Inspection on 25/09/07 for Eltandia Hall Care Centre

This inspection was carried out on 25th September 2007.

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

Eltandia Hall Care Centre 14/12/09

Eltandia Hall Care Centre 22/04/09

Eltandia Hall Care Centre 29/04/08

Eltandia Hall Care Centre 18/10/06

Eltandia Hall Care Centre 19/10/05

Eltandia Hall Care Centre 17/05/05

Eltandia Hall Care Centre 25/11/04

Eltandia Hall Care Centre 09/06/04

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Eltandia Hall Care Centre Middle Way Norbury London SW16 4HA Lead Inspector Liz O’Reilly Key Unannounced Inspection 25th September 2007 10:30 X10029.doc Version 1.40 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 Eltandia Hall Care Centre DS0000019089.V352650.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 Older People and 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. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Eltandia Hall Care Centre Address Middle Way Norbury London SW16 4HA 020 8765 1380 020 8765 1399 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) www.schealthcare.co.uk Southern Cross (LSC) Ltd vacant post Care Home 83 Category(ies) of Dementia (63), Dementia - over 65 years of age registration, with number (63), Old age, not falling within any other of places category (63), Physical disability (20) Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. As agreed on 19/06/2006, Service users with Dementia, age 60 years and above can be accommodated within the home. 18th October 2006 Date of last inspection Brief Description of the Service: Eltandia Hall Care Centre is a purpose built home arranged over two floors with two residential units on the first floor and two units offering nursing care on the ground floor. The residential units comprise of one unit providing a mix of respite and permanent care for older people and one unit providing long term care for older people with dementia. One nursing unit offers long term care for older people. The second nursing unit provides care for younger adults with physical disabilities. All residents are provided with their own single bedroom accommodation with en suite toilet facilities. The home is situated in a residential area of Mitcham. Public transport in the form of local bus services are close by. Parking is available within the grounds. Fees for this service are;- From £550 per week for older people From £725 to £1050 per week for younger people With nursing needs. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by three regulation inspectors and consisted of a visit to the home, discussion with people who use the service, staff and the manager. A sample of records were examined and surveys were provided for people who use the service and staff. One inspector used the Short Observational Framework for Inspection. This involved a focused observation of the activity taking place for a small number of people with dementia in a communal area. We allowed additional time following the visit to the home for surveys to be returned. However we only received three completed surveys from people who use the service and seven surveys from staff. Judgements in this report have been made using all the above information. This is the first inspection of the service since the change in ownership. What the service does well: What has improved since the last inspection? This is the first inspection of the service since the change in ownership and management. Therefore previous requirements do not apply. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 6 What they could do better: Staff need more and on going training on working with people living with dementia and disabilities in a person centred manner. We feel there is too much emphasis placed on getting tasks done rather than spending quality time with people and engaging people in meaningful daily living activities. Staff need to place as much care in meeting the social and emotional needs of individuals as they presently do their physical needs. This needs to be seen in the care planning and in the care provided. A review of meal times must be carried out to ensure that there are enough staff available to make meal times a more social occasion. It is recommended that additional high calorie snacks are available at all times, as finger foods, for those people who may be of a low weight or at risk of weight loss. It is also recommended that staff sit with people who use the service and share meal times. A clear record of food must be kept for each person. Staff must take care to use all risk assessment and monitoring tools and record where referrals have been made to dieticians or other health care professionals. In order to offer opportunities for people to maintain and or develop a more domestic and independent lifestyle people living in the younger persons unit should be provided with an accessible kitchen and dining area. Staff should consult current good practise guidelines for people living with dementia to provide a more accessible and stimulating environment. Care needs to be taken to get repairs done as soon and as possible and staff need to be more active in promoting people bringing their personal things to the home with them. The use of uniforms is not in line with good practice in person centred dementia care and should be reviewed. In order to ensure that records are kept up to date and accurate, regular checks must be carried out on any money held in the home for people who use the service. Consideration should be given to making key policies and procedures more accessible, particularly the complaints procedure. The new management team need to look at how people who use the service can gain more access to activity outside the home. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 People who use this service receive adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are given information on what they could expect from the service before they made the decision to move in. The documents which give information on the service have not been completely up dated since the new organisation took over the home. Pre admission assessments make sure that the needs of individuals are known before they move in and that the home can meet these needs and wishes. However this information is not always used to plan the care. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 10 EVIDENCE: At the time of the visit to the home the documents used to give people information on the service, the Statement of Purpose and Service Users Guide, were still in the process of being updated to include information on the new organisation. The manager should make sure that this information is available in a variety of ways to be easily accessible. People we spoke to told us they had chosen to move into the home and had been given the opportunity to visit before they made any decision. Before anyone moves in an assessment of their individual needs is carried out by the placing local authority and or staff from the home. This information should be used to set up an initial care plan so that people get the care and support they need from the first day. We found that there were differences in the information on the pre admission assessment and the initial care plan. Staff need to make sure that the information they are given is used carefully and any changes are recorded. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 12 7, 8, 9 & 10 People who use this service receive adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service are provided with an individual care plan but they are not always actively encouraged to be involved in the development or review of the plan. Care plans are reviewed on a regular basis but care is not always taken to make sure that information is accurate or in full detail. Generally care plans focus on the physical needs of people with few details of how people would like their care given. The health care needs of people who use the service are mostly met and medication is well managed. EVIDENCE: Each person is provided with a care plan which sets out their needs and how they will be met. However we found variations in the quality of care planning throughout the home. As noted in the last key inspection of this home if staff are to support people to achieve personal goals and lead as full a life as possible then as much emphasis needs to be placed on the social, emotional and cultural needs and wishes of people as is at present placed on their physical needs. We found some care plans had good information about the individuals life and important events in their past along with their physical needs. Other care plans we saw did not have any background information recorded. The care plans on another unit were detailed and reflected the needs and wishes of the people concerned. However they focused on physical needs and gave little information on the strengths of people or how they would be supported in living the rest of their lives. In more than one instance a number of parts of the care plan had not been completed and information on pre admission assessments and previous care plans had not been carried over accurately. In one instance a person was described as independently mobile, unsteady, needing the assistance of two staff to walk and to be prone to falls. This person was recorded as refusing to wear a hearing aid and also to have good hearing. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 13 The information in care plans relating to people living with dementia or those who have shown aggressive behaviour in the past is basic. This suggests to the inspectors that staff are in need of further and on going training on supporting people in these circumstances. Care plans are not person centred and we found staff were in need of further training on person centred care and planning. Evidence that people who use the service, or their representatives, are consulted on their care plans needs to be in place. Care needs to be taken to review the care plans for those people who are staying at the home for respite care. Risk assessments relating to health were not always completed. In one instance a nutritional risk assessment indicated that a person was at very high risk. However this was not transferred into the care plan nor was a nutritional intake record in use. Without this information in the care plan with actions for staff there is a risk that the nutritional needs of this person will be overlooked. Pain and depression assessment forms were available but had not been used. A number of people who use this service may not be able to tell staff if they are in pain or feeling depressed therefore it is important that staff use the tools they have to assess individuals and take action. People who use the service including those staying on a respite basis have access to local GP services. Arrangements are in place for regular dental, optical and chiropody checks to be available. Records show that staff consult with other health care professionals including the tissue viability and district nurses. People who use the service told us that staff supported them to keep medical appointments. Records of medication administered were found to be up to date across the home. All medication was seen to be safely stored. Staff who administer medication have received appropriate training. Staff keep a record of all medication delivered to the home and returned to the pharmacy. On one unit the record of medication received had some omissions. Staff need to make additional checks to make sure this is kept up to date. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service receive adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Certain staff are clearly motivated to providing meaningful activities for individuals. However many staff are focused on physical tasks rather than providing a person centred service. Although the service recognises the right of individuals to have control over their lives and to make their own choices this does not always happen in practice. Opportunities for people to be independent and involved in community activities are limited. Mealtimes in the home is not considered to be an enjoyable event. Little thought is given to providing a relaxed, comfortable social environment for meal times. