Inspection on 04/01/06 for Elmslea

This inspection was carried out on 4th January 2006.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

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 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 Stokes Unannounced Inspection 4th January 2006 3:00 Elmslea DS0000009018.V260532.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 Elmslea DS0000009018.V260532.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. Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 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.V260532.R01.S.doc Version 5.0 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 22nd June 2005 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 within 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 DS0000009018.V260532.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection to review the standards of care provided. I arrived at 3.00 pm and left at 6.30 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. Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4. The home is providing residents with appropriate information and encouraging visits to the home, these assist prospective residents make an informed choice about where to live. The information provided does not currently meet all requirements. EVIDENCE: 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 persons have a ‘statement of purpose’, ‘service user guide’ that is designed to give prospective residents and their advocates information about the homes services and facilities. The ‘service user guide’ provided at inspection does provide useful information about the home but does not meet all the requirements of regulations 4 and 5. This ‘service user guide’ must also include the homes complaints procedure and the address and telephone number of the Commission for Social Care Inspection (reference: regulation 5). The registered persons must also give details of any specific therapeutic techniques used in the care home and the arrangements made for their supervision. This information on services provided for residents is required in the statement of purpose (reference: regulation 4 and schedule 1:17). Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 Page 8 These requirements must be complied with to demonstrate that the registered providers ensure residents; advocates and purchasers of services are given all the appropriate information listed in regulations. The development and completion of these documents has been discussed and raised as requirements in previous reports, with timescales that have been extended and not met. The requirement is made again for the registered providers to comply with these regulations and the intended outcome will see all existing and future residents provided with a revised pack of information that clearly sets out the details required to ensure vulnerable residents are informed and protected. Elmslea DS0000009018.V260532.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, 7 and 9. There is a care planning system in place that provides relevant information to satisfactorily meet the needs of residents. This system does not currently ensure that support agencies are informed of therapeutic activity occurring at the home and involved in a coordinated approach to care. EVIDENCE: The home maintains care plans for all residents that are developed from assessments and used to ensure appropriate care is given with reference to ‘duty of care’ and risk assessments. Care plans refer 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. The registered providers and staff support residents to make decisions and consider the consequences of their behaviours. The homes ‘service user guide’ states that a member of staff is currently undertaking a diploma in Counselling. A discussion occurred with this member of staff and the registered providers regarding counselling activity occurring at the home with residents. This activity is not currently part of an agreed plan with funding authorities, the 6 monthly psychiatric reviews or recorded in care plans. A requirement is made to include details in the care plan of all Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 Page 10 therapeutic interventions conducted in the care home for residents. The care plan must include details regarding the purpose of the intervention conducted, the residents agreement, who is involved and how funding authorities and other agencies are assisting in the review and monitoring of these interventions. This issue is linked to the services provided at the home (standard 1) and must be clarified in the ‘statement of purpose’ to clarify what services are provided at the home. The monitoring of this ‘agreed work’ by external agencies will provide an important role in the review process for contractual arrangements, best value indicators and a coordinated approach for the welfare of residents. Elmslea DS0000009018.V260532.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): 11, 13, 15 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 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. Residents are provided with good food that is nutritious and appetising. Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 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 the following 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. 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 has been achieved. 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 DS0000009018.V260532.R01.S.doc Version 5.0 Page 13 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 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 DOH guidelines detailed in ‘No Secrets’. A requirement to include the complaints procedures and the contact details of this Commission in the guide for residents will provide further evidence regarding the welfare of residents. Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 Page 14 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 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 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 DS0000009018.V260532.R01.S.doc Version 5.0 Page 15 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, 33 and 35. 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 support staff were available to discuss the routines and developments at the home. Residents were preparing the evening meal and the home was organised to provide for their welfare. The residents and registered persons returned from various activities and assisted in the completion of this inspection process. 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 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. 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. Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 Page 16 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 and 42. The registered persons are experienced providers of care, maintaining a safe and pleasant environment for residents. The registered person intends to provide a solution to the identified risk area. 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. A discussion occurred with the registered persons regarding the security of the building at night where a resident may open a ground floor window for ventilation. This presents a potential risk to the individual and other vulnerable adults in this group living situation. The registered persons are required 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 appropriate arrangements for staff training in fire precautions, first aid, food hygiene, health and safety and the maintenance of equipment. Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 Page 17 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 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elmslea Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 x DS0000009018.V260532.R01.S.doc Version 5.0 Page 18 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. Standard YA1 Regulation 4 and 5 Requirement The registered provider must provide a statement of purpose and service user guide with reference to the details given in this report and reference to these regulations. Previous timescale not met. The registered provider must develop and agree with each service user an individual Plan which may include treatment and rehabilitation, describing the services and facilities to be provided by the home, and how these services will meet current and changing needs and aspirations and achieve goals. The registered provider must ensure, so far as is reasonably practicable for the health, safety and welfare of service users and staff. Timescale for action 31/03/06 2. YA6 15 31/03/06 3. YA42 12 31/03/06 Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 Page 19 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 Elmslea DS0000009018.V260532.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall 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 DS0000009018.V260532.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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