Inspection on 17/08/06 for Elmwood

This inspection was carried out on 17th August 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elmwood 23/02/06

Elmwood 07/06/05

Elmwood 24/03/05

Elmwood 08/07/04

Elmwood 24/03/04

Elmwood 16/07/02

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Elmwood 221 Loose Road Maidstone Kent ME15 7DR Lead Inspector Eamonn Kelly Key Unannounced Inspection 17th August 2006 10:00 Elmwood DS0000023930.V301854.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 Elmwood DS0000023930.V301854.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. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elmwood Address 221 Loose Road Maidstone Kent ME15 7DR 01622 751894 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) maria.davis@tiscali.co.uk Mrs Maria Davis Mrs Maria Davis Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2006 Brief Description of the Service: Elmwood residential home provides personal support and accommodation for up to 6 people. Twenty-four hour supervision is provided with a member of staff on duty at night and the owner/manager, who lives at the premises, on call. Each service user has a single bedroom. All bedrooms are situated on the ground floor. The premises are suitable for people who use wheelchairs. Equipment that contributes to the comfort of service users is obtained as needed. A new electrically operated bed and a standing-aid hoist have recently been purchased. Car parking is available at the front of the premises. The home has two vehicles for use by staff and service users. Service users have easy access to bus services. There are good day care facilities within the home. The garden is suitable for use by service users, staff and visitors. Weekly fees are £534-£781. Additional charges (eg. hairdressing, private chiropody, holidays, clothing, phone call costs, towels, toiletries, newspapers, some travel costs, meals out, some day care facilities, personal spending) that service users must meet are shown in the personal contract between the home and each service user. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection visit between 2.30-6pm consisted of meeting with service users and members of staff on duty. All bedrooms and communal areas were visited and a number of records associated with service user care and safety were seen. Survey questionnaires (“Have Your Say About...”) were sent by the CSCI to the home prior to the inspection visit. Relatives, representatives and care managers returned 16 completed survey questionnaires. Comments made were positive. The inspection visit concentrated on the care and support in place for service users. Meetings with members of staff and service users served to give a broad understanding of how service user’s current and changing needs are addressed. The results indicated that service users are well cared for at the home. What the service does well: What has improved since the last inspection? Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 6 The owner/manager continues to identify where better procedures, staff training, improvement to the premises and service user support are necessary and to implement those measures. 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. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4, 5. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. New service users are admitted following a full assessment of their support needs. They and their main representatives would benefit from receiving a personal contract that contained information about the rights and responsibilities of the home and the service user. EVIDENCE: Most service users have lived at the home for many years. In the case of a service user recently admitted, a full assessment was undertaken. This involved the prospective service user, members of the family, and a care manager. Soon after, a key worker was allocated to the service user. Specialist needs, risk, social and personal care needs were identified and a care plan record begun. In the example discussed of the most recent admission, it was clear that the needs and aspirations of the new service user are being met. The procedure at admission stage enabled the prospective service user and representative(s) to visit prior to making a decision and to meet members of staff and other service users. Each service user (or his/her main representative) does not have a copy of a personal contract that specifies the terms and conditions of residency and the Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 9 rights and responsibilities of both parties. The need for such a personal contract is irrespective as to whether or not a placement agreement exists between the home and a local authority. The contract must include any issues specific to the individual service user. Examples of these that relate to service users at the home were discussed with the owner/manager. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 10 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, 9. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. Service users are enabled to take control of their lives. EVIDENCE: Each service user has a care plan that contains information about his/her support needs and how these are being met. Those seen have recently been reviewed and updated. Two service users are being helped with preparing personal care plans that includes personal photographs and information about themselves and others. These are produced using symbols that service users understand. Profiles of each service user discussed with the day care co-ordinator indicated that service users make decisions about their lives and that staff provides assistance as needed. Members of staff outlined how individual choices are made. Staff are skilled in providing service users with the information, assistance and communication support that they require to make decisions about their lives. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 11 Members of staff have, through their experience and training, the skill to identify risks to individual service users and to take steps to minimise these risks. Where a situation occurred earlier in the year where a day care activity at a local college presented a specific and serious risk, action was taken to prevent further or similar occurrences. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 12 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 to 17. Quality on this outcome area is excellent. This judgement was made using available evidence including a visit to this service. Service users have a support framework at the home that enables them to personally develop, have educational opportunities within and outside the premises, engage in personal relationships and have leisure opportunities. EVIDENCE: Service users are assisted to attend college. They receive support within the home with numeracy and literacy activities. Some are able to use a computer at the home. Service users are supported with finding and keeping paid and volunteer jobs. They receive advice and support from staff with benefits and finance problems. There is commendable emphasis on using a variety of communication methods to help service users maintain independent living skills. Service users are closely integrated with the local community. Staff time with and support for service users outside the home including evenings and weekends is a Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 13 recognised part of staff duties. The maintenance of personal relationships is an important part of service user support. Guidance is provided by staff in all aspects of relationships including keeping contact with families and friends. A commendable range of leisure activities is available to service users depending on their abilities and preferences. Two vehicles (a service user’s Motability vehicle and a home owned vehicle, both Vauxhall estates) are used for this purpose. There are agreed routines for service users to take part in household activities. Service users are helped in commendable style with aspects of education, occupation, leisure and routine in a variety of ways. The Day Care Co-ordinator organises activities and opportunities and monitors progress. Examples discussed included how changes are made to some planned activities for agreed reasons and other activities substituted. Staff meetings are held. The minutes suggested that members of staff identified potential issues in some detail relating to each service user and how these should be addressed. Staff/service user meetings are held, for example, to discuss and agree food preferences and meals for the coming week. An example of this negotiation was observed during the visit. Good records are kept relating to all aspects of service users lifestyles. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 14 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, 20. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. The home provides good personal and healthcare support to service users. EVIDENCE: Profiles of each service user discussed during the inspection visit confirmed that guidance and support is provided regarding personal hygiene, personal support needed, and assistance with appearance. Key workers have a particular role with this. Each service user has a single bedroom and some keep their own door key. Service users’ health is monitored. Potential problems are identified and are dealt with at an early stage. This includes referral to an appropriate specialist where necessary. Information about service user’s health and personal care needs is contained in care plan records. This includes routine visits to GP’s, dentists and opticians. Discussions with members of staff confirmed that they are able to support service users with recurring or new emotional problems. Staff receive training in assisting service users with specific health problems (for example, diabetes, epilepsy, cerebral palsy). Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 15 Medication is stored securely. MAR (medication administration record) sheets seen were up-to-date. Staff receive training in administration of medicines by invasive means. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 16 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, 23. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. Service users’ comments and concerns are solicited and taken seriously. They are protected from abuse and neglect. EVIDENCE: Service users and their representatives are encouraged to make their views known. The home has a complaints procedure. Service users were assisted by a member of staff or a close family member to complete a CSCI survey questionnaire. Issues of service user protection are included in the home’s induction procedure. Members of staff met were aware of how service users should be safe from abuse or neglect at all times whether they are at the home or elsewhere. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 17 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, 28, 30. Quality on this outcome area is excellent. This judgement was made using available evidence including a visit to this service. Service users live in premises that are suitable for them. EVIDENCE: The premises comprise bedroom accommodation, communal areas and garden facilities that are suitable for use by people with physical frailties. Each service user has a single bedroom that is comfortable and well furnished. All bedrooms are on the ground floor. This makes life easier for people with physical disabilities. Specialist equipment for alleviation of service user’s disabilities has recently been purchased. There are very good facilities for leisure and provision of activities within the home. The garden is suitable for use by service users. Some help with maintenance of the vegetable garden. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 18 The home was clean and well maintained. The facilities of the home both indoor and outdoor are excellent and add greatly to the comfort and lifestyles of service users. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 19 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): 31, 32, 34, 35, 36. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. Service users are in the care of members of staff who are qualified and who receive ongoing training support at the home. EVIDENCE: Members of staff met on this occasion demonstrated how they have an understanding of why service users can express frustration at issues where, for example, they feel that they are unable to communicate with each other or with staff. The good staff support for service users is enabled by the staffing structure. The home has an owner/manager, deputy manager, day care co-ordinator and support workers. Most support workers have achieved or are working towards NVQ Level 2 in Care. The deputy manager is undertaking the Registered Manager’s Award. She has achieved NVQ Level 3 in Care. The day care coordinator has obtained NVQ Level 3 in Promoting Independence. A recently appointed member of staff has completed a range of mandatory training in a short time. She is being encouraged to undertake NVQ training relatively soon. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 20 The owner/manager promotes an active training policy. All members of staff receive fire safety training, manual handling training and annual updates, medication administration training, first aid training and updates, and food hygiene training. In addition, members of staff receive training in topics relevant to service user care and support (for example, adult protection, epilepsy, sign language and communication, administration of rectal diazepam, and information courses on understanding reasons for challenging behaviours, and types of syndromes or disorders that service users could have). It was not possible to make an assessment of recruitment procedures through access to staff files as the owner and deputy manager were unavailable. However, from information given by the day care co-ordinator and members of staff and confirmed by phone on the following day by the owner, service users are protected by good recruitment procedures. This includes the taking up of CRB (criminal record bureau) checks for all staff. No members of staff are allowed to work (including under direct supervision) pending receipt of a CRB check until a POVA-first response has been received. Members of staff receive formal supervision about every 6 weeks the outcomes of which are recorded and kept in individual staff files. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 21 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, 39, 42, 43. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. Service users have the benefit of living in a well run home. EVIDENCE: The owner/manager, Mrs Maria Davis, has run Elmwood residential home for 10 years. During this time and previously, she acquired wide experience in supporting people with learning and physical disabilities. She is an NVQ assessor and has undertaken a range of courses relevant to the support of service users. She has introduced a progressive staff support and training policy at the home. During the inspection visit, service users and members of staff were at ease and there was a positive and relaxed atmosphere. Members of staff had a confident and knowledgeable approach which assisted each service user to proceed with different activities. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 22 The pre-inspection questionnaire completed by the owner contained a declaration that relevant safety checks and associated maintenance records were up-to-date. These included the checking of all electrical items at the time they are taken into the home and annually thereafter. Also, the fire safety procedures as described by the day care co-ordinator are comprehensive. These include safety lectures for all staff, testing of fire safety equipment and fire drills with live evacuation of premises practiced. The range of training organised at the home helps to underpin the continuing safety and protection of service users. Six completed CSCI surveys “Have your say about…” were received from service users. They received assistance in completing the surveys from staff and family members. Other completed surveys were returned by care managers, relatives and GP’s/community nurse. The feedback was positive in all respects. Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 23 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 x 2 3 3 3 4 3 5 1 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 4 25 x 26 x 27 x 28 4 29 x 30 4 STAFFING Standard No Score 31 3 32 3 33 x 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 3 Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 YA5YA5 Regulation 5 (1) (b) Requirement Timescale for action Each service user or their representative must receive a personal contract that states the 15/10/06 rights and responsibilities of both parties. “The registered manager develops and agrees with each prospective service user a written and costed contract of terms and conditions between the home and service user”. [NMS 5.2]. “The registered person shall produce…which shall include…the terms and conditions in respect of accommodation to be provided for service users, including as to the amount and method of payment of fees”. [Care Home Regulations 2001: 5 (1) (b)]. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Elmwood Refer to Good Practice Recommendations DS0000023930.V301854.R01.S.doc Version 5.2 Page 25 Standard Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Elmwood DS0000023930.V301854.R01.S.doc Version 5.2 Page 27 - 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. 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