Inspection on 19/12/06 for Erskine Hall Care Centre

This inspection was carried out on 19th December 2006.

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

Erskine Hall Care Centre 24/09/07

Erskine Hall Care Centre 08/05/06

Erskine Hall Care Centre 10/01/06

Erskine Hall Care Centre 25/05/05

Erskine Hall Care Centre 15/10/04

Erskine Hall Care Centre 23/08/04

Erskine Hall Care Centre 02/06/04

Erskine Hall Care Centre 30/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Erskine Hall Care Centre Watford Road Northwood Middlesex HA6 3PA Lead Inspector Hazel Wynn Key Unannounced Inspection 10:30 19th December 2006 and 12th January 2007 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 Erskine Hall Care Centre DS0000019345.V324712.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. Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Erskine Hall Care Centre Address Watford Road Northwood Middlesex HA6 3PA 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) 01923 842 702 01923 842 703 BUPA Care Homes (AKW) Ltd Manager post vacant Care Home 85 Category(ies) of Old age, not falling within any other category registration, with number (85), Terminally ill over 65 years of age (10) of places Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home may accommodate one person aged 50 years or over who requires nursing care. To admit (within the current registration limit of TI category) three terminally ill persons between the age of 18 to 65 years. 8th May 2006 Date of last inspection Brief Description of the Service: Erskine Hall Care Centre is part of BUPA Care Homes Limited and is registered to provide nursing care and accommodation for up to 85 older people. Within that number the home is registered to provide terminal care for up to 10 persons, of whom up to 3 may be between the ages of 18-65 yrs of age. Erskine Hall is a purpose built nursing home, set back from the road in very pleasant grounds, with ample parking facilities. Accommodation is arranged on three floors, each with a day room and served by a passenger lift. All rooms are above the minimum size required by the National Minimum Standards and have en-suite facilities. Catering and laundry facilities for the home are situated in the basement along with a hairdressing room. Erskine Hall is situated in Northwood, Middlesex, conveniently situated for North West London and South West Hertfordshire, with good access to public transport. The statement of purpose, service user guide and previous CSCI inspection reports are available at the mangers office at Wilton House (a copy of the service users guide will be provided to prospective service users by the home) CSCI inspection reports are also available on the CSCI web site. The fee range for this care service is from £513 to £1,039. Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. On the 19th December 2006 three inspectors carried out a key inspection visit to the service; during the visit to the service, the inspectors met with several service users to gain their views and to observe care provision. There were adequate numbers of staff employed at the home. The inspection visit also included a tour of the premises, interviews with, service users, relatives/visitors, staff and checking records relating to care and the running of the business. On the 19th December 2006 visit the inspector also met with the fire officers who were carrying out their inspection. On the 12th January 2007 two inspectors made a second visit to the service to complete the inspection process by examining some records that had not been covered on the visit of the 19th December 2006 and again met with service users, staff, relatives and the manager. The manager has completed and application to become the registered manager of Erskine Hall and the organisation will need to forward this to the CSCI by 28th February 2007. Pending the application being received by the CSCI, the current arrangements for the management of the home are satisfactory. At the end of this inspection feedback was given to the manager regarding the outcomes of this inspection. What the service does well: What has improved since the last inspection? Since the last inspection in May 2006, the lounge on the ground floor has been refurbished and all communal areas provide very comfortable and attractive accommodation. The staff rest room and accommodation for meals has been refurbished. On the visit of the 12th January 2007 the recommendations of the fire officer (of the visit 19th December 2006) had been actioned. Work has been carried out to improve care plans with a special emphasis on reviews (plans are in place to introduce a more user friendly format for the care plans to replace the existing format). Recruitment of staff was in process in December 2006 and by the 2nd visit on 12th January 2007 a new floor manager with an in depth background in palliative care had commenced employment and new care staff had also been recruited. The staffing levels in the palliative Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 6 care unit have been increased. Staff training plans have been reviewed and training needs identified; plans are in place to meet training needs during 2007. 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. Erskine Hall Care Centre DS0000019345.V324712.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 Erskine Hall Care Centre DS0000019345.V324712.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): Standard 3. Standard 6 is not applicable to this home. Service users do not move into the home without first undergoing a thorough assessment of need and being assured that their needs can be met. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of service users individual initial assessments were seen on the care plans sampled and these appeared to be comprehensive; a plan of care is drawn up with the service user and where appropriate their representative and identifies how the assessed needs will be met and providing assurances that the needs can be met by the home. Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7 – 10. Care plans include the health, personal and social care needs of the individual service user; care plans are in need of further improvement. The service users health care needs appeared fully met although one care plan showed a gap in review dates. Appropriate management of medication is in place at the home. Service user’s rights to privacy and respect are upheld. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of care plans provided evidence for this inspection. Some of the care plans provided conflicting information; for example: one entry said there was an unexplained weight loss and answered no against an entry for poor appetite whilst another entry stated that there was a history of weight loss and poor appetite with a waterlow assessment stating that appetite was average. There were a large number of identical entries in the daily records; this was Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 10 discussed with the manager on the visit of the 12th January 2007; the manager does agree that there are issues with care plans and an improvement plan is in place; new care planning formats are being introduced at the home. On the visit of 19th December 06 one care plan showed a gap in review dates and this was discussed with the quality manager who stated that she would bring this outcome to the manager on her return to work. There were no issues arising from checks on the medication systems in place, a sample of Medication records were looked at and medication was clearly recorded. Controlled medication was appropriately managed and recorded. A policy, procedure (which includes risk assessment and management) are in place for people who would be able to manage their own medication. Service users spoken with during both days of the inspection stated that they were happy with their care and that they felt that their rights to dignity, respect and privacy were upheld. Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 –15. The lifestyle experienced in the home by services users matches their expectations and preferences in respect of their social, cultural, religious and recreational interests and needs; and service users maintain contact with family, friends, representatives and the local community if they wish. Service users are supported to maintain choice and control over their own lives and they receive a wholesome, appealing, balanced diet with suitable and flexible arrangements for the enjoyment of their meals. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users spoken with stated that they were satisfied with the lifestyle experienced in the home, although some preferred not to take part in some or any of facilities available. Some of the services users spoken with were still adjusting to the change of moving to a care home. One of the service users was enjoying using his skills to provide entertainment to other service users in the home during the December 2006 visit. The home Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 12 has an activities programme, including religious services, seasonal parties, bingo, quizzes and exercise programmes. Service users and their relatives were complimentary about the service and said that staff were very caring and showed respect. The visitor’s book showed that there are a constant flow of relatives and friends visiting service users at differing times. Service users are encouraged to maintain contact with the community. All of the service users spoken with said they enjoyed the food served at the home and the menu reflected a healthy and varied diet is offered with alternatives to choose from. The new floor manager in the palliative care unit met with the inspectors and demonstrated that she has the necessary skills to supervise and support staff to assist service users who have problems with eating and/or who have complex dietary needs. A complaint which included comments regarding meals, from a relative of a service user no longer at the home had being investigated and responded to. Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Complaints are taken seriously, information received is acted upon and the service users are protected from abuse. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager takes complaints very seriously and the records show that complaints are investigated in line with the home’s policy and procedure. Action has been appropriately taken where the outcome of an investigation has deemed this necessary and the manager has used the disciplinary process following an investigation since the last inspection took place; a member of staff is now no longer employed in the home. Policies, procedures and staff training in abuse awareness are in place to provide service users with protection from all forms of abuse. Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. The environment is safe and well maintained, clean, pleasant and hygienic. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the building was undertaken on both days of this inspection and the home was found to be clean fresh and well maintained. A requirement for improvements to be made to staff rest and meal accommodation as an outcome of the last inspection had been met and a further requirement for the ground floor lounge to be brought to a state of good repair and decorative order had also been met. The local fire authority were carrying out an inspection of the premises on the 19th December 2006 visit and requirements/recommendations made during that inspection had been met by the visit of the 12th January 2007. Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 15 A safety notice was in place to draw attention to a ripple in the carpet of the hallway on the ground floor whilst awaiting for this to be re-stretched; the inspectors pointed out that it may need repositioning as if the hall door was open it was not immediately visible. Erskine Hall Care Centre DS0000019345.V324712.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): Standards 27 – 30. Adequate staffing levels are maintained and staff training needs have been identified and plans to meet these have been made. Staff are monitored regarding their competence to manage their tasks and to provide a safe service to the service users. Recruitment procedures at the home are robust and managed in line with the home’s policies and procedures. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: An observation of the moving and handling of a service user identified a training/re-training need of staff in moving and handling techniques (it was observed that staff used an underarm method to move a service user in their bed). The manager has identified that there is a need for further staff training and has planned a training programme to address gaps. All new staff are following the Foundation in Palliative Care Training Programme as part of their induction programme. The Liverpool Pathways is being introduced in the home which will further the improvements being made in the service (the Liverpool Pathways is a co-ordinated approach to meeting the care needs of service users in the end of life phase). The Liverpool Pathways will provide further learning opportunities for staff. Care plan training will be renewed as the new care plan formats are introduced over the early months of 2007. Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 17 A sample of three staff records provided evidence of robust recruitment procedures being adhered to. Erskine Hall Care Centre DS0000019345.V324712.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): Standards 31, 32, 35 and 38. The home does not have a registered manager. The manager in post demonstrates good ethos, leadership and management skills and is running the home in the best interests of the service users. Service users financial interests are safeguarded. Service users and staff are protected by the home’s policies and procedures and practices in respect of health, safety and welfare. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is not yet registered by the CSCI, an application for the registration of manager must be received. The current manager has a good management approach and has made very satisfactory improvements in the service which evidence that the home is being run in the best interests of the service users. New staff have been recruited and one of three new floor Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 19 managers has commenced employment with a second floor manager taking up post by the end of the month of this inspection. The manager has been very selective in recruiting staff to ensure that staff have the necessary skills and attitude to provide a good service. A sample of service users financial records showed that service users finances are safeguarded. A maintenance programme is in place and health and safety records including fire safety, food hygiene records, medication and staff recruitment were well maintained and provided evidence that the health, safety and welfare of service users and staff is promoted and protected. Erskine Hall Care Centre DS0000019345.V324712.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 1 3 3 X 3 X x 3 Erskine Hall Care Centre DS0000019345.V324712.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 OP31 Regulation 8(1) Requirement A fit person must be registered to manage the home. The proprietor stated that the registration application process would commence on the day of the inspection. Due to the circumstances of this post being vacant (and satisfactory manger arrangements being in place) a new deadline has been set receipt of the application by February 2007. Keep all care plans reviewed within date. A care plan was examined on the ground floor, which appeared to have passed the review date. Timescale for action 28/02/07 2. OP7 15 (2) (b) 28/02/07 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. Refer to Standard OP30 Good Practice Recommendations There is a need to review the skills of staff in relation to an DS0000019345.V324712.R01.S.doc Version 5.2 Page 22 Erskine Hall Care Centre observation of an inappropriate moving and handling technique observed during the inspection. Care plan training was discussed and the manager stated that care plan training will be one of the priorities with the introduction of the new care plan formats. Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Erskine Hall Care Centre DS0000019345.V324712.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!