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 15 EVIDENCE: People who use the service have access to an activities room, a room with specialist equipment which people can use to relax and a room set out as an old fashioned sitting room all of which are on the first floor. The levels of activity we observed varied across the home. In the long stay residential unit on the first floor staff were seen to try and engage people in activity and conversation. Books, games and craft items were available for people to use. Rummage boxes, soft toys / dolls and sensory items could also be provided in the lounge for people to use. Staff told us that one person was regularly involved with activities such as washing up and preparing tables. One person on the younger persons unit told us that they occasionally take part in activities on the first floor. On other units we found little activity going on. Staff told us that it was difficult to support people to go out as it left the staff remaining at the home “too busy”. Two people on the younger persons unit told us that they could not access the kitchen area on the unit to make their own drinks or snacks. This does not allow people to maintain or develop their independent living skills. This has been raised with the previous owners of the home who, were we were informed, looking at providing a more domestic style, accessible kitchen dining room on the younger persons unit. We were informed that one activities officer had recently left unexpectedly. However we are of the opinion that all staff should be involved in supporting and engaging people in activities. There were times when staff could have spent more time talking and interacting with people rather than serving or clearing up items. This showed particularly when morning drinks and lunch were being served. Many staff missed opportunities to involve people in what was happening and to talk with them as part of a social occasion. All staff should be provided with training on or guidance from a trained person on engaging people who are living with dementia in meaningful activities. The lack of opportunity for people who use the service to spend time outside the home is of some concern. People who use the service confirmed that visitors are welcome at the home, at any time. Visitors were seen to be made welcome and left to be with their relative. However more consideration should be given to offering privacy during visits. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 16 We observed staff put a bib on two people where it was clearly stated in their care plans that they did not want this. The manager informed us that napkins had been ordered to be used instead of the bibs. This will provide a more adult aid. People who use the service told us that the food was “ok”, “usually good”, “fine”, “quite good” and “very nice”. Two people told us they always enjoyed the food and one person said they did not like “the same thing so often”. The menu for the day was not on display on each unit. Meals were served in the dining rooms, lounge areas and in bedrooms. Further work needs to be done on providing a more pleasant mealtime which is less focused on the task and more focused on the social occasion. We observed people served meals in lounges with no tray or cloth, no condiments, tables too far away and in some instances no conversation from staff. In one unit seven out of the ten people in the dining room remained in wheelchairs during their meal. A number of people in the lounge were falling asleep over their meals. One member of staff was observed helping two people at once to eat their meal. At the same time the senior person on the unit was giving out medication. A significant number of people were provided with a soft or liquidised meal. Consideration should be given to using moulds for soft meals, which will provide a more attractive meal and give more of an indication as to what the food is. There was little social interaction between staff and people who use the service. Consideration should be given to providing people with more opportunities to help themselves at meal times and for staff to sit down and share the meal. At the end of the meal, people were encouraged to finish and go back to the lounge. Staff should think about the routines in place and whether it matters how long lunch takes. The record of food was not fully completed with little information on what was being provided for those on special diets. We were informed that people on a diabetic diet mostly received banana and yoghurt for sweet. A large number of people are on high calorie diets but we found little evidence of additional snacks being available for between meals. Biscuits were available on one unit but only plain biscuits were available. No information on how additional calories were being added to main meals. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service receive adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The home keeps a record of all complaints along with actions taken and outcomes. The home understands the procedures for safeguarding adults, participates in and provides information if needed to external investigations. EVIDENCE: People who use the service told us they would speak to either staff or their relatives if they were unhappy about anything. However when asked if they knew how to make a complaint not everyone we spoke to knew how to do this. The manager should look into how the complaints procedure could be made more accessible. During the course of this inspection we were informed of two complaints which were still being investigated at the time this report is being written. The manager is working with social services to investigate the issues raised and has take appropriate action to safeguard people who use the service. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 18 A record of complaints is maintained which shows what the concern is, what action was taken and the outcome. Three complaints were recorded on file. Since the inspection visit two further complaints have been made and are in the process of being investigated by the local authority. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 23 & 26 People who use this service receive adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Each person is provided with their own bedroom with en suite toilet facilities, en suite showers are available in the younger persons unit. People can personalise their rooms but in practice this does not appear to be well promoted. The kitchen facilities particularly in the younger persons unit do not meet the specialist needs of individuals or promote independence. The environment in the units for people living with dementia could be improved. The bathrooms on the older persons nursing unit are not well maintained. The home is clean and tidy. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 20 EVIDENCE: People who use the service told us that they found the home to be fresh and clean at all times. We found most of the lounge areas well maintained. Staff on the long stay residential unit have made efforts to make the lounge area more homely and we are aware that people on the younger persons unit were involved in choosing décor and furnishings for their lounge. Further work needs to focus on the other two units which have a more clinical appearance. We would recommend that the organisation look at current advice on the environment for people living with dementia. Staff told us that people who use the service can bring to the home items of their own furniture and belongings. It was noted that some of the bedrooms had been personalised in this way but this was not consistent across the home. Staff need to work on this to make sure that positive steps are taken to encourage people to bring their own things to the home. One bathroom on the nursing unit had a significant amount of water coming through the ceiling and was being used as a storage area. The shower room on this unit was in poor condition with a damaged floor, tiles lifting from the wall and a faulty shower head. The third bathroom was missing tiles and contained a clothes rail. The equipment being used for repairs to the tiling was left in the bathroom. Action was taken for the leak to be repaired and tiling equipment to be removed when pointed out to the manager. In another unit one bathroom had been partly painted and was being used to store a significant amount of clothing. A check on all bathrooms and toilets needs to be carried out with a rolling programme for the redecoration and repair compiled. Consideration should be given on how bathrooms and toilets could be made less clinical in appearance. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service are generally satisfied with the care they receive. Sufficient staff are available but a review needs to be carried out to make sure that working practices such as those seen at meal times meet the needs of people who use the service. Staff are provided with good opportunities for training. However the amount and levels of training do not reflect the specialist nature of the service said to be offered in each unit. In order to safeguard people who use the service appropriate checks are carried out on staff before they start working in the home. EVIDENCE: Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 22 Observations at the time of our visit, feedback from staff and the staff rota indicated that there were enough staff to meet the needs of individuals. However the manager and senior staff need to look at how staff are working and how peak times are managed to make sure that all staff are working effectively. Consideration should be given as to how all staff can be more involved in supporting people in activities in the home. Comments received from people living in the younger persons unit suggested that they felt there were staff shortages at times and they were concerned about the welfare of staff particularly at night. Enough staff must be available so that people can take part in activity in the community, take up educational and social activities. Care should be taken to make sure that staff who are moved between units have the necessary knowledge and skills for each specialist area. Consideration should be given to ensuring that a person with knowledge and experience of supporting people with disabilities from a social perspective is part of the senior staff team in the younger persons unit. Feedback from staff and examination of records showed good opportunities for training. To make sure that all staff have the skills and knowledge to meet the needs of individuals, training needs to be targeted at the specialist areas the service provides. Training on working with people living with dementia and disabilities needs to be provided to all staff on an on going basis at a level appropriate to their role. People who use the service told us that they felt staff listened to them and acted on what they said. Discussion with staff and examination of records showed that care is taken to make sure checks are carried out for all staff before they start to work in the home. The manager is aware that she must get a full employment history from each person and find out why they left their previous job if they were supporting vulnerable adults or children. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 24 31, 33, 35 & 38 People who use this service receive adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The manager is aware of her responsibilities to take into account the wishes and opinions of people who use the service in planning and running the home. The recording of money held on behalf of people who use the service was not in good order. Staff make regular checks on the home to ensure the health and safety of people who use the service and visitors EVIDENCE: There have been a large number of changes for the home over the last year. The home has been taken over by a new organisation and the management team have changed. The manager is in the process of being registered by the CSCI. Staff generally said they felt well supported by the manager. However not everyone was receiving regular supervision yet. The manager was aware of this situation and was working on a supervision programme at the time of this inspection. Discussion with the manager indicated that she was intending to consult with people who use the service and their representatives in planning and making decisions about the service. The manager told us that staff were now wearing uniforms again as people who use the service had said this was what they wanted. The manager should also take note of present good practice in homes for people living with dementia which suggest that uniforms do not encourage a person centred approach or homely atmosphere. Consideration should be given to how staff could let people who visit the home know who they are without resorting to formal uniforms. Staff make regular checks on the home to make sure the health and safety of those living and working there is protected. Discussion with staff and examination of records showed that the handover of money held on behalf of people living at the home was not handled well. Present records did not match with those previously held in a number of instances. In one instance one person was recorded under two names. When we asked if there were two people living at the home with these names we were initially told there was. It later came to light that this was not the case. An immediate requirement was made for all accounts to be audited and put in order. The organisation confirmed that this had been carried out by the timescale set. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 25 Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 26 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 Standard No Score 1 2 2 X 3 2 4 X 5 X 6 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 ENVIRONMENT Standard No Score 19 2 20 X 21 2 22 2 23 2 24 X 25 X 26 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 2 34 X 35 1 36 X 37 X 38 3 Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 15 Requirement A review of care plans must be carried out to ensure that the needs and wishes of people who use the service are met. Evidence of consultation with the person involved, or their representative, must be available. Care plans must be accurate and for older people throughout the home reviewed on a monthly basis. The social, emotional, cultural and religious needs of individuals must be included along with information on how these needs and wishes will be met. To make sure that individuals receive the treatment and support they need as well as access to other health care professionals staff must carry out appropriate health care assessments and record actions taken. A review of meal times must be carried out to ensure that:DS0000019089.V352650.R01.S.doc Timescale for action 10/01/08 2. OP8 13(1) 12/12/07 3. OP15 17(2) Schedule 05/01/08 Page 28 Eltandia Hall Care Centre Version 5.2 4 (13) 16(2)(i) 18 A record of food is maintained for each person. Each individual is provided with a varied diet including those who require or request a special diet. Sufficient staff are available at meal times to meet the needs of individuals. Meal times are unhurried and provide opportunities for socialising. That people who use the service are provided with opportunities to serve themselves at least part of the meal with staff support. Snacks are easily available for people who need high calorie diets. More consideration is given to the presentation of meals and the provision of condiments and accompaniments. 4. OP27 16(2) (m) 18(1)(a) Sufficient staff numbers, equipment and facilities must be available to allow people who use the service to engage in local, social and community activities. 05/01/08 5. OP19 23 (2)(b) To make sure that people who 12/12/07 use the service are provided with a well maintained environment any damage to the building must be reported and attended to as soon as possible. A record of the reporting of repairs should be maintained. A plan for the redecoration of the bathrooms must be provided to Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 29 the CSCI. 6. OP19 16(2)(h) To support people to develop and maintain independent living skills plans need to be made to provide an accessible kitchen and dining room for those people living in the younger persons unit. 7. OP30 18(1) (c ) (i) In order to meet the needs of individuals all staff must be provided with on going training on supporting people who are living with dementia and disabilities. 05/01/08 05/01/08 8. OP35 17(2) Schedule 4 paragraph 9. In order to safeguard the 12/10/07 finances of individuals living at this home a review of all records relating to money held must be carried out. This review must cover the transfer from the records held by the previous manager and administrator of the home to the present manager and administrator. Confirmation that the review has been carried out and all records are in order must be supplied to the CSCI. These requirements were met within the timescales set. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 30 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. 4. 5. Refer to Standard OP7 OP19 OP24 OP15 OP27 Good Practice Recommendations The Registered Persons should consider providing residents with the opportunity to supply a life history for their file. The Registered Persons should look to improving the environment taking into account current good practice guidelines in dementia care. Staff should consider how they could be more active in encouraging people to bring personal items to the home. Consideration should be given to staff joining people who use the service at meal times. The Registered Persons should ensure that a person with knowledge and experience of supporting people with disabilities from a social perspective is part of the senior staff team in the younger persons unit. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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. Eltandia Hall Care Centre DS0000019089.V352650.R01.S.doc Version 5.2 Page 32 - 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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