Inspection on 31/08/05 for Elsinor Residential Home

This inspection was carried out on 31st August 2005.

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

Elsinor Residential Home 18/08/09

Elsinor Residential Home 29/08/07

Elsinor Residential Home 19/09/06

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 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Elsinor 5-6 Esplanade Gardens Scarborough North Yorkshire YO11 2AW Lead Inspector David Blackburn Unannounced 31 August 2005 09:45 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 Older People. 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. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Elsinor Address 5-6 Esplanade Gardens Scarborough North Yorkshire YO11 2AW 01723 360736 01723 370558 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) Ramond Ltd Mr Terence James Bennett Care home only 35 Category(ies) of DE(E) Dementia - over 65 (35) registration, with number OP Old age (35) of places Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: NONE. Date of last inspection 18/01/05. Brief Description of the Service: Elsinor is a large imposing building situated on the south side of the town. A former hotel, it has been adapted to provide accommodation for a maximum of 35 older persons. On five floors it provides single and shared bedrooms for people who by reason of age, infirmity or social condition require the care and attention that can no longer be suitably provided in other settings. Some residents 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, undertaken by a team of staff employed throughout the 24 hour day. There is a full catering service; an in-house laundry for linen, bedding and personal clothing and a domestic and cleaning service. A handyman provides a daily maintenance service. 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. All service users are registered with local medical practitioners and have access to specialised health services through their GP. Local services in the town are used for chiropody, dental and optical requirements, either by attendance at surgeries or by domiciliary visits from the practitioner. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection upon which this report is based was the first to be undertaken in the inspection year April 2005 to March 2006. It was carried out over six hours including preparation time. The focus was on the key standards together with those that were the subject of requirements or recommendations at the last inspection. An inspection of some parts of the premises including a number of bedrooms was carried out. A number of records including some policies and procedures and other documents, for example staff records were examined. Discussions were held with the registered manager and some staff on duty including senior care assistants, care assistants, catering and domestic staff. A number of residents currently accommodated in the home were spoken with, some in the privacy of their rooms. Three visitors and one visiting professional also had conversations with the inspector. All made positive comments about different aspects of the care, services and facilities on offer. This was the first inspection of the home following its purchase by Ramond Limited. Mr Bennett remained as manager. What the service does well: Good assessment methods were in place that ensured those admitted would have their personal and health care needs fully understood and recorded prior to admission. Personal and health care needs of residents including medication were generally well recorded and acted upon by staff promoting good health. A visitor said “I have no concerns about my relative.” Another commented “She is well looked after.” The service users were happy with the food being provided. Proper attention was given to any special dietary needs. Residents made positive comments about the overall catering service. “I enjoy all my meals. They’re lovely.” “The lunch was nice, but so are all meals.” The number of staff employed by day and by night gave service users the confidence that their needs could and would be met. Visitors said “They all work hard to provide what is needed.” Another praised the manager and staff for their hard work. Residents were similarly very supportive of the staff team. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 6 “They’re all grand.” “They are always ready to help. Nothing seems too much.” Overall, proper regard was given to matters of health and safety so that those living there were safe and secure. Staff confirmed they had received the required mandatory training in such matters as moving and handling, first aid and fire safety. A visitor said “It’s always clean and warm. There’s never any smell and you can’t so that about all homes in this town.” What has improved since the last inspection? What they could do better: Staff administering medication should undertake a regular count of any controlled drugs to ensure any discrepancies are immediately noticed and rectified. The complaints procedure should contain information on how to contact the new registered provider. The registered manager should obtain a copy of the revised multi-agency agreement on the protection of vulnerable adults. All staff employed in the home must have a current enhanced disclosure from the Criminal Records Bureau prior to commencement of employment. Where this may delay an appointment a POVA/First check may be obtained. The registered provider is reminded of the need for any registered manager to have achieved a National Vocational Qualification in care and management to level 4 by December 31st 2005. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 7 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. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6. Residents were assured their needs and choices would be properly assessed and met. EVIDENCE: The files of the last two residents to be admitted were examined. One had been admitted from the community, the second from another care home. Each file contained an assessment. In the first this had been completed by a care manager of the funding authority and in the second by a care co-ordinator of the local health care trust. Further information had also been provided by staff from the care home. Staff from Elsinor had visited each prospective resident and completed the home’s information and assessment sheet providing any required additional details. Staff at the home did not provide intermediate care. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Residents’ physical and health care needs including medication were generally well recorded ensuring they were properly understood and met in an appropriate manner. EVIDENCE: A number of care plans were seen including those of the last two residents to be admitted. Each care plan recorded strengths, needs, how those needs were to be met and by whom. The care plans were supported by an assessment of activities of daily living. A monthly evaluation was undertaken with any changes being recorded. Those evaluations were signed and dated. A daily record was also maintained that showed the events and occurrences as they affected that resident. Health care needs were recorded. Each resident and their relatives had been provided with a Fact and Information Sheet that recorded how individual health care needs could and would be met. Each file seen contained a risk assessment with particular regard to the dangers of falling. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 11 Nutritional needs including any special requirements were recorded on the activities of daily living assessment sheet. Pressure area care, tissue viability and continence promotion were promoted and maintained in conjunction with the advice, guidance and support of the appropriate health care specialist. The necessary aids had been provided. Proper procedures were in place for the receipt, storage, administration, recording and return of medication. Improvements had been made to the storage and administration of any controlled drugs. It was recommended that staff administering medication undertook a regular count of any controlled drugs to ensure any discrepancies were immediately noticed and rectified. All staff who administered medication had received the appropriate external training. Proper arrangements were in place for the promotion and maintenance of dignity and privacy in relation to the care given to residents. Staff were diligent in observing how care was to be offered, when it was to be offered and where. Bedroom doors had locks and most bedrooms had an en-suite facility. Residents were appropriately dressed. Telephones could be provided to rooms, although none of the present residents had taken advantage of this option. Residents said they were very happy with the manner in which care was given. “I have no complaints.” “I’m very happy.” “It’s alright here. I’m well looked after.” Visitors echoed these comments. “He’s well looked after. They do care for him.” “We have no worries. They do their best. She’s not always the easiest to please.” The visiting professional said “Discussion and work on dignity and privacy forms a major part of the training in the home.” Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15. Residents’ opportunities for social interaction were promoted and maintained enabling them to have a number of different life experiences. Their dietary needs were well met through the provision of varied and nutritious meals. EVIDENCE: A variety of in-house activities were on offer. Residents’ enjoyment of and response to these activities were noted in the minutes of the Residents’ Meetings, as were requests for additional pastimes. Exercise classes, musical afternoons and outside entertainers appeared the most popular. The home had its’ own mini-bus and outings were regularly offered. Some residents were able to get out to local facilities and amenities. A discussion was overheard about a trip to a local pub. Visitors said they were welcome to call at any time. None felt there were any unnecessary restrictions imposed on them. They were offered suitable refreshments including meals. One resident, assisted by a care assistant, was writing a letter to a relative. All residents were expected to handle their own financial affairs either by themselves or through the services of a third party. The registered manager collected some personal money but this was immediately given to the resident concerned. Proper records were being kept and were seen. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 13 The home had a dedicated chef with experience in catering for this resident group. The menu, devised by the registered manager and chef, taking into account the likes, dislikes, preferences and choices of residents, was on display. It showed a good variety of food being offered. Changes were being made to the menu following feedback from residents given in a recent survey on food provided in the home. Options were available at breakfast and tea. While a three course set meal was organised at lunchtime, alternatives were available. Diets were well catered for. Observation of one meal showed food well presented with good portion control. Alternatives to the set meal were being offered. Residents were very happy with the meals and made numerous complimentary comments including “We get plenty to eat.” “The food’s always nice.” A relative said “He seems happy with the food. I‘ve never heard him complain.” Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18. Residents had the assurance that their concerns and worries would be listened to and acted upon and that procedures were in place to protect them from harm. EVIDENCE: A complaints procedure was seen. This showed how to complain, to whom and gave timescales for response. Clear reference was made to the regulatory authority. The procedure should show the name and address of the new registered provider. The registered manager said a revised procedure was to be produced. The registered manager had produced an “Elder Abuse Policy” and this was seen. This was complimented by a number of other relevant policies including whistle blowing and aggression. These matters had been discussed at a recent staff meeting. The minutes were seen. The registered provider should obtain a copy of the revised multi agency agreement on the protection of vulnerable adults. This should then be discussed with staff and implemented. Residents said if they were worried about anything they would talk to the staff or Mr Bennett. All were confident their concerns would be addressed and resolved. A visitor said she had “raised a number of matters with Mr Bennett. He had listened and done something about each one. I will approach him again if I’m worried about my relative’s care. He sorts it out.” Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26. Residents were able to live in a clean, comfortable and hygienic home. EVIDENCE: Elsinor is a large imposing building occupying five floors and situated on the south side of the town. A former hotel it has been extended and adapted to provide for a maximum of 35 residents in 25 single and five shared rooms. 