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Inspection on 20/12/05 for Elvy Court Nursing Home

Also see our care home review for Elvy Court Nursing Home for more information

This inspection was carried out on 20th December 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Care plans are comprehensive and offer good guidance to staff in supporting the daily lives of the service users. It is evident through the inspector talking to members of staff that the emotional health of the service users is of a high priority to the home and that staff are pro-active in maintaining and supporting service users with their emotional needs in order to maintain their quality of life. The Registered Manager has been instrumental in developing the staff team to work towards improving the quality of care since joining the home. Evidence of the manager`s positive contribution towards the home was given by staff, service users and relatives. Many residents were spoken to and all who were able to do so confirmed that the staff are very caring and kind to then at all times. The inspector noted that staff spoke to the service users in a respectful and courteous manner.

What has improved since the last inspection?

Improvements were noted with regard to updating and changing to a new care planning system. All areas of the home appeared to be cleaned and maintained to a high standard.

What the care home could do better:

On standards inspected during this announced inspection some suggestions and recommendations were made along. Some shortfalls were noted with regard to Adult Protection training.

CARE HOMES FOR OLDER PEOPLE Elvy Court Nursing Home 204 London Road Sittingbourne Kent ME10 1QA Lead Inspector Robert Pettiford Announced Inspection 20th December 2005 09:30 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 Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 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. Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Elvy Court Nursing Home Address 204 London Road Sittingbourne Kent ME10 1QA 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) 01795 437449 01795 437450 Southern Cross Healthcare Services Limited Mr Keith Bartlett Care Home 57 Category(ies) of Dementia - over 65 years of age (32), Old age, registration, with number not falling within any other category (25), of places Physical disability (8), Terminally ill (5) Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Patients detained under the Sections of the Mental Health Act may not be admitted to the home 1st August 2005 Date of last inspection Brief Description of the Service: Elvy Court Nursing Home is a purpose built nursing home set over two floors. The home is situated on the main A2 road with Sittingbourne town centre being approximately ¾ mile distance. A bus stop is located nearby with the nearest railway station being in the town centre. Parking is available to the front of the home. Service users are accommodated on two separate units within the home. Each unit has separate lounge and dining rooms. Specialist bathing facilities and additional specialist equipment, for example hoists, are provided. There is a garden for use by service users. The home has a full time activities coordinator. A hairdresser visits the home on a regular basis. Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced Inspection at Elvy Court took place on 20th December 2005. The Inspector agreed and explained the inspection process with the Registered Manager. Documentation and records were read. A tour of premises was also undertaken. The focus of the inspection was to assess Elvy Court in accordance to the National Minimum Standards for Older People. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. As this report was made following an announced visit and may not cover the standards in sufficient depth for the reader to make a judgment about the home, it is recommended that a copy of the last unannounced inspection report dated 1st August 2005 also be obtained. What the service does well: Care plans are comprehensive and offer good guidance to staff in supporting the daily lives of the service users. It is evident through the inspector talking to members of staff that the emotional health of the service users is of a high priority to the home and that staff are pro-active in maintaining and supporting service users with their emotional needs in order to maintain their quality of life. The Registered Manager has been instrumental in developing the staff team to work towards improving the quality of care since joining the home. Evidence of the manager’s positive contribution towards the home was given by staff, service users and relatives. Many residents were spoken to and all who were able to do so confirmed that the staff are very caring and kind to then at all times. The inspector noted that staff spoke to the service users in a respectful and courteous manner. Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 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 Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this occasion. EVIDENCE: Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 9 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 the following standard(s): 7,8,9,10 Service users benefit from having clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Service users also benefit from being treated with respect and their dignity and independence is promoted. Health needs are met and resident’s benefit from having full access to all professional health care services as required. The service users’ welfare is protected from harm by the home’s policy and procedures with regard to the administration and dispensing of medication. EVIDENCE: Several care plans were read and found to be comprehensive and contain good detail. The home has recently changed it system of care planning. Therefore it was acknowledged that further updating was required. Care plans contained a full client profile along with admissions assessments and contact details for relatives along with physical and social assessments. Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 10 The home has in place very detailed systems of assessment and screening tools which include pressure area’s, dependency, moving and handling, nutritional, malnutrition, continence, falls risk review and client reviews. It was clear from the records that the service users were all registered with a local GP and their care needs were being fully met. Access to other health professional such as Chiropodist, Opticians and District Nurses were well documented. The Home uses a Monitored Dosage System. The inspector viewed the storage arrangements and some records including Medication Administration Record (MAR) sheets. The medication policy was comprehensive. Brief guidance and “when required” protocols were included with the Medication Administration Records which contained clear photographs of residents. Relevant Department of Health and health related documents were circulated to staff for information. There was evidence that the home worked with the pharmacy and Doctors. Medication rooms were well equipped, clean and tidy and at appropriate temperatures. Evidence was seen that the Registered Manager has ensured and promoted best practice with regard to the handling of the medication within Elvy Court. Service users spoken with all felt well cared for and were happy to live at the home. Good interaction was seen between staff and the residents and staff were seen to respect the service users dignity and privacy and used the preferred term of address for individuals. Personal care is given in a way that clients prefer allowing for preferences were possible. Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 11 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 the following standard(s): Not inspected on this occasion. EVIDENCE: Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 16,18 Service users know that their concerns and complaints are taken seriously and that policies and procedures are in place. Service users are not fully protected from the risk of abuse due to the lack of training for some of the staff with regard to Adult Protection. EVIDENCE: The inspector viewed a copy of the Home’s complaints procedures. The procedure included details of how to complain, timescales for response and information for referring a complaint to the Commission for Social Care Inspection A copy of the complaints procedure has been provided and explained to service users where possible. The inspector viewed and discussed copies of the Home’s Policy for the Protection of Service Users and staff “Whistle blowing” procedure. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training however in abuse has not been provided to the majority of staff. Out of a staff team of 41 only 27 have received any formal training. The inspector requested that priority be given to ensure that all staff have received Adult Protection training to protect service users from abuse. Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 13 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 the following standard(s): Not inspected on this occasion. EVIDENCE: Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Service users can feel confident that their care, social and emotional needs will be meet by sufficient staff on duty at all times who have the training and skills they need to meet their needs. Service users are protected from potential abuse by the home’s robust staff recruitment procedures. EVIDENCE: The home has a mix of management personnel, care staff, chef and kitchen assistants, laundry assistant, maintenance specialist, and housekeeping staff. A copy of the staffing roster seen indicates that rotas have been prepared for the following month. The home provides seven AM carers with 2 qualified staff and six PM carers with 2 qualified. The home has three carers and 2 qualified working nights. The rota and observations during the inspection reflected sufficient staff to support residents to participate in activities and to meet their personal needs. The manager stated that staffing levels are regularly reviewed taking account of the changing needs of residents. The number of staff having attained or who are working towards attaining a relevant National Vocational Qualification. This demonstrates commitment by the home to ensuring there is a suitably trained workforce. A copy of the Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 15 induction programme was inspected. The topics reflected those set out by the National Training Organisation. Currently 51 of care staff have an NVQ Level II in Care or above. The CSCI requirement was for 50 by the end of 2005. Staff training within Elvy Court on evidence seen did on the whole meet with the required standards. However shortfalls were noted with regard to training in Adult Protection /Abuse. The manager was requested to include this as a priority within the homes action plan. The inspector viewed details of the Home’s recruitment procedure and a number of records relating to staff members recruited. The home undertakes a recruitment practice including submission of an application form detailing all previous work history, requests proof of I.D and copies of qualification certificates, seeks written references. All staff appointments are subject to a probation period, which is subject to review. The manager reported all staff had received statements of terms and conditions of employment, evidence of which was seen in the file. Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36 Service users benefit from living in a well managed home whose staff receive regular supervision. Service users can feel confident that they benefit from a home which is run for their best interests. Service users can be confident that there are safeguards in place to protect the management of their finances and their interests in general. EVIDENCE: It is evident through the inspector talking to members of staff that the emotional health of the service users is of a high priority to the home and that staff are pro-active in maintaining and supporting service users with their emotional needs in order to maintain their quality of life. Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 17 The Registered Manager has been instrumental in developing the staff team to work towards improving the quality of care since joining the home. Evidence of the manager’s positive contribution towards the home was given by staff, service users and relatives. The Registered Manager is actively involved in the day-to-day management of the home and also undertakes working with both staff and service users. He has many years of management experience and is both qualified as a RMN Nurse and has an RMA Registered Managers Award, which covers both care and management. This enables him to support and brief staff, and to receiving staff and service user feedback. The manager undertakes staff appraisals. The manager reported that each staff member receives formal staff supervision sessions on a regular basis and these are recorded. More frequent supervision and work appraisals are undertaken during the induction period of new staff. The inspector viewed several records relating to personal monies held at the home. In the records seen small amounts of money were accounted for separately. It is used by the service users for purchase of hairdressing and other small items. The home ensures that access is restricted and that it is appropriately stored in a safe. Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 18 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 x x x x x x x x 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 4 4 4 x 3 3 x x Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 19 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 OP18 Regulation 13(6) Requirement 13.—(6) The registered person shall make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Timescale for action 20/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Elvy Court Nursing Home DS0000026162.V262864.R01.S.doc Version 5.0 Page 21 - 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. 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