CARE HOMES FOR OLDER PEOPLE
Emmaus House Walkmill Close Moresby Park Whitehaven Cumbria CA28 8XR Lead Inspector
Nancy Saich Unannounced 20 July 2005 08:45 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Emmaus House Address Walkmill Close Moresby Park Whitehaven Cumbria CA28 8XR 01946 591362 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cumbria Emmaus Trust Patricia Davies Care Home 24 Category(ies) of OP - Old Age registration, with number DE(E) - Dementia, over 65 of places Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 24 service users to include: up to 24 service users in the category of OP ( Old age, not falling within any other category) up to 2 service users in the category of DE(E) (Dementia over 65 years of age) 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 01 December 2004 Brief Description of the Service: Emmaus House is a purpose built home that caters for up to twenty-four older people, two of whom may have dementia. The home is owned and operated by the Emmaus Trust, a charitable organisation set up by the Christian Brethren Church. Some, but not all residents are members of this church. The home is managed by Mrs Patricia Davies who has been in post since April 2005. The home is in a residential area of Moresby, a village approximately three miles from Whitehaven, and is within walking distance of village amenities. The home has its own grounds and car parking. Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection completed by Nancy Saich. The inspection started at 8.45 a.m and lasted for five and a half hours. The inspector spent time with residents privately in their rooms and in small groups in the lounge. She spoke to the deputy manager and to the care and ancillary staff. She also looked at paperwork that confirmed the things these people discussed What the service does well:
This home is good at ensuring they only admit people they can give the right care and services too. Residents said that they had received a visit from someone from management and were given plenty of information about the home before they decided to move in. They also felt that the staff gathered plenty of information about their needs to allow them to deliver good standards of care. The residents said that they were happy with the way the staff assessed their needs and wrote down these in specific documents that helped staff to know how to care for them. They were happy with the health and personal care they received. Several people commented on the psychological and spiritual care they received and felt that the manager and her deputy were very good at helping with these needs. All the residents spoken to said the food was of a very high standard and residents were seen enjoying their meals. One person said, “I am flourishing here, good food, good company and kind staff…”. Residents said there were enough activities to keep them interested in life. There were a number of religious activities in the home and this suited the residents as many people had chosen the home because of its strong Christian ethos. They also said they enjoyed parties, outings and hobbies and that the balance of things on offer was just right for them. Residents were aware of how to complain but had no concerns about how they were treated. The home is set in well-tended gardens and is decorated and furnished to a high standard. The building was very clean and tidy on the day but managed to have a homely feel and residents were relaxed and comfortable in their environment. The staff team were happy at work. They and the residents said that the home was well staffed and this gave plenty of time to focus on residents needs. One
Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 6 resident said “I am amazed at the ratios…there’s always plenty of people around and nothing is too much trouble for them…”. There was evidence to show that staff receive good levels of training and supervision so that they are well equipped to give good levels of care and services to the residents. Residents said the staff group was well established and there had been few changes and this was a good thing as they liked being cared for by people they had grown to trust and who knew them well. The home has a new manager who is maintaining and improving the established systems in the home. Staff and residents felt that they had been given plenty of time to get used to the new manager and she was taking her time to introduce changes. This was considered to be a very good thing as the residents felt the home runs smoothly and any fears they had about change had been put to rest. 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.
Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4,5 The home is good at discovering the needs of potential residents and this ensures that they only take new residents who they can care for properly. EVIDENCE: One new resident was spoken to at length and this discussion showed that this person had been given plenty of information and that they had been given a chance to visit. This residents’ file confirmed what had been said and several other residents files showed that staff made sure they knew as much as possible about new residents and were well prepared to give them the care and services they need. Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 This home delivers good standards of personal and health care to residents allowing them to be as well and as happy as possible. Residents said that this support was given with the respect they felt they deserved. EVIDENCE: Residents spoke positively about how the staff helped them with their personal care needs and made sure their health was as good as possible. A new resident explained how the home arranged for a new G.P, how the nurse visited and how the staff made sure things were properly arranged to allow for as much independence as possible. Residents were aware that these things were written up for all the staff to give assistance in the same way. These ‘care plans’ gave plenty of detail of how things were to be managed on their behalf. One resident summed it all up by saying she had ‘flourished’ under the care of the home. The inspector checked the medication and observed the member of staff who was dealing with this. The medication was being managed properly and residents were given suitable medication in a safe and controlled way. Residents said they were treated properly. One person said she chose to do different things depending on how she felt and that staff let her do this. Their
Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 11 reassurance and that the way they treated her stopped her from feeling ‘down’ and she felt respected as a person. Residents spoke about being encouraged to be independent and about being given support when needed and privacy when they wanted. Generally the residents thought they were treated just right. One person wanted it noted that the support given by the manager and her deputy was ‘just wonderful’. Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Residents in this home have a range of suitable activities and are encouraged to be as independent as possible. They felt they had plenty of options and choices in their lives. EVIDENCE: The home provides a wide range of activities but there is an emphasis on worship. Ministers and visitors from all local churches visit and residents go out to services. Residents go out on local trips and the staff or members of the trust ensure that people can get out into the community if they wish. There are regular activities run by volunteers and staff and residents said they could attend these if they wanted or could opt out if it wasn’t of interest. Residents felt they did have choice over how they run their lives. They didn’t feel there were any ‘rules’ as such but were aware that they had to ‘rub along together’. This seems to be managed well by the staff team supporting the residents. Every person spoken to was happy with the choice of food and how it was cooked and presented. Several people said they had put on weight since they came to the home and the inspector thought everyone looked well nourished and healthy. Residents ate well and said they looked forward to meal times. Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 These issues are managed well by the home giving residents the right to complain and also giving everyone the right to be protected. EVIDENCE: This home has never received a major complaint and the residents say that any concerns are dealt with before they become complaints. The procedures for making a complaint are available in the home. Residents said they were sure that no one was ill treated in the home but they were confident that the manager and the Trust would deal with any such matter. The staff knew how to protect the residents and knew how to contact outside agencies if something really worried them. No one spoken to had any concerns at all and said that everyone worked with a common goal of pleasing and protecting the residents. Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,26 This home provides a homely and comfortable environment where residents feel safe and relaxed. EVIDENCE: The inspector toured the building and all areas were seen. The communal areas were clean, warm and comfortable. The individual bedrooms were also very clean and tidy. All areas of the home had good quality carpets, furniture and fittings. The décor was clean and fresh in all areas. Residents said that the home was always clean and tidy and they liked it this way, as it was comfortable and uncluttered. Residents could move around their home without any worries about their safety. Residents said they liked having a single room with ensuite facilities and this helped maintain their privacy and dignity. Residents’ rooms really reflected their personal preferences and lifestyles and most of the residents spend quite a lot of time in their own rooms pursuing their own interests. Staff obviously took pride in the home and were working together as a team to ensure that the domestic tasks were completed in an efficient way. Staff were aware of the need to prevent cross-infection and they had good knowledge of
Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 15 how to do this. There were no hazards seen in the building and staff had a good idea of how to maintain the health and safety of everyone in the home. Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The residents of Emmaus house are properly cared for by a skilled and welltrained workforce and this allows them to have very good standards of care and services provided for them. EVIDENCE: Residents said there were always plenty of staff on duty and that extra staff came in when there was a service in the home or some other activity when more staff were needed. The staffing rosters were seen and these confirmed good staffing levels. One resident said they were ‘amazed’ at the staff/resident ratios and felt that the very good staffing levels meant that staff had time to stop and talk to residents and give them ‘that little extra that makes all the difference to older people…’. One other person said that sometimes she got a little mixed up but there was always a member of staff on hand who had time to ‘put me right’. There had been no changes to the staff team in the past year apart from the appointment of the new manager. The inspector had checked this and it had been done properly with all checks completed. Residents said, ‘we don’t often lose staff…they seem to like it here…’. The staff said they were a very settled team and almost everyone had completed their NVQ and that they worked well together. The extremely low turnover of staff was important to residents who said that they preferred to be cared for by staff they knew well and who they had learnt to trust. They also said well established staff knew their ways and were familiar with their needs. Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 17 There were plenty of observed examples of staff and residents interacting well together. The inspector saw staff behaving in a sensitive and caring way towards residents. Staff said they had undertaken all sorts of training in the last year and were looking forward to undertaking more. They had enjoyed the courses they had completed and spoke about how they had been able to use the skills and knowledge in their daily work. Residents thought that staff at all levels ‘know their job’… Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,35,38 This home has well thought out systems that allow the home to run smoothly on behalf of the people who live there. The retirement of one manager and the appointment of another was achieved in a trouble free way that caused minimal disruption to the lives of residents. EVIDENCE: This home is run on Christian principles and the way the Emmaus Trust operate the home on these. Residents and staff all said that the Trust always acted in the best interests of the residents. There were plenty of examples of how they responded to various issues without delay. The Trust had carefully chosen a new manager and staff and residents all said that she was doing her job well and had moved into her role of leading the home without fuss or disruption. Residents said that the manager, her deputy and members of the Trust were approachable and one person said they were ‘people of integrity and understanding’. The inspector was given the impression that the ethos and
Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 19 values of the residents were respected and valued and reflected in the way the management and staff behaved. Money kept on behalf of residents was checked and found to be in order. The inspector and the deputy discussed a minor change to recording this but generally this matter was properly managed to protect residents. The home was hazard free on the day and there was evidence around the home to show that staff were aware of how to manage health and safety in the home. Staff showed good levels of knowledge of things like infection control, fire safety and food hygiene. Residents said they felt safe and well looked after in the home. Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 3 x 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 4 13 3 14 3 15 4
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x 4 3 x 3 x x 3 Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 21 NA 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 Regulation Requirement Timescale for action 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. Refer to Standard Good Practice Recommendations Emmaus House F58 F10 s22550 emmaus house v234433 200705 ui stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith, Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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