23 single rooms and four shared rooms had en-suite facilities some including a bath. A number of bedrooms were seen. They varied in size and shape but all met current requirements. They were well decorated with good furnishings in serviceable condition. The majority of those seen had been well personalised. There were five communal bathrooms including two now provided with specialist equipment. Five sitting rooms were provided, including one for those who wished to smoke, on different floors giving residents the choice of where and with whom Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 16 to sit. The dining room was on the lower ground floor adjacent to the kitchen. New dining room furniture had been provided. Improvements had been made to the lift including a “voice reminder.” The laundry was located on the lower ground floor and could be accessed without the need to cross any communal area. There were policies and procedures in place to minimise the risk of cross infection and contamination. Those parts of the premises seen were clean, tidy and odour free. Residents said they were happy with their rooms and the general overall state of the home. Visitors were complimentary in their remarks about the premises. They said staff worked hard to maintain standards and that there were never any unpleasant smells irrespective of what time they visited. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. Residents were given good and consistent care by a motivated, trained and competent staff team. The appropriate external agencies must be consulted before staff are appointed to ensure residents’ continued protection from harm. EVIDENCE: There were 26 care staff including five senior staff. They were supported by the registered manager, catering staff, domestic assistants, a handyman and an administrator. The current deployment of care staff was seen as adequate to meet current assessed needs. Of the 26 care staff, six had achieved an National Vocational Qualification in care to at least level 2. Three further staff were working towards the award and seven had been proposed to start in the near future. Staff and the visiting education professional confirmed these figures. The files of the last two members of staff to be employed were examined. Each contained an application form with the requirement for two references, and a statement of the terms and conditions of employment. Enhanced disclosures from the Criminal Records Bureau (CRB) were not available on one file seen. The guidelines issued by the Department of Health must be followed and a current enhanced disclosure for all staff obtained prior to commencing duties, even where one was available from former employers. Where staffing Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 18 difficulties may be encountered the registered manager should seek a POVA/First check. The files seen had evidence of training undertaken by the individual staff member. Induction training was given in-house and through an external company using the “Working in Care Induction Standards Programme” (WICIS). This uses five key areas of skill and knowledge and was said to meet the “Skills for Care” published standards. Residents and visitors were complimentary towards all staff. They described them as “hard working”, “caring and concerned” and “always pleasant and ready to help.” The visiting professional said her involvement with the home and staff led her to the conclusion that staff were hard working, conscientious and caring.” Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35 and 38. Residents live in a well-managed, safe and secure environment. EVIDENCE: The registered manager was well experienced with many years in the care sector. He was aware of the need to gain a National Vocational Qualification to level 4 in care and management by 31st December 2005. Complimentary remarks and comments were made about the registered manager by residents, staff and visitors. A system for gaining residents’ views on the provision of food in the home had been devised based on a written questionnaire. This had been distributed and the replies received, 22 returned from 34, seen as positive. While the overall response had been supportive of the registered manager and catering service, a number of suggestions had been made. These were being discussed by the registered manager and chef and incorporated into the menu wherever possible. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 20 Residents’ meetings were held monthly and staff meetings quarterly. A health and safety policy had been produced that included infection control, COSHH (substances hazardous to health), fire safety, and general safety matters. Training money had been identified to update staff in moving and handling, fire safety, first aid and food hygiene. Proper regard was being given to the promotion and maintenance of a safe and secure environment for service users, visitors and staff. A number of satisfactory safety reports and certificates were seen relating to the premises. Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 2 x 3 x 3 x x 3 Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 22 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 29 Regulation 19 Requirement All employees must have a current enhanced disclosure from the Criminal Records Bureau obtained by the registered provider prior to employment. Timescale for action From the next staff to be appointed. 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. 3. Refer to Standard 9 16 18 Good Practice Recommendations Staff administering medication should undertake a regular count of any controlled drugs to ensure any discrepancies are immediately noticed and rectified. The complaints procedure should contain information on how to contact the new registered provider. The registered manager should obtain a copy of the revised multi-agency agreement on the protection of vulnerable adults, discuss this with staff and ensure its implementation in the home. The registered provider is reminded of the need for any registered manager to have achieved a National Vocational Qualification in care and management to level 4 by December 31st 2005. 4. 31 Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit 4, Triune Court Monks Cross York YO32 9GZ 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 Elsinor J53-J04 S64473 Elsinor V244839 310805 Stage 4.doc Version 1.40 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!