Inspection on 18/08/09 for Elsinor Residential Home

This inspection was carried out on 18th August 2009.

CQC found this care home to be providing an Excellent service.

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

Elsinor Residential Home 29/08/07

Elsinor Residential Home 19/09/06

Elsinor Residential Home 31/08/05

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Key inspection report Care homes for older people Name: Address: Elsinor Residential Home 5-6 Esplanade Gardens Scarborough North Yorkshire YO11 2AW     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Pauline ORourke     Date: 1 8 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Elsinor Residential Home 5-6 Esplanade Gardens Scarborough North Yorkshire YO11 2AW 01723360736 01723370558 elsinor@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ramond Limited care home 35 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 35 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 35 Dementia - Code DE, maximum number of places: 35 Date of last inspection Brief description of the care home Elsinor is a large house situated on the south side of the town. The home provides accommodation for a maximum of 35 older persons. Some people may suffer from dementia. The majority of the bedrooms have an en-suite facility. The home provides personal care including assistance with bathing, toileting, washing and dressing, where required. Activities are provided on a planned basis and the home has its own mini-bus which is used regularly for outings. Outside entertainers are occasionally employed and a hairdresser visits on a weekly basis. People who live at Elsinor are registered with Care Homes for Older People Page 4 of 26 Over 65 0 35 35 0 Brief description of the care home local medical practitioners and have access to specialised health services through their GP. The home has a statement of purpose and service user guide, which provide information about the scope and nature of the care and facilities on offer. These, with CSCI reports, are available on request at the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The Care Quality Commission inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 6 of 26 The key inspection has used information from different sources to provide evidence for this report. These sources include: Reviewing information that has been received about the home since the last inspection. Information provided by the registered person in an Annual Quality Assurance Assessment form (AQAA) Comment cards returned from people living at Elsinor and from other people with an interest in the service. A visit to the home by one inspector that lasted for six hours. During the visit to the home twelve people who live there, four staff and two relatives were spoken with. Care records relating to four people who live at Elsinor five staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Elsinor for the people living there. Information about the home is available in a Service User Guide and the weekly cost of staying at Elsinor is three hundred and seventy five pounds and seventy seven pence. The actual amount payable by the person living at Elsinor is dependent on a financial assessment. The Registered Manager was available for feedback at the close. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Only minor areas have been identified as possibly benefiting from improvement and these are: Whilst there is some reference to some of the diverse strands of the community not all are identified in the Statement of Purpose and Service User Guide. These documents Care Homes for Older People Page 8 of 26 should be expanded to include all the diverse strands of the community and that they would be welcome at Elsinor. Daily records should be kept for everyone living in the home. This will allow patterns to be developed of different behaviours and may indicate when someones mental health is deteriorating or they are unwell. The medication records should contain a list of staff and their signatures. This will enable the person doing an audit to recognise immediately who has administered the medication. A regular review of accidents and incident should be carried out and be incorporated in to the monthly reviews to show if there are any changes needed to the care plan. The quality assurance questionnaires should be extend to include health and social care professionals. This will give a broader picture of the home and assist in the annual development plan. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using 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. People who decide to use this service can be assured their needs will be met. Evidence: When someone is looking to move in to The Elsinor they are initially invited to have a look round and to see the home itself. At this time they are given information in document called a Service User Guide. This document is backed up by the Statement of Purpose and both documents outline what is on offer in the home. This document could be further developed to include reference to all of the diverse strands of the community and that they would be welcome at The Elsinor. The manager and a senior member of staff visit each person before they are admitted and carry out a full assessment of need. This ensures the staff have the skills necessary to meet their needs. A trial period is organised and this is reviewed and only when both parties are satisfied is the placement made permanent. Care Homes for Older People Page 11 of 26 Evidence: Observation showed that staff had a good understanding of each persons needs and wishes. The surveys returned indicate that people feel they receive enough information about what is available so that they can make the choice to live at Elsinor. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the care and support they need. The staff provide support in a sensitive way that promotes the independence and dignity of the people who live at Elsinor. Evidence: Five case files were seen and each contained a care plan outlining the level of support required by the individual concerned. These plans were pertinent to the individual and staff review them each month. The care plans included relevant risk assessments, a deprivation of liberty assessment and a detailed personal history. There was also a motivation chart and a behaviour rating scale. Staff spoken with were knowledgeable about an individuals needs and they keep some daily records although they do not record each day for every person. Feedback from relatives indicated that they are kept up to date with the care and support required their relative living at Elsinor. Key workers are assigned and they monitor the persons personal items and liaise with the family to ensure they know when these things needs replacing. The case files contained evidence that people accessed a variety of health care services. A record is kept of when doctors, district nurses, community psychiatric Care Homes for Older People Page 13 of 26 Evidence: nurses and chiropodists visit them. Surveys were received from health care professionals and these said overall good working relationships - willing to listen and take advice and constructive criticism and the care service assess people before admission, review their health care needs, and always act to improve their health care needs they correctly administer medication A visiting chiropodist said the staff are always welcoming and supportive, they follow my instructions and I visit on a regular basis Records of the receipt and administration of medication were clear and accurate and recording was up to date. A monitored dosage system is used. All staff who handle the medication have received training in the safe handling of medicines from the Primary Care Trust. It is recommended that the administration record contain a list of staff and their signatures so that when an audit is carried out it is clear who has administered the medication. The Annual Quality Assurance Assessment form indicated there was a medication policy in place that covered the receipt and return of unused medicines, and administration of medicines. Throughout the visit the interactions observed between people who lived in the home and staff was seen to be relaxed and friendly. Staff called people by their chosen names and always knocked on a closed door before entering. Feedback received from relatives said: the staff are friendly and always approachable. They are eager to listen and try to solve any problems straight away and they are skilled at dealing with my relative who can be stubborn. People in the home said that the staff are wonderful. They always knock on my door before they come in and you can have a bit of fun with them. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make choices on a daily basis and are supported to do this by the staff. They enjoy a good and varied diet and a social and recreational programme helps them to maintain their interests and hobbies. Evidence: Staff work closely with people to discover their preferences in relation to their daily life and activities their views are sought through conversations with them and their representatives and by the completion of surveys asking for their preferences. The home keeps a record of who takes part in planned activities. People are able to go out for drives in the homes minibus that operates three times a week. The trips out are planned following discussions with people to see where they would like to go. Questionnaires had been completed with people about future trips and other activities they would prefer to take part in. A non-denominational church service is held in the home once a month for people who wish to attend. People are given the opportunity, where possible, to have their say at in-house meetings. If people wish to go out they are encouraged to do this independently or with somebody to accompany them. Visitors are welcome at any time and comments received from them include, the staff always take time with the Care Homes for Older People Page 15 of 26 Evidence: residents and There is regular entertainment On the day of the inspection people were encouraged to play dominoes, bean bag darts, have a sing-a-long and dancing. These measures help people continue with their chosen routines for as long as possible and encourage people to become involved in activities they prefer. Menus showed a good choice of food on offer that provided a balanced diet. People were complimentary about the food. People who require assistance with their diet are given enough time to take meals without being rushed. At the house meetings and through survey forms twice a year, peoples views are sought on the food provided. Any changes suggested are incorporated into menus to ensure that people are getting the food that they like. Breakfast is served from 7.30 am until 11.30 am. This allows people to get up when they choose. A full breakfast menu is available throughout this time. There is also a choice at midday and teatime. The meal served on the day was well presented and looked appetising. The cook said that they only provide diabetic diets at this time but if necessary specialist diets can be provided. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using 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. People who live at Elsinor and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected. Evidence: The home has a complaints policy and procedure to follow. Surveys returned indicated that people knew about this and would know who to speak with if they had a complaint. People felt confident they would be listened to and any concerns acted upon. People and their representatives are also given the forum to air any concerns they may have at the regular meetings that are arranged. There have been no complaints received by the Care Quality Commission since the last inspection. The manager at the home has dealt with one. All complaints are recorded with the outcome. Staff spoken with were clear about their responsibilities where they suspected abuse was happening. At the time of the inspection 20 of the 27 staff had received training in Safeguarding from the local authority. All staff are thoroughly vetted prior to the commencement of their employment and this ensures they are suitable to work with vulnerable people. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using 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. People live in a safe, comfortable environment. Evidence: The home is well decorated and pleasant, there are no unpleasant odours. There is an ongoing renewal and redecoration programme. A relative said, The home is always clean, warm and it never smells There is a rolling programme of building maintenance. The service employs an external independent health and sfaety company to ensure they continue to meet the required legislation regarding building risk, maintnenance and COSHH. There are several communal areas accessible to people who live at Elsinor. The corridors and staircases are wide and allow for several people to walk side by side. The lounges are large and are spacious enough to allow people to sit in quiet if they choose to. Visits from the fire authority and the environmental health department have shown that the home meets their requirements. The laundry service provided meets the needs of people. A relative said that the laundry is always done well and that people always look well presented. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff, that, have been thoroughly vetted prior to the commencement of their employment, support people. They receive regular training and are in sufficient numbers to ensure they can provide the support required by the people in the home. Evidence: The home is well staffed with a core staff group who have been employed at the home for a long period. This gives people confidence in the staff group as staff are familiar to them and fully aware of their needs and wishes. Seventeen out of the twenty one staff have achieved a qualification at NVQ level 2 or above. Two senior carers have achieved NVQ Level 4 in care and also the registered managers award. On the day of the inspection there were four carers, two senior carers, the mangager, a cook, a kitchen assistant and a laundry assistant. Staff files are well organised and contain all relevant information. The home recruits staff well; letting applicants know that it follows an equal opportunities policy, always obtaining two references and a Criminal Records Bureau check before deploying staff to work with people. The manager confirmed that staff received induction and foundation training that meets the Skills for Care standards. Staff said they are offered the opportunity to undertake training in areas that would help them meet the needs of the people that they care for. These include dementia awareness, first aid and palliative care. They are given the opportunity to discuss training during their Care Homes for Older People Page 19 of 26 Evidence: supervision sessions when work issues are also discussed. People feel confident in the staff and felt that we think the staff deservce a medal for what they do and staff very helpful - friendly and the staff are friendly and always approachable. They are eager to listen and try to solve any problems straight away and staff are reliable and work closely together Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well managed and systems are in place to protect their health and safety. Evidence: The manager, Mr Terence Bennett, has many years experience in the care profession. People living at the home, their relatives and staff all said they receive excellent support from him, and would feel happy to approach him about any issues they may have. A member of staff said that they feel very comfortable to discuss any work issues with him. A relative said that he was very approachable and went out of his way to speak with them when they visited. Mr Bennett is assisted in his role by the two senior carers who are qualified to NVQ level 4 and hold a management qualification. The home has developed a quality assurance system. The views of people living in the home and other interested parties are taken into consideration and used to develop the plan for the development of the service and to improve outcomes for people living Care Homes for Older People Page 21 of 26 Evidence: there. People are told about the results of surveys during house and staff meetings. It is recommended that this survey be extended to include visiting professionals, this will allow for a broader picture of the home to be established and will assist in the annual development plan. The manager does not deal with personal monies for anyone living at Elsinor. The health and safety records were checked and all were found to be up to date. Risk assessments for fire, the environment, COSHH and people who live in the home were in place. An independent company carries out regular health and safety checks to ensure compliance with relevant legislation. All accidents and incidents are recorded and when necessary they are reported to the Care Quality Commission. Whilst the accidents are reviewed on a regular basis it be useful for the key workers to incorporate these in to the monthly reviews carried out. This might then show any patterns of incidents and allow staff to alter the care plan accordingly. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 1 Whilst there is some reference to some of the diverse strands of the community not all are identified in the Statement of Purpose and Service User Guide. These documents should be expanded to include all the diverse strands of the community and that they would be welcome at Elsinor. Daily records should be kept for everyone living in the home. This will allow patterns to be developed of different behaviours and may indicate when someones mental health is deteriorating or they are unwell. The medication records should contain a list of staff and their signatures. This will enable the person doing an audit to recognise immediately who has administered the medication. The quality assurance questionnaires should be extend to include health and social care professionals. This will give a broader picture oft he home and assist in the annual development plan. A regular review of accidents and incident should be carried out and be incorporated in to the monthly reviews to show Page 24 of 26 2 7 3 9 4 33 5 38 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations if there are any changes needed to the care plan. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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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