Inspection on 29/04/08 for Elora House

This inspection was carried out on 29th April 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elora House 30/04/07

Elora House 07/11/05

Elora House 15/08/05

Elora House 31/03/05

Elora House 08/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Elora House 48 Netherfield Gardens Barking Essex IG11 9TL Lead Inspector Julie Legg Unannounced Inspection 29th April 2008 10:00 Elora House DS0000027887.V362401.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 Elora House DS0000027887.V362401.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. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elora House Address 48 Netherfield Gardens Barking Essex IG11 9TL 0208 591 2260 0208 591 2260 elora@tiscali.co.uk 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 Dia Tilakasiri Mr Dia Tilakasiri Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th April 2007 Brief Description of the Service: Elora House is a private owned care home, which is registered for three adults with a learning disability. The home is situated in a residential area of Barking and is undistinguishable from other houses in the road. On the ground floor of the home there is one bedroom, an open plan kitchen, dining/lounge and a small conservatory. Upstairs there are another two bedrooms, a combined bathroom and toilet and a staff office/sleep-in room. At the rear of the property is an enclosed garden, which has a fishpond in-situ. The home is well situated for all local amenities, including shops, library and leisure centre. It is also close to Barking railway station and the bus terminus. The home is run as a family type home, which aims to promote independence and choice and to assist the service users with developing their daily living skills. The Statement of Purpose is available to all residents and relatives. All of the service users have been given a Service User Guide. The fees for the home are £725-750a week, this does not include hairdressing, toiletries, and private chiropody or holiday spending money. This information was given by Dia Tilakasiri (the registered proprietor and manager) on 29th April 2008. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use the service experience adequate quality outcomes. This inspection took place over one day. The proprietor/manager was present for the duration of the inspection and was available for feedback at the end of the inspection. Discussions took place with the manager and one care staff. Further information about Elora House was also gathered from service users, staff, relatives and social care professionals. A tour of the home was undertaken and all of the rooms were seen to be clean and free from any offensive odours. Service users’ files were also examined and case tracked: including risk assessments and care plans, together with the examination of staff files and other home records. These records included medical charts, financial transactions, and staff rotas and staff records. Additional information relevant to this inspection has been gained from the Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment tool, which all providers are required to complete once a year. It focuses on how well outcomes are being met for people using the service. It also provides us with some statistical information about the service. We had a general discussion on the broad spectrum of equality & diversity issues and the manager was able to demonstrate a good understanding of the varied needs around religion, sexuality, culture, disability and gender. We also had a discussion with the manager and people living at the home as to how they wished to be referred to in this report. They expressed a wish to be referred to as ‘service users’. This is reflected accordingly throughout this report. We would like to thank the service users, manager and staff for their input during this inspection. What the service does well: The home is small, clean and has a relaxed atmosphere and service users take part in some of the day-to-day activities within the home. Service users are happy living at the home and the manager and staff are keen to ensure that they lead fulfilling lives. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 6 The staff team is very stable and the level of experience of working with people with a learning disability is high. All of the staff are NVQ trained. Relatives and social care professionals are satisfied with the service being provided and feel that the service users are well looked after. Relatives stated, “They look after A really well. He phones me and the staff help him to send me cards”. “I am very happy with the way they are cared for”. A social care professional stated, “There has been an improvement in their behaviour and social skills since living at Elora House”. What has improved since the last inspection? What they could do better: The manager must ensure that care plans are person centred and reviewed in line with the National Minimum Standards. Daily records need to be more informative and relate to residents’ care plans. Risk assessments need to be evaluated, reviewed and updated as this could have an impact on the safety and well being of the service users. The manager in conjunction with the service users need to look at their individual aspirations and wishes regarding social activities within the home and in the wider community. Some redecoration and refurbishment has been undertaken however further work in one bedroom and the living room needs to be carried out. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 7 A quality assurance of the service needs to be undertaken, taking into account the views of the service users, relatives and stakeholders. From this information an annual development plan needs to be developed that reflects the aims and outcomes for the residents. 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. The summary of this inspection report can be made available in other formats on request. