Inspection on 07/06/05 for Elmwood

This inspection was carried out on 7th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Elmwood 17/08/06

Elmwood 23/02/06

Elmwood 24/03/05

Elmwood 08/07/04

Elmwood 24/03/04

Elmwood 16/07/02

Similar services:

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Insight - Eastchurch

Southfields

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33 St John`s Church Road

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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 Sophie Wood Announced 7 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. Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Elmwood Address 221 Loose Road Maidstone Kent ME15 7DR 01622 751894 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) Mrs Maria Eliza Davis Mrs Maria Eliza Davis CRH Care Home 6 Category(ies) of Learning Disability (6) registration, with number of places Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24 March 2005 Brief Description of the Service: Elmwood is a detached property with all bedrooms being occupied on a single basis. Service Users are accommodated on the ground floor, the first floor being the office and Owner’s private living accommodation. All of these rooms have been fitted with television points and there is a call bell system, which operates within the Home. According to its Statement of Purpose, the Home provides a secure, homely environment in which a small group of 6 adults with learning disabilities can live happily, on a long – term basis.The Home is located on one of the main roads into Maidstone, some two miles from the town centre. The nearest shops and other public amenities are within walking distance of the Home. There is car parking to the front and side of the house and buses pass close by.There is a large garden to the rear of the property with a patio, lawn, vegetable area, fishpond and various other shrub and flower areas. Situated within the garden are various areas where Service Users may walk or sit. Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection commenced at 9.30 am on 7th June 2005 and lasted for eight and a half hours. Time was spent touring the home, interviewing the manager, deputy and care staff and speaking with all six residents and some visiting relatives. Additional information was received through the manager’s completed pre –inspection questionnaire and comment cards received from residents, staff, family members and professional visitors to the home. No statutory requirements have been made from this visit, demonstrative of the excellent quality of care that continues to be provided. Staff are well – managed and supported and this reflects positively in terms of their own care delivery. The inclusion of residents’ views continues to shape the service and maintains a very stable group, who have no desire to move on into any other form of accommodation. The feedback from all parties was extremely complimentary, with one relative stating to the inspector that the home should receive an award from CSCI for the excellent standard of care it continues to deliver. What the service does well: What has improved since the last inspection? Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 6 More staff have commenced with NVQ training and the home continues to undergo planned decoration and refurbishment. 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 H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 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 standard(s) 2, 3, 4 Prospective residents’ needs are assessed and they have the opportunity to make an informed choice before deciding whether to live at the home. EVIDENCE: All of the six residents have lived at the home for a number of years now and remain a very stable group. There are no plans for anyone to imminently ‘move on’. Residents spoken with confirmed that they had all visited the home and made a clear choice about wanting to live there. Care files examined supported that individuals had only been given the opportunity to move in because the home was confident it could meet their needs. The manager does have policies / procedures in the event of a new admission, however; given the current situation, this aspect was not fully explored by the inspector. Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 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 standard(s) 6, 7, 8, 9, 10 Residents are fully aware of the contents of their care plans and are encouraged to set their own goals. Clear, detailed risk assessments keep residents safe, whilst allowing opportunities. Residents are consulted in ways that are meaningful and appropriate. They have a real sense of ownership about their home and trust that staff maintain their confidences. EVIDENCE: Individual care plans were inspected. Goals and needs are explicitly clear. They are focused, monitored and regularly reviewed. Residents told the inspector that they know the contents and set many of the targets themselves. All of the residents lead busy lives, which present challenges, risks and the opportunity to make mistakes. Increasing independence is a key aspect of the home’s aims for its residents. Regular house meetings and individual key – working sessions enable residents to make own views known and all such meetings are recorded in writing. Residents’ wishes determine mealtimes, menus, holiday venues, décor and activities. Staff receive guidance and training in the handling of confidential information. They know when and how such information should be ‘passed on’. The inspector observed close, positive interaction between staff and residents, enabling residents to feel genuinely liked and respected. Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 10 Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13, 14, 15, 16, 17. Residents are enabled to develop through regular contact with the outside world. The home encourages the introduction and maintenance of meaningful relationships with a wide range of people outside of the home. Residents are valued by the staff, who actively encourage self – determination. Meals are nutritious, varied and wholesome. EVIDENCE: Care plans specifically target the personal development of individuals, describing the ways in which residents are to be supported to enjoy increased opportunities. The use of a full – time day care coordinator, who has a separate room filled with resources further enhances the development of literacy and numeracy skills, independence programmes and arts and crafts. Residents spoke very positively about this resource. They talked to the inspector about aspects of their lives that were important to them including, “going to work”, “seeing my boyfriend” and “going on holiday”. Weekly planners detail how each individual will spend their time and each one is very different. Details included work and social activities, relaxation time and chores to complete in line with group living. Thus, although personal choices are Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 12 highly valued, the responsibilities associated with living with others are made clear. A major emphasis is placed upon the enjoyment of mealtimes, which are unhurried, social occasions, observed as being enjoyed by all. Residents menu – plan, shop for, prepare and cook meals, albeit with the necessary supervision from staff. Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20, 21. Personal care is delivered sensitively in accordance with residents’ wishes and care plans clearly detail how physical and emotional health needs are to be supported. EVIDENCE: Some residents require more personal care than others. For those that do, care plans clearly detail how and under what circumstances this support should be delivered. Staff spoken to demonstrated a sound understanding as to how they would ensure privacy and dignity at such times and residents confirmed this happens in practice. At present, no residents control and administer own medication. This has been determined through a risk assessment process and the home operates safe and clear practices in this area. All of the residents have been consulted about their wishes in the event of dying and these are recorded on their files. One particular resident has experienced some difficulties associated with her own ageing and has also recently suffered a bereavement. The support received from all of the staff team for this individual is commendable. Elmwood H56-H06 S23930 Elmwood V222881 070605 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, 23. Residents have ample opportunities to express their views. These are listened to, valued and acted upon. Clear procedures are in place to ensure residents are protected from abuse, neglect and self – harm. EVIDENCE: Resident’s meetings are held weekly and are recorded in writing. All of those spoken with stated that these and individual key worker sessions are meaningful and worthwhile. None of the residents is afraid to make suggestions and comments. In fact, the inspector noted how confident people were in expressing own views, indicative of the culture that exists within the home. Residents know how to complain and so do family members and visitors. Such individuals informed the inspector that formal complaints do not need to be made, as issues are quickly resolved satisfactorily. The home implements clear and specific guidance for staff and external training courses are accessed. These measures and the use of clear risk assessments, protect residents, staff and visitors from abuse and accusations. Once again, there have been no adult protection investigations since the last inspection. Elmwood H56-H06 S23930 Elmwood V222881 070605 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, 29, 30. Residents live in a clean, well – maintained, homely environment. Bedrooms are very much ‘owned’ by the occupant and are furnished in a way that best meets their needs and promotes independence. There is ample communal space, accessed and enjoyed by all. EVIDENCE: The home is spacious and well – maintained. All bedrooms are single occupancy and have been personalised in accordance with the occupant’s wishes. Where needed, grab rails and other minor aides are in place to ensure optimum independence and toilets and bathrooms are close by. All residents can lock their bedroom doors if they wish and a number had brought own furniture and possessions when they first moved in. Communal areas include a large kitchen – about to be completely refurbished, dining room, lounge, conservatory and a large rear garden. All of these areas are accessible to everyone. On the day of the inspection, one resident was having a birthday party and all areas of the home were being used and enjoyed. Elmwood H56-H06 S23930 Elmwood V222881 070605 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) 31, 32, 33, 34, 35, 36. Clear lines of accountability and responsibility are followed and residents know exactly who to talk to. Staff receive more than the required amount of training per year and the courses attended are relevant to the needs of the residents. New staff receive a thorough induction and all have regular, documented supervision meetings. EVIDENCE: All staff have clear and specific job descriptions and contracts and residents know and understand the roles and responsibilities of their carers. Staff are conversant with care plans and what they mean in terms of their own practice. Individual personnel files were randomly selected in order to explore the home’s recruitment procedure. This was sound, however, the written policy is not as thorough as the actual recruitment practice itself and should be reviewed. New staff benefit from a comprehensive induction programme, followed by monthly supervision meetings. Whilst this is recorded in writing, staff do not receive their own copy and although they highly value supervision, they have not completed a supervision contract, which would clearly define its purpose and function. A rolling programme of training is in place; the manager is appropriately qualified, the deputy is currently completing the NVQ Registered Manager’s Award and the day care coordinator has NVQ 3. Of the three full – time carers, one has completed NVQ 2 and the other two have Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 17 commenced. Of the remaining eight part – time staff, four have completed NVQ 2. Staff told the inspector that they feel valued and supported by management and that training is given a high priority. This was evidenced through the records seen, which confirmed the variety and frequency of courses attended. Elmwood H56-H06 S23930 Elmwood V222881 070605 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, 38, 39, 42. The home is well – run and an effective leadership style promotes and encourages resident and staff participation. Residents are confident that their views and wishes contribute to the ongoing development of the services offered. Sound working practice safeguards the health, safety and general well – being of residents. EVIDENCE: The owner / manager is suitably qualified and has many years’ experience in this setting. Staff remain at the home and turnover is low. People understand what is required of them. They feel supported and encouraged and receive good quality training. This aspect reflects positively in terms of the quality of care delivered to residents. The views and opinions expressed by residents and staff are taken into account by the owner / manager in terms of her own quality assurance monitoring and the services offered have indeed been shaped by those living in the home. All records regarding health and safety checks, routine servicing of appliances and equipment were seen by the inspector. All were up to date and the home possesses adequate insurance Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 19 cover. Staff and residents are conversant with emergency evacuation procedures and a clear ‘on call’ arrangement means the home has 24 hour access to a senior member of staff. Elmwood H56-H06 S23930 Elmwood V222881 070605 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 x 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 4 3 3 3 3 Standard No 11 12 13 14 15 16 17 4 4 4 4 4 4 4 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Elmwood Score 4 3 3 4 Standard No 37 38 39 40 41 42 43 Score 3 4 3 x x 3 x H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 21 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 34 36 Good Practice Recommendations It is recommended that the recruitment policy be reviewed to accurately reflect the good practice that is followed. It is recommended that staff be furnished with supervision contracts and that they sign the written notes as an indicator that they agree with the contents. It is also recommended that staff are given their own copy of such notes. Elmwood H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent 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 H56-H06 S23930 Elmwood V222881 070605 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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