Inspection on 22/06/05 for Elmslea

This inspection was carried out on 22nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 13/06/07

Elmslea 11/07/06

Elmslea 04/01/06

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 Stokes Announced 22 June 2005 10:00 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 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 Stationary 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 D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Elmslea Address 34 Dunheved Road Launceston Cornwall PL15 9JQ 01566 777661 01566 Telephone number Fax number Email 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 CRH 15 Category(ies) of MD, Mental Disorder 15 registration, with number of places Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Total number of service users not to exceed 15 Date of last inspection 22 September 2004 Brief Description of the Service: Elmslea provides accommodaton 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. Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection to review the standards of care provided. I arrived at 10.00 am and left at 4.00 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 and staff and accepted an invitation to have lunch with them. The registered provider also assisted me with a tour of the premises. Comment cards were returned from 7 relatives and 10 residents. In addition the registered person completed a detailed pre inspection questionnaire to provide details of the homes services. 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. Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 4 and 5. The home is providing residents with appropriate information and encouraging visits to the home, that assist prospective residents make an informed choice about where to live. The information provided does not currently meet all requirements. EVIDENCE: The registered provider states it is essential to exchange information during pre admission meetings. The home completes a full assessment and encourages prospective residents to visit the home with their social worker or community psychiatric nurse. The registered providers liaise with the placing authority to ensure that the home can meet the needs of the prospective resident and that the welfare of existing residents is maintained. The registered provider gave me a statement of purpose and service user guide that is designed to give prospective residents and their advocates information about the homes services and facilities. The information provided does not meet all the requirements of regulation 4 (with an 18-point checklist provided in schedule 2) and regulation 5. These issues were raised as a requirement in the previous report and must be complied with to ensure residents are given all the information listed in regulations. Each resident is issued with a contract stating the terms and conditions of the home. The local authorities may issue a 3 monthly contract regarding fees, that is renewed as required. Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 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 standard(s) 6, 7 and 9. There is a care planning system in place that provides staff with the information they need to satisfactorily meet the needs of residents. EVIDENCE: The home maintains a care plan for all residents. These are developed from assessments and used to ensure appropriate care is given with reference to ‘duty of care’ and risk assessments. 3 plans of care were inspected and these appropriately referred to the various needs of residents, contact sheets, medication, history of care and family contacts. Residents stated that they felt supported by staff at the home and staff members exhibited appropriate skills and attitudes in their interactions with residents. Residents are supported to make decisions and consider the consequences of their behaviours. The homes statement of purpose states, ‘ residents run a weekly score table of individual achievement, awarding or deducting points towards social privileges’. A recommendation is made to ensure that any ‘loss of privileges’ is recorded and made available to the multi disciplinary review process involving the funding authority or advocates, where appropriate. A recommendation is made that the home provides a policy explaining the homes approach for ‘Cognitive Behavioural Therapy’, covering all aspects of these issues, how Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 9 individual achievement points are awarded or deducted and how issues regarding restrictions on choice and movement are considered. This recommendation is made for the protection of residents and the registered providers; it will also facilitate communication with funding authorities to demonstrate how an important aspect of the homes ‘aims’ is achieved. The comment cards received by this Commission, from relatives and residents were mainly positive and one relative stated,’ My daughter continues to develop, there is ongoing improvement and I feel she has never been happier’. A resident commented that,’ I like living here, although I would like to become more independent eventually’. Another comment received from a resident stated,’ you are given help that is not always in the way that you want but I think it will be helpful in the long term’. It is recommended that where the care plan is developed to include therapeutic interventions, the purpose and agreed action is discussed with the placing authority and this is recorded. Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 14 and 17. Links with the community are good with various opportunities available for residents to access recreational and educational facilities. EVIDENCE: The homes philosophy of care emphasises a programme of activity and exercise. Residents 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 3 residents occasionally assist the registered person on their farm. The home is also providing a range of in house arts and crafts. Residents 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 to develop relationships. Residents are encouraged to eat together to promote inclusion and social skills. I had lunch with residents and staff and this was observed to be a lively and pleasant experience. Residents are provided with good food that is nutritious and appetising. Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 11 Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 18, 19 and 20. The health care needs of residents are met with evidence of a multi disciplinary approach. EVIDENCE: Records showed that service users are accessing local services independently and regular 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. A telephone conversation occurred with social work staff to discuss the services provided by the home. A discussion occurred with the registered provider regarding the reporting of incidents to this Commission concerning the welfare of residents and issues that may occur such as self harm, missing persons and where residents require medical attention. The residents are self-caring and only prompting and encouragement may be required regarding personal care issues. All bedrooms for residents are en suite and lockable. The medication procedures were reviewed and a requirement that a secure storage facility is provided for the Insulin Flexi Pen equipment used by a resident at the home. The majority of residents are assisted to participate in self-medication procedures. Residents are provided with a weekly cassette of their prescribed medication to encourage independence, the registered person monitors these procedures. Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 13 Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 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 standard(s) 22 and 23. 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 guidelines detailed in ‘No Secrets’. Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 26, 27, 28 and 30. 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 registered person assisted me with a tour of the home. 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. Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 and 36. The registered person is providing a stable and suitably trained staff team in appropriate numbers to provide for the welfare of service users. EVIDENCE: 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 residents welfare. Staff files show evidence of appropriate references, checks for recruitment procedures, supervision and induction procedures. The home normally provides 3 members of staff on duty throughout the day. Waking night care staff are not provided, the registered persons live on the premises and they are on call for residents that may require attention at night. A discussion occurred regarding the registered person being registered with the European Therapies Institute and the home offering 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 6 monthly reviews involving relevant professionals, residents and recorded as part of the agreed care plans. The homes statement of purpose states,’ We also have regular weekly in house clinics with our retained acupuncturists and therapist. Residents can also use the services of a local hypnotherapist when appropriate’. It is recommended Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 17 that where the care plan is developed to include therapeutic interventions, the purpose and agreed action is discussed with the placing authority and this is recorded. A requirement is made that CRB procedures are undertaken for all new staff appointments. The existing CRB checks brought by staff are not acceptable when recruiting. This must be rectified for all staff recuited without new CRB checks completed. The requirement also refers to ‘volunteers’ or other sessional workers that are providing services to residents at the home. Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42. The registered persons are experienced providers of care, maintaining a safe and pleasant environment for residents. The identified risk area should be reviewed. 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 providers do not have a registered manager and the previous report refers to a discussion regarding a registered person completing the NVQ 4 and Registered Managers Award. A recommendation is made for the registered persons to inform the Commission of their proposals. A discussion occurred with the registered persons regarding the security of the building at night where residents are opening windows for ventilation. This presents a risk to vulnerable adults in this group living situation. The registered persons are recommended to discuss this with residents, complete risk assessments and provide an acceptable solution that offers both ventilation and security for residents. The registered person has made Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 19 appropriate arrangements for staff training in fire precautions, first aid, food hygiene, health and safety and the maintenance of equipment. Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 20 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 2 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 x x 3 Standard No 31 32 33 34 35 36 Score x 3 x 2 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elmslea Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 21 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 1 Regulation 4 and 5 Requirement Timescale for action 31.8.05. 2. 20 13 3. 34 The registered person must provide documents that meet all the requirements of regulation 4 (with an 18-point checklist provided in schedule 2) and regulation 5. These issues were raised as a requirement in the previous report and must be complied with to ensure residents are given all the information listed in regulations. (Timescale of 31.12.04 not met.) The registered person must 31.8.05. review medication procedures and ensure that a secure storage facility is provided for the Insulin Flexi Pen equipment used by a resident at the home. The registered person must 31.8.05. ensure that CRB procedures are undertaken for all new staff appointments. The existing CRB checks brought by staff are not acceptable when recruiting. This must be rectified for all staff recuited without new CRB checks completed. The requirement also refers to ‘volunteers’ or other sessional workers that are providing services to residents at the home. Version 1.30 Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Page 22 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. Refer to Standard 6 Good Practice Recommendations The registered person should ensure that any ‘loss of privileges’ is recorded and made available to the multi disciplinary review process involving the funding authority or advocates, where appropriate. A recommendation is made that the home provides a policy explaining the homes approach for ‘Cognitive Behavioural Therapy’, covering all aspects of these issues, how individual achievement points are awarded or deducted and how issues regarding restrictions on choice and movement are considered. The registered person should develop the care plans to include therapeutic interventions, the purpose and agreed action should be discussed with the placing authority and this is recorded. The registered person should inform the Commission of their proposals regarding the completion of the NVQ 4 and Registered Managers Award. The registered person should discuss security arrangements with residents, complete risk assessments and provide an acceptable solution that offers both ventilation and security for residents. 2. 6 3. 6 and 36 4. 5. 37 42 Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell PL25 4AD 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 Elmslea D52-D04 S9018 Elmslea V219050 220605 Stage 4.doc Version 1.30 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!