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 8 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 Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2 and 3 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Prospective service users and their relatives have the information they need to be able to make an informed choice about moving into the home. The assessment of needs and other information received from health and social care professionals means that staff have detailed information to enable them to determine whether or not they can meet the needs of prospective service users. Prospective service users know that the home can meet their needs. EVIDENCE: The Statement of Purpose and the Service User Guide are both available to prospective service users in an easy to read format. Prospective service users and relatives can use this information to decide whether the home is suitable for them. The current service users have been living at the home for some considerable time; the most recent service user moved into the home in 2004. The manager stated that all prospective service users would be appropriately assessed prior Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 10 to admission and that information would also be gathered from health and social cares professionals as well as relatives and other significent people. The admission process would be designed around the needs of the prospective service user. The prospective service user may make several visits to the home and possibly an overnight stay to ensure that they like the home and to meet the other service users. This transition period would also allow staff to get to know the prospective service user and to know whether they can meet the their needs. One service user told the inspector “I visited the home before I moved in and met everyone”. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,8 and 9 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. All of the service users’ identified needs are reflected in care plans and risk assessments, however these provide staff with the information they need to identify and meet individual service users’ needs. Service users are encouraged to be as independent as possible and supported to make decisions about their lives. EVIDENCE: All three service users’ files were examined, these contained a care plan and risk assessments, Staff were observed interacting with service users and some elements of the care plans were discussed with the manager. The care plans identify personal care, social care, religious and health care needs of each individual service user and how these needs are to be met. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 12 There has been an improvement in the care plans; they are written in plain language and are easy to understand but they are not detailed or person centred; they do not clearly identify their skills and abilities and how they make choices in their life. There was evidence that all of the service users have had an annual review in the last eight months, which were carried out by the funding authority. All three reviews stated that the placement continued to meet the service users’ needs and that no further action was required. A relative confirmed that she had attended the review and that there had been no major issues. A social care professional stated that “There has been an improvement in A’s behaviour and his social skills”. There was no evidence that the care plans are reviewed and updated as required by the National minimum Standards. This is to ensure that care plans are reflecting the service users’ current needs. This is Requirement 1. Care plans were examined alongside the daily records and compared with the support being given. There are daily written records, which reflect the activities that have been undertaken that day. However these records need to reflect the well being of the service users and how residents are involved in the life of the home and evidence care plan goals. This is Requirement 2. All of the service users are able to participate in activities within the home, such as setting and clearing the table, washing up, making a cup of tea and their own breakfast, preparing the vegetables, putting the washing in the washing machine and gardening. One of the service users attends a horticultural course at the local college and another works one day a week at a local barber’s shop. None of the service users choose to attend a place of worship. All of the service users are able to handle small amounts of money and are encouraged to pay for their own personal items when visiting the shops and car boot sales. One of the service users told the inspector, “I enjoy working at the barbers, I get my hair cut for free ”, and another service user said, “I do my own breakfast every morning”. Staff were observed interacting with the service users, their relationship was easy going and friendly but in a professional manner. Some aspects of the service users’ care were discussed with the manager, particularly in relation to their personal care, dietary and social care needs. Two of the service users were at home during the inspection and gave their views. Comments from the service users were “I’m happy here”, “the staff are ok” and “M takes me shopping and to the café”. There is a small stable care staff team, who know the service users and their needs very well. Relatives written comments, “the home functions very well with great respect between staff and residents”, “they enable B to live as independent as possible”. Service users are encouraged to take reasonable risks and there were risk assessments and guidelines in place. Risk assessments that were examined showed areas identified such as, tasks and activities within the home, in the community and health risks. They evidenced that service users are being Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 13 supported to experience ordinary living within a safe environment. The risk assessments are not being evaluated reviewed and updated and this could have an impact on the safety and well being of the service users. This is Requirement 3. There was written evidence that service users are being consulted on the dayto-day running of the home; service users’ meetings are regularly held and their views are taken on board regarding holidays, menu planning and day- today activities within and outside of the home. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15,16 and 17 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users have opportunities for personal development within the home and access to educational placements and day services. Leisure activities within the local community could be more varied. Service users have appropriate personal and family relationships. Their rights are respected and are supported to take responsibility for their actions. There has been an improvement in the meals, which are now varied and nutritionally balanced. EVIDENCE: Service users’ care plans identify lifestyle choice, such as local leisure activities, activities within the home, day services, college placements, employment and family contact. All of the residents have opportunities for some personal development within the home and in the community. One Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 15 service user attends a horticultural course at a local college two days a week and one day a week he works in a local charity shop. Another service user attends a local drop-in centre and works one day a week at a local barber shop. He told the inspector “I really like it, sometimes I get tips”. One of the service users does not wish to attend any day services as she thinks she is too old. She enjoys going out shopping with her keyworker and having lunch at the local café. She also enjoys attending her hair appointments at a local salon. All three of the service users attend various clubs and are going to Norfolk for their holidays this year. The service users have varied interests, such as, car boot sale, visiting the local library, amusement arcades and the cinema. All of the service users enjoy visiting Fairlop Waters, where they enjoy playing pool. One of the service users swims for a local club and takes part in swimming galas. He has won numerous medals that are proudly displayed in his bedroom. One relative commented, “They could go on more trips, like to London and the seaside”. One service user said, “I would like to go to Southend” another service user said “I would like to do some baking”. These comments were discussed with the manager who will talk to the service users about other activities or social outings they would like to attend. This is Requirement 4. All of the service users’ have their own televisions and music centres in their bedrooms and there was evidence of their particular interests and hobbies. One had football posters displayed and a large volume of CDs, another had pictures that he had coloured and his swimming medals, the other service user had lots of photographs and ornaments on display. The three service users receive visitors, some more regularly than others. One of the service users goes home every Sunday and returns on Monday, he travels there independently by bus. Another service user told the inspector “My brother visited last week, we spent time in my bedroom talking”. Another service user sees his family less frequently but he is in contact by telephone and letters. His relative wrote, “They help A to write cards and buy presents and ring me”. There are no set ‘house’ rules and service users were observed to go about the home freely. At the time of the inspection one service user arrived back from the shops, another service user was watching television and the remaining service user was attending college. Staff have the overall responsibility for the cleaning of the home, however the service users are able to participate at varying levels, such as, dusting their bedrooms, putting their clothes away, helping with putting their laundry in the washing machine and putting the rubbish out, as well as assisting with maintaining the fish pond and garden. The home does not employ a cook and care staff shop, prepare and cook all of the meals, with the involvement and a limited degree of support from Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 16 individual service users. Service users are involved with menu planning and food shopping. The staff are very aware of special dietary needs, such as diabetic diets. Records were seen of the past months menus. On the day of the inspection there were more than adequate quantities of food available, including fresh fruit/vegetables and meat. All of the service users are able to help themselves to drinks and snacks whenever they wish. During the inspection one of the service users was seen to make a cup of tea for themselves. The inspector asked the service users “do you enjoy the food and do you get enough to eat?” One service user said, “Yes, its really good”. Another service user said, “I enjoy it”. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and20 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users receive personal support in the way they prefer and their physical and emotional needs are met. There are clear medication policies and procedures for staff to follow; this will ensure that service users are safeguarded with regard to their medication. EVIDENCE: Care plans and daily records were examined and discussed with the manager. The care plans identify health and personal care needs and how these needs should be met. Service users are supported and helped to be independent and can take responsibility for their personal care needs. Two of the service users do not require assistance with their day-to-day personal care, though they sometimes need reminding. One of the service users does require some minimal assistance with bathing and same gender care is given. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 18 Service users were dressed in clothes that were appropriate for the time of year and which suited their personalities. One service user stated, “I can have a bath when I want”. A relative stated, “A always looks clean and tidy”. Another relative stated, “They really look after him”. Records inspected showed that service users have health action plans. All of the service users are supported to access dental care, well woman clinic, opticians, diabetic nurse, chiropody, and any GP or hospital out- patient appointments. Two service users confirmed that they had attended dental, chiropody and optician appointments. All of the service users require support to attend their appointments, however the manager identified in the AQAA that he and the staff are going to work with some of the service users to enable them to attend their health appointments independently. One of the service users has glasses and dentures, but refuses to wear either of them. Two of the service users are diabetic, regular blood tests ensure that his blood sugars are under control. Two of the service users are weighed fortnightly, as one is prone to loosing weight; he also has supplement drinks and the other service user is prone to putting on weight; a healthy eating is encouraged. The other service user is weighed monthly. There are policies and procedures for the handling and recording of medication within the home. Staff have received medication training and there is a list of staff (with their signatures) that are competent in the administration of medication. Medication Administration Records (MAR) charts were checked and all were completed appropriately. The manager regularly regularly checks the medication records to ensure compliance. One of the service users is able to self- administer her medication on a daily basis, however there was no up to date risk assessment in place. This was highlighted to the manager who undertook a risk assessment at the time of the visit. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The service users’ views are listened to and acted upon. Service users are protected by the policies and procedures and the monitoring systems within the home. EVIDENCE: The home has a clear complaints procedure, which is available in pictorial format. A copy of the procedure has been made available to all of the service users and to their relatives. Since the last inspection there has not been any complaints. The manager was advised that any complaints however minor should always be recorded. The Commission has not received any complaints since the last inspection. The manager stated that he welcomes complaints and suggestions about the service. In discussions with relatives and the service users, it was obvious that they were aware of the complaints procedure and would have no hesitation in making a complaint if necessary. All of the relatives stated that they were aware of the complaints procedure and would have no hesitation in making a complaint, if required. Two of the service users were asked, “If there was anything you were not happy about, who would you tell?” One of the service users said, “I would tell Dia or my mum”, another service user said, “I would Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 20 tell M (staff)”. The two service users told the inspector that they were happy at the home and did not want to live anywhere else. The home has a Safeguarding Adults policies and procedures; these include the local authority (London Borough of Barking and Dagenham) policy and procedure, DOH document ‘No Secrets’ and the home’s policy and procedure. There was signed evidence that these had been read by the staff. The manager was clear in what incidents needed to be referred to the Local Authority as part of the local safeguarding procedures. The member of staff that was spoken to was very clear on what constituted abuse and their responsibilities to report any potential abuse. Staff surveys also indicated that they were aware of what action to take in reporting potential abuse. Staff files indicated that all members of staff have covered the subject of Safeguarding Adults during their induction and during their NVQ training and other formal training. It is good practice for this training to be updated every three years. This is Recommendation 1. The home has policies and procedures for the safekeeping and expenditure of service users’ money. The three service users’ monies were checked; all were found to be correct. There was a clear audit trail and receipts were available for all expenditures. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24,25,26 and 30 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. The home is homely, clean, and free from any offensive odours. However some redecoration and some refurbishment need to be undertaken to ensure that the service users’ home is safe and comfortable. EVIDENCE: The home is in keeping with other properties in the road. A tour of the home was undertaken including the service users’ bedrooms. The home is furnished in a homely fashion and the entire home was clean, tidy and free from any offensive odour. On the ground floor there is an open plan kitchen, dining/ lounge area, one of the bedrooms and a small conservatory which houses the washing machine and tumble dryer. Upstairs there are two bedrooms and a combined bathroom and toilet as well as the staff office/sleeping- in room. All of the bedrooms were personalised with posters, swimming medals, soft toys, CDs, Videos and family photographs. All have televisions and music centres Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 22 and one service user has recently purchased a flat screen television. The three bedrooms are of a good size; two of the bedrooms have been redecorated and new carpet laid, service users were involved in choosing the décor of their bedrooms. However the third bedroom needs to be redecorated so that the décor is more age appropriate and the wardrobe and a small chest of drawers need to be replaced; the back of the wardrobe has come away and the drawers are broken in the small chest. The open plan kitchen, dining/lounge area is in need of some redecoration and the carpet needs replacing as it is showing signs of wear and is very heavily stained. This is Requirement 5. The garden is well kept. All of the service users enjoy sitting in the garden one of the service users enjoys maintaining the fishpond and the garden. All of the service users enjoy sitting in the garden Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34,35 and 36 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence including a visit to this service. Service users are mostly supported by qualified and competent staff. Staffing levels are satisfactory and there are sufficient staff on duty. The majority of the staff have the skills and training to ensure that staff are able to meet the individual needs of the service users. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. Staff are receiving supervision but annual appraisals need to take place. EVIDENCE: Duty rotas were inspected and they correlated with the staff member on duty, there is sufficient staff on duty to meet the needs of the service users. There are three service users living at the home and there is always one member of staff on duty, at night there is a sleeping member of staff. There is good staff retention within the home and permanent staff covers any absences, this Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 24 ensures continuity of care for the service users. The staff team are culturally diverse and this reflects the local community in which the home is situated. There is a recruitment policy and procedures. Five staff files were inspected and these showed that appropriate recruitment procedures were being followed; all of the files had a completed application form, an up to date Criminal Records Bureau (CRB) check, copies of appropriate documentation, such as, permission to work and proof of identity. Staff training that has been undertaken includes; Health & Safety, risk assessment, emergency first aid and challenging behaviour. All of the staff have attained their NVQ 2/3 qualification. Not all of the staff have attended safe food handling training, this is essential as all of the staff are involved in the preparation and cooking of meals. Further training is also required in infection control and moving & handling. The manager is aware that there are some gaps in the training programme and plans to deal with this. This is Requirement 6. It would be beneficial for the staff if the manager completed a training profile for each member of staff, which identified what training they had undertaken and what training they required. This is Recommendation 2. Staff files indicated that supervision has taken place however this appears to be limited to talking about the service users and not about the development and well being of the member of staff. All of the staff completed surveys and all stated that ‘the manager is supportive and always available’. There was no evidence that annual appraisals are taking place. This is Requirement 7. Service users spoke positively about the staff, one service user said, “I love going out with M, she takes me shopping”, another service user stated, and “they are nice”. A relative stated, “They look after him really well”. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 41 & 42 People using the service experience adequate quality outcomes in this area. We have made the judgement using a range of evidence including a visit to this service. The manager of the home is a qualified and experienced person, however they must ensure that the home is run in the service users’ best interests at all times. The home’s record keeping, policies and procedures safeguard the rights and best interests of the service users. EVIDENCE: The manager is very experienced and qualified (NVQ 4) to manage the home and has a sound understanding of the service users’ needs. The staff spoken to Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 26 during the inspection spoke about how supported they felt by the manager and that he was very approachable. This inspection identified that standards particularly in relation to care planning, staff training, supervision and appraisals need to improve. These areas were discussed with the manager who recognised the improvements they need to make. The Annual Quality Assurance Assessment (AQAA) was completed and the information gave a reasonable picture of the current situation within the service. The AQAA gives some detail about the areas where they still need to improve (as identified above) and the ways they are planning to achieve this are briefly explained. Audits, spot checks and quality monitoring systems need to be reintroduced to provide evidence that practice reflects the homes policies and procedures. Information needs to be gained from service user meetings; complaints, concerns and compliments; and quality assurance questionnaires to service users, relatives and stakeholders. This information will assist in making improvements and influence service delivery. All this information needs to be collated and a report made available to the service users and any other interested parties, including the Commission. This is Requirement 7 The home has responsibility for the personal allowances of some of the service users and secure facilities are provided for their safekeeping, with records being maintained and accurate. All of the service users are able to handle varying amounts of money, and one service is able to withdraw his money from his Building Society account. A wide range of records were looked at including fire safety, emergency lighting, health and safety checks and accident/ incident reports. These records were found to be up to date and accurate. The annual Gas safety inspection was carried out on the day of the inspection (29/04/08) and the 5 year Electrical safety certificate was dated12/02/08. All accidents and injuries are recorded appropriately. There have only been minor injuries and no hospital admissions. The home has a fire risk assessment and a fire inspection has taken place within the last twelve month, which was satisfactory. The water temperatures of the water outlets are tested monthly and fridge and freezer temperatures are also regularly recorded. Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 27 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 3 2 3 3 3 4 X 5 X 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 2 25 3 26 2 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X 3 3 X Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 28 Yes 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 YA6 Regulation 15 (2)(b) Requirement The registered person must ensure that each service users care plan are person centred and kept under review, at least every six months. This is to ensure that care plans are reflecting the service users’ current needs. Previous timescale 30/06/07 not met. The registered person must ensure that all daily records reflect the well being of the service users and how residents are involved in the life of the home and evidence care plan goals. Previous timescale 31/05/07 not met. The risk assessments are not being evaluated reviewed and updated and this could have an impact on the safety and well being of the service users. Previous timescale of 30/06/07 not met. The registered person to consult with the service users regarding a programme of leisure activities in the home and in the community that meet their wishes and their aspirations. DS0000027887.V362401.R01.S.doc Timescale for action 30/09/08 2. YA7 17(1)(a) 30/09/08 3 YA9 13(4)(a) 30/06/08 4 YA14 16(2)(n) 30/09/08 Elora House Version 5.2 Page 29 5 YA24 16(2)(c) 6 YA35 18(1)(i) 7 8 YA36 YA39 18(2) 24 The registered person must maintain the environment and ensure that the home is fit for purpose and that service users are able to live in a safe and comfortable environment. The registered person must ensure that all staff receive appropriate training to ensure service users’ safety. The registered person must ensure that all staff receive yearly appraisals. The registered person shall establish a system for reviewing the quality of the care provided at the home, that takes into account the views of the service users and significent others. Previous timescale 30/09/07 not met. 30/09/08 30/09/08 31/08/08 30/09/08 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 YA23 Good Practice Recommendations Staff files indicated that all members of staff have covered the subject of Safeguarding Adults during their induction and during their NVQ training and other formal training. It is good practice for this training to be updated every three years. It would be beneficial for the staff if the manager completed a training profile for each member of staff, which identified what training they had undertaken and what training they required. 2 YA35 Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection London Regional Contact Team 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Elora House DS0000027887.V362401.R01.S.doc Version 5.2 Page 31 - 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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