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Inspection on 08/05/06 for Erskine Hall Care Centre

Also see our care home review for Erskine Hall Care Centre for more information

This inspection was carried out on 8th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

From observation and feedback from the residents, strong evidence indicated that care and support was good; feedback from one service user was that "the home was first choice and couldn`t be better, food is plentiful with choice, plenty of drinks and a good response to the call bell" similar comments were stated by others. The service provides staff with the training they require to provide a safe and reliable service to individual residents. Staff feel well supported by the management team of the home.

What has improved since the last inspection?

Since the last inspection a new manager has taken up post who has a wealth of experience and who presented with a very positive attitude and in a professional manner.When residents take a supply of medication out of the home for a short period, this is recorded in a manner to ease auditing. There were no gaps in medication recording. Ongoing palliative care training was being arranged as part of the training schedule.

What the care home could do better:

The standard of staff rest and meal accommodation needs to be improved to an acceptable standard, a requirement has been made again in this respect. The resident`s ground floor lounge needs to be brought up to an acceptable level of repair and decorative order.

CARE HOMES FOR OLDER PEOPLE Erskine Hall Care Centre Watford Road Northwood Middlesex HA6 3PA Lead Inspector Hazel Wynn Key Unannounced Inspection 8th May 2006 10:00 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.V294993.R01.S.doc Version 5.1 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.V294993.R01.S.doc Version 5.1 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 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.V294993.R01.S.doc Version 5.1 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 catergory) three terminally ill persons between the age of 18 to 65 years. 10th January 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 fee range for this care service is from £513 to £1,039. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been drawn up following an inspection carried out by two regulation inspectors representing CSCI on 8th May 2006 using available evidence gathered during the inspection including observation, discussion with residents, care staff and the manager and perusal of records maintained in the home. The inspection visit provided an opportunity to speak to the home’s new manager and several staff. A number of residents and relatives were also spoken with. Medication, recruitment, care plan and health and safety records were inspected. A variation was applied for and approved following the last inspection visit in December 2005. This enables the service, subject to assessment, to admit up to three persons for palliative care aged between 18-65 years in addition to their standing registration categories. All of the key standards were assessed during this inspection and the overall outcome was very positive. Residents were supportive of the home, the way they were treated and the standard of care that they receive. Staff felt that they were encouraged and enabled to acquire and update the training that they need to provide care for the residents. Based on this inspection visit and information received since the last inspection visit, the overall quality of this service is good. What the service does well: What has improved since the last inspection? Since the last inspection a new manager has taken up post who has a wealth of experience and who presented with a very positive attitude and in a professional manner. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 Page 6 When residents take a supply of medication out of the home for a short period, this is recorded in a manner to ease auditing. There were no gaps in medication recording. Ongoing palliative care training was being arranged as part of the training schedule. 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. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 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.V294993.R01.S.doc Version 5.1 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): 3. Standard 6 is not applicable. The quality outcome in this area is good; this judgement has been made using all available evidence including a visit to this service. A full assessment is carried out in order to establish the needs of individual residents prior to the service user moving into the home. The service does not provide intermediate care. EVIDENCE: From records examined during this inspection, evidence was gained that the home undertakes a rigorous process of assessment to make sure that they are able to offer the care and services that people considering becoming residents need. Intermediate care is not provided by this home. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 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 and 10 The quality outcome in these areas is good: This judgement has been made using all available evidence including a visit to this service. The individual care plans seen set out within them, the personal and social care needs of the residents for whom they were drawn up and the meeting of the health care needs was being fully met. Medication is managed appropriately with protocols in place for any individual who can self medicate. Residents are treated with dignity and respect and privacy guarded. The quality outcome in these areas is good. EVIDENCE: A sample of care plans were examined during the inspection and found to contain all necessary data conducive to meeting the assessed needs of individual residents. One care plan appeared to be overdue for review. Protocols are in place for residents who can manage their own medication and for medication taken out of the home for a service user spending a period away from the home. There were no gaps in the medication records seen and medication was appropriately stored. Medication checked was able to be reconciled. Policies and procedures were being adhered to in the management Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 Page 10 of controlled medication. Medication no longer required, was being disposed according to guidance and the homes policies and procedures for the disposal of medication. Residents spoken with by inspectors confirmed that they considered that they were treated with dignity and respect and that their rights to privacy was upheld; the residents spoke highly of the care staff. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 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): 12 - 15 Quality in this outcome area is good: This judgement has been made using all available evidence including a visit to this service. The home provides a range of activities, choices of menu and alternative relaxation areas and encourages participation in and by the community. The lifestyle matches the expectations and preferences of the residents. Contact with family, friends and community is actively supported. Residents are supported to exercise choice and control over their lives. The food served is wholesome, balanced and appealing and alternative mealtimes can be arranged. Dining area are pleasant and some residents are served their meal in their own room. Quality in this outcome area is good. EVIDENCE: Residents stated that there is a full programme of activities and they can choose to take part in any of these. A keep fit programme was being run on the upper floor. Residents stated that various religious communities come into the home to run services during the week. One of the inspectors met briefly with the activities organiser who recommended that a record be maintained regarding attendance; the activities organiser felt that this extra paper work would take away valuable time from the actual activities; this was further Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 Page 12 discussed with the manager and it was advised that a simple record is maintained to show the good work done and also for various auditing reasons. One service user stated that living at Erskine Hall is like living in a hotel. They can come and go as they please and enjoy life as they wish. Residents stated that they have residents meetings and meetings with the chef; both of these are held regularly. Visitors arrived at various times of the day and confirmed that they are always welcomed and feel comfortable; they were happy with the service provided to their relatives. All of the residents spoken with stated that the food served is very good and plentiful with plenty of beverages. The mid day mealtime was observed as part of this inspection; the meal served looked very appetising and residents stated that it was good. Residents who required support with eating their meal were assisted appropriately. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 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 the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to this service. Complaints are listened to, taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: Residents spoken with during this inspection confirmed that they were confident that if they lodged a complaint it would be dealt with appropriately. The complaints record provided evidence that complaints are responded to according to the complaints procedure. Staff training is provided for abuse awareness and this was confirmed both by staff and by the records. Policies and procedures are available in the home for the protection of residents from abuse and health and safety procedures were being adhered to in all areas inspected. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 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 the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using all available evidence including a visit to the service. The home is safely maintained but the staff accommodation (rest room) is badly in need of refurbishment. The lounge on the ground floor is also in need of decoration and upgrading. The home is generally clean and hygienic. EVIDENCE: A tour of the home was undertaken during this inspection and was generally found to be clean pleasant and hygienic. Two requirements have been brought forward from the last inspection: the staff rest room is badly in need of refurbishment and the lounge on the ground floor requires redecoration and general upgrading of some furnishings. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 Page 15 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 - 30 Quality outcome in these areas are good. This judgement has been made using all available evidence including a visit to the service. There were adequate numbers of skilled staff on duty and on the rota, ensuring that residents are in safe hands at all times. Robust recruitment offered support and protection to the residents. The staff were trained and competent to carry out their jobs. Quality outcome in these areas are good. EVIDENCE: On the day of the inspection there were adequate staff on duty and the rota provided evidence that the home is always adequately staffed. The training records provided evidence of training. Staff also confirmed that they received regular updates for all mandatory and additional training. Service users stated that they felt they were in competent hands. A large sample of recruitment files were examined and these all contained the robust checks required. The files contained all of the data necessary for the protection of residents when recruiting staff. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 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, 33, 35 and 38 Quality outcome in these areas are good. This judgement has been made using all available evidence including a visit to the service. The new manager was previously the registered manager of another home, has vast experience, and is fit to be in charge. The home is run in the best interests of the residents and their financial interests are safeguarded. The health and safety of residents and staff are promoted and protected. Quality outcome in these areas are good. EVIDENCE: The manager is new to the home and was busy prioritising her plans for how she will lead this home; she was previously the registered manager of another home and has vast experience and is awaiting registration. The manager in meeting with the regulation inspectors presented as very approachable, committed and professional. A Clinical Quality Manager is also employed in the home, to provide additional management resources. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 Page 17 Staff and residents were supportive of the management team and throughout the inspection there was a very positive interaction observed between visitors to the home, residents the care team. Financial records held on behalf of residents were checked and found to be well maintained and accurate. There is a policy and procedure in place regarding residents’ finances. Various records were examined during this inspection, including medication records, fire safety, and maintenance records and these were found to be well maintained with safety checks regularly carried out. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 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 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 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 OP19 Regulation 23(2)(d) & (5) Requirement The standard of staff rest and meal accommodation must be improved to an acceptable standard. THIS REQUIREMENT HAS BEEN BROUGHT FORWARD FROM THE PREVIOUS INSPECTION. The resident’s ground floor lounge must be brought up to an acceptable level of repair and decorative order. Timescale for action 30/06/06 2. OP19 23(2)(d) (5) 30/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations Keep all care plans reviewed within date. A care plan was examined on the upper floor, which appeared to have passed the review date. Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Erskine Hall Care Centre DS0000019345.V294993.R01.S.doc Version 5.1 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. 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