Inspection on 29/01/07 for Elton Hall Care Home

This inspection was carried out on 29th January 2007.

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

Elton Hall Care Home 27/02/06

Elton Hall Care Home 24/05/05

Elton Hall Care Home 06/10/04

Elton Hall Care Home 14/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Elton Hall Care Home Elton Hall Elton Village Stockton on Tees TS21 1AG Lead Inspector Neil McKenzie Key Unannounced Inspection 11:00 29 January & 2nd February 2007 th X10015.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 Elton Hall Care Home DS0000059240.V328127.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. 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. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elton Hall Care Home Address Elton Hall Elton Village Stockton on Tees TS21 1AG 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) 01642 570200 01642 583218 Bondcare Homes Limited Mrs Jean Kemp Care Home 76 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0), of places Physical disability over 65 years of age (0) Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two named individuals who are under the age category are allowed to reside in the home. 27th February 2006 Date of last inspection Brief Description of the Service: Elton Hall Care Home is a 76 bedded home for 43 older people and 33 older people with dementia. Elton Hall Care Home is a modernised stately home, set in its own extensive grounds, bordered by woodland and open countryside. The home is less than two miles from Stockton-on-Tees. The home retains many of its original features. There are large lounges and an oak panelled dining room. The building is centrally heated throughout. Access to the first floor is either by a five-person lift or one of the staircases. The home has a south facing sun terrace that overlooks the rose gardens. Elton Hall Care Home has both single and shared bedrooms, all of which have an en-suite with a toilet and washbasin. All bedrooms, bathrooms and toilets are equipped with a call alarm system. The lowest fee a week is £353.00. The highest fee is £371.00. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspection lasted for 8 hours and this included 2 visits to the home. During the visits the inspector spoke to 4 residents, 3 staff and 4 relatives to find out what their views were about living and working at Elton House. The inspector also spent time speaking to the manager of the home and her line manager, the operations manager. The inspector spent some more time watching how staff and residents are with each other. A tour of the home took place and records looked at included staff recruitment and training, resident care plans and how the home handles money and medication. There was also questionnaire’s sent to the home, and these were looked at to help decide how well the home does in meeting the National Minimum Standards. What the service does well: What has improved since the last inspection? The home is currently in the middle of an ongoing maintenance/redecoration/ refurbishment programme to improve the quality of the environment for residents. This includes a renewed fire alarm and nurse call system as well as recently decorated ground floor lounges, bedrooms and toilets. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 6 The number of staff completing a National Vocational Qualification in care has increased and currently 50 of staff has the qualification. A new manager has been appointed and has been registered with the Commission for Social Care and Inspection as a person fit to be in charge. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 7 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 Outcomes Statutory Requirements Identified During the Inspection Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. Information about the home is available and appropriate. The care needs, and aspirations, of any prospective residents will be assessed prior to admission. EVIDENCE: The manager said that all residents are provided with a Statement of Purpose, which contains all of the required information about the home and how to contact the home. A copy was made available for examination during the visit to the home. The statement contained the required information. It was also evident that residents keep a copy of this guide in their bedrooms. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 9 The home also has a colourful brochure with photographs that is given to people interested in the home. One relative whose mother has recently moved into the home stated, ‘ we saw a number of homes before mother moved here’. As well as these visits the manager of the home confirmed that they are aware of the need to ensure that full and comprehensive assessment of need takes place, prior to admission to the home. To help facilitate this, a pre-admission assessment form has been devised, information from which can then be transferred into a care plan. The files looked at had completed needs assessments available. However, information written in these assessments would benefit residents more if there was more detail about their social and health needs. The formats are in place for this information to be detailed. In addition to these pre-admission assessments those residents who had not referred themselves to the home had in their records a pre-assessment of needs completed by an external qualified professional. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments were in place with evidence of review and updating. Residents’ well being is promoted by effective storage and administration of medication. Residents feel they are treated respect and sensitivity. EVIDENCE: Five care plans were examined during the inspection. All of the care plans contained basic assessment of needs, however, there was a lack of written detail with regard to some social and health needs. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 11 The formats are in place for written detailed information to be included in the care plans. For example, health-visiting forms, risk of falls, nutrition, mental health, pressure sores and social interests. It was evident from staff records that there had also been care planning and risk assessment training. A relative visiting the service-expressed concern about a resident not eating and there was evidence in the care plan that this was the case and was being monitored daily by both the home and specialist health workers. Discussion with the manager and her line manager suggested that the practice of a regular meeting with professionals and the relative to review progress might benefit the resident. During the inspection the home’s arrangements for receiving, storing, administering, recording and returning resident’s medication were examined and discussed in depth with the older persons unit manager and a senior carer based in the dementia unit. At the time of the inspection visit, medication was seen to be correctly stored with accurate records for the medication held in both the older persons unit and the dementia unit. The unit manager and senior carer was able to show and describe how medication is received and disposed of and how this is recorded. Separate storage and records for controlled drugs are counter signed when administered. At the time of the inspection three residents self medicated their own angina sprays and one their eye drops. The unit manager said this practice is supported by a risk assessment and reviewed once a month. A medication consent form should benefit residents from an additional agreement with the home regarding medication that is self administered and left in a safe place in their room. Staff members who handle medication attend an external training course and receive a certificate on completion. This was evidenced in staff records. Individual residents’ medication record sheets contained photographs of the person to help ensure that residents receive the correct medication. The residents’ who spoke to the inspector stated that staff treated them with respect and dignity. For example, one resident stated, ‘very good, cannot fault staff, very homely’, and another resident said ‘no real complaints, staff are fine, do their best’. One staff member commented, ‘ some people prefer to wash themselves, others their hair only, some refuse, we will go back but do not force them’. It was observed that staffs work hard at meeting the emotional and physical needs of residents. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. The resident’s benefit from planned social activities that provide variety and interest for people staying in the home. Residents maintain contact with families and friends from open visiting. On the whole the home provides a wholesome, varied menu that ensures dietary needs of residents are met. EVIDENCE: At time of the inspection an activity programme was displayed in the home that included a photograph of the activity worker. Her photograph was also available for residents in their bedrooms to remind them of who she is and what she does. During the inspection there was evidence of planned activities taking place with bingo and dominoes. Also in the dementia unit residents were being offered shoulder and head massage. As one resident stated, ‘this is really good’. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 13 Residents are also encouraged and given the choice to go out and visit friends and or shop. One resident described visiting their former place of work and another resident stated, ‘I get taxis and I am going down to visit my family today, we keep in touch’. In addition to this the home has access to a mini bus that takes people out on trips to places such as Whitby. All the relatives who spoke to the inspector said they are encouraged to visit the home and have opportunity to meet residents with privacy. A relative said ‘it is a lovely home, lovely atmosphere’, and another relative stated, ‘ staff lovely, no restrictions when visiting, any time you want to’. Food is said to be on the whole good and the meal served at the time of the inspection was tasty and wholesome. There was a choice of menu for residents to choose from on a daily basis and evidence of personalised menus for residents with particular dietary needs and or preferences. One resident stated, ‘food is better some days’ and a relative who has eaten in the home commented,’ food is generally good’. One resident suggested a preference for a gravy boat on the dining table to pour one’s own gravy. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. Residents are protected by a complaints procedure and a policy and procedure on adult protection and prevention of abuse. EVIDENCE: There is a complaints procedure displayed in the home and a policy and procedure for the protection of residents from abuse. There was evidence of a complaints file with a complaints form for residents and relatives. The file contained written details of complaints and actions taken by the home to resolve complaints. Staff also said they had received regular training in respect of adult protection. Certificates held in staff records evidenced this. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. The home offers a pleasant and comfortable environment for people using the service; a major refurbishment programme is currently addressing outstanding requirements in relation to décor and carpet replacements. EVIDENCE: The home is currently in the middle of an ongoing maintenance/redecoration/ refurbishment programme to improve the quality of the environment for residents. This includes a renewed fire alarm and nurse call system as well as recently decorated ground floor lounges, bedrooms and toilets. There are plans to decorate the outside of the home and replace carpets in corridors. A relative visiting the home stated, ‘it is a lovely home, lovely atmosphere’. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 16 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. Residents are supported by an effective and well-trained staff team and made safe by good recruitment practice. EVIDENCE: On the day of the inspection there were 26 residents staying in the elderly frail part of the home and 16 residents in the dementia part. Staff rotas examined showed that there were sufficient staffs on duty during the day and night. The unit manager stated that the number of staff on duty is reviewed with regard to numbers of residents and their needs. The recruitment and selection records of three members of staff were examined in the home. The recruitment files of staff looked at contained application forms that were backed up by two written references. Evidence was also in place to show that Criminal Records Bureau disclosures at Enhanced level had been received for the staff members prior to them starting work in the home. Staff employed from abroad also had their work permits held in their records. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 17 Discussion also took place with the manager who confirmed that staff completed the required mandatory training including fire, first aid, health safety and food hygiene. At the time of the inspection 50 of the staff completed National Vocational Qualification (NVQ) in Care level 2 or 3. staff files looked at contained certificates in NVQ. had and had The Residents should benefit from care staff receiving further training with regard to their specific needs, for example, dementia. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 18 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good). This judgement has been made using available evidence including a visit to this service. The home is well run and whilst the needs and wishes of residents are central to the provision of care this is being strengthened by relative survey. EVIDENCE: The new manager has worked hard to ensure the home is well run, and she has recently been registered with the Commission for Social Care and Inspection as a person fit to be in charge. The new manager stated, ‘ a lot to do in the home’ and there was evidence of improved training and regular supervision introduced by the manager to ensure the needs of residents come first. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 19 A random sample of 2 resident’s personal allowances and records were examined and there were no discrepancies with the balance stated on the transaction sheet and the actual amount contained in the individual money envelope. The transaction was made more robust by ensuring that 2 members of staff sign financial transactions. Residents also benefit from a regular audit completed by the operations manager to ensure the home is safe and provides good quality care. The home has in the past completed an annual survey to illicit the views of residents and relatives on how the home could be made better from their point of view. The manager showed a recent survey sent out to relatives to gain their views on what could improve the home. Details of health and safety were made available through the pre-inspection questionnaire and tour of the premises. These records were recorded as up to date with relevant certificates, for example gas safety, available on request. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 20 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO 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 OP3 Regulation 14, 15 Requirement Assessment and care plan formats are in place and are used but residents must benefit from more written detail about their social and health needs. Timescale for action 02/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP30 OP9 Good Practice Recommendations Care staff should receive further training with regard to specific needs of residents, for example, dementia. A medication consent form should benefit residents from an additional agreement with the home regarding medication that is self administered and left in a safe place in their room. Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Elton Hall Care Home DS0000059240.V328127.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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