 38 37 The Commission must be notified of any event that adversely affects the well being of a person living at the home. Providers have a duty to make such report, which demonstrate openness. 07/11/2009 40 38 12 The Registered Providers 07/11/2009 must ensure that the home is managed in a manner that respects the rights of individuals and provides them with the support they need. People who live in care homes must be treated with respect. 41 38 12 The Registered Provider must 31/10/2009 act in a professional manner Page 16 of 19 Care Homes for Adults (18-65 years) Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action and facilitate contact with health and social care professionals. Recording must be done in a professional manner. This is so that the people who live at Elmslea can recieve the services to which they are entitled. 42 39 24 The Registered Providers 07/11/2009 must that quality assurance processes are implemented. This should include ensuring that they are familar with the day to day experiences of people who live at Elmslea, and ensure no one is subject to unreasonable rules or restrictions. People who live in care homes must be treated with respect. Care Homes for Adults (18-65 years) Page 17 of 19 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 18 of 19 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 19 of 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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