Inspection on 04/08/05 for Queen Elizabeth House

This inspection was carried out on 4th August 2005.

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

Queen Elizabeth House 28/06/06

Queen Elizabeth House 25/01/06

Queen Elizabeth House 19/01/05

Queen Elizabeth House 06/09/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE QUEEN ELIZABETH HOUSE Queen Elizabeth Road Eastmoor Wakefield WF1 4AA Lead Inspector Mavis Pickard Announced 4 August 2005 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. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Queen Elizabeth House Address Queen Elizabeth Road Eastmoor Wakefield WF1 4AA 01924 302395 01924 302396 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) Wakefield MDC Mr Paul Smith Care Home - Personal Care only 27 Category(ies) of Old People - 27 registration, with number of places QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 19/01/05 Brief Description of the Service: Queen Elizabeth House is a purpose built care home for older people operated by the Social Care Dept of Wakefield Metropolitan District Council. The home has 27 beds and communal areas including dining room, smokers lounge and non-smokers lounge. At the rear of the home leading from the non-smoking lounge is an additional room, which leads out onto a paved patio area and into the rear garden. The rear garden is mainly grassed with shrubs and borders as well as a greenhouse. To the front of the home is a car parking area and grassed areas. The home has hairdressing and laundry facilities. The home does not provide nursing care but is supported by local Health Centres and the GPs and Primary Care Teams visit as required. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Although the registered manager was not present at this announced inspection the home was running well and the inspection was completed over a 5-hour period with help from 2 assistant managers. The home, which is registered, to accommodate up to 27 older people presently accepts only short-term placements to facilitate hospital discharge. On the day of this visit the home was accommodating 20 people, 9 permanent residents and 11 people who required either respite [usually short term care whilst their main carer takes a break] or interim care [usually following hospitalisation whilst a domiciliary care package is set up] The Inspector would like to thank residents, management and staff for their hospitality during this visit. What the service does well: What has improved since the last inspection? What they could do better: To ensure that where residents are admitted for short-term interim care they are robustly supported to be transferred home at the soonest possible time. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 6 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. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 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 standard(s) 2 & 3 Each resident has a contract. All residents have their needs assessed prior to being accommodated. EVIDENCE: The case files of several residents were examined, all people have a contract of residence setting out the terms and conditions by which they stay at the home, however the contract does not indicate which room the resident will occupy. All case files examined gave evidence that the individual had been assessed with for the care they need, prior to being accommodated. The assistant managers said that even though a prospective resident has a care management [social worker] assessment they or the registered manager would also assess the individual so that they are sure that residents needs can be met. The nature of this style of care is that the home may be asked to accept emergency admissions; the management team said that in this situation they QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 9 would resist pressure to accommodate anyone should the pre-admission assessment indicate that their needs could not be met. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.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 & 9 Residents care needs are set out in individual care plans. The home does not always follow its own medication policies. EVIDENCE: Residents care needs are recorded in individual care plans which set out the perceived need in relation to that resident, e.g. mobility, continence, eating and drinking, weight, social and activity etc. These plans give evidence of the perceived need, what action is to be taken to meet that need and goals which are aspired to, showing over time how these may be achieved. There are presently no residents who take responsibility for their own medication. The home has a system for the storage and administration of prescribed medication. It was a requirement of the previous inspection that the homes manager must ensure that accurate recordings are made of medication received into the home and that residents are only administered medication, which has been prescribed for them and from their own supply. Although at this inspection there was no evidence that medicines were being administered to residents QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 11 other than the named individual there was clear evidence that prescribed creams were being used for people other that the person for whom it had been prescribed. This practice must stop. During this visit it became clear accurate stock balance records are not always maintained in respect to medication kept in the home. A requirement is made in respect to these issues. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.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) 13 & 14 Not all residents are supported to maintain contact with their loved ones. Residents are not always helped to exercise choice. EVIDENCE: From speaking with residents, with staff and from direct observation it is clear that where possible residents maintain contact with family and friends. Records show that this is the case and that residents do have regular contact with the local community. Where residents are accommodated for short term care either respite or interim care they are supported as far as possible to keep contact with their own home and their family/partner. It is sometimes the case that an aged partner is unable to travel to visit their loved ones in the home. The registered person/registered manager may wish to consider setting up system to ensure that such contact particularly with a partner is maintained. Residents said that do have choice with respect to food, activities and the time they wish to rise or retire. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 13 The Inspector is concerned that in respect to bathing one bathroom seems to be used more frequently that the others. This ground floor bathing area is not near the bedrooms of any residents who reside on the first floor. Having spoken with some staff it is concerning to note that the choice of use of this bathroom may involve staff choice rather than residents choice. It is important that residents are given real choice of where to bathe. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 &18 The home has appropriate policies and procedures in respect to complaints The home’s policies and procedures are not always followed in respect to alleged adult protection issues. EVIDENCE: Residents spoken with said that they would feel confident that any concerns they had were dealt with properly. Complaints records were inspected and found to be detailed. However although Wakefield District Council’s policies and procedures give detailed guidance for staff about the way to deal with abuse or alleged abuse, a complaint recorded some months ago that raised concerns about an alleged abusive situation between 2 residents had not been referred to the lead agency whose first point of contact in the Wakefield area would be Social Care Direct. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 22 & 26 The home is generally well maintained and safe, however not all equipment is operational. The home is generally clean. EVIDENCE: From direct observation and from the examination of records it is clear that residents live in a safe well-maintained environment. Staff spoken with said that there are no concerns about maintenance issues. In the main the home is clean and there were no offensive odours detected. However during a tour of the home it was found that the ground floor ‘parker bath’ was dirty and that although staff had been noted to be supporting a resident to and from the toilet they had not left the toilet in a hygienic condition. Staff said that a bathroom on the first floor fitted with a manual bath hoist [seat] cannot be used, as the bath seat is not working properly, that this issue QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 16 has been reported some time ago but that the equipment remains non operational. [Please refer also to standard 14] Since the inspection the registered manager has confirmed that the bath hoist was operational on the day of inspection and that staff had been mistaken. It was noted that towels, flannels, toiletries, combs, hairbrushes and nailbrushes were being stored in communal bathing areas. It is concerning that such personal items may be used communally. Residents should have personal items such as these stored in their own bedrooms. Where the home provides such items as toiletries etc it is seen as best practice that they be given to individuals, discreetly named and kept in their room. In respect to towels and flannels it is seen as best practice that these be provided daily to resident’s bedrooms. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 17 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, 29 & 30 The home employs sufficient staff. Not all records are made available for the purpose of regulation. EVIDENCE: It was clear that on the day of inspection the home was employing sufficient experienced staff to meet the needs of people accommodated. The management team said that all care staff except 2 has achieved the National Vocational Qualification [NVQ] at level 2 or above. One of the homes assistant managers has achieved NVQ 4; the second assistant manager is to undertake the course soon. The home maintains training files for all staff however the management team said that mandatory staff training with respect to First Aid, Moving and Handling, food hygiene etc is presently not available and that some staff training is overdue. Since the day of inspection the registered manager advises that although some staff training is overdue, the staff on duty during the inspection were mistaken in saying that the above training was not available to them. The home does not maintain a staff-training matrix. It was a requirement of the previous inspection report that a record be kept at the home, either electronically or manually, of all persons employed at the QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 18 home including the details as outlined in Sch4 (6). Staff said that this is achieved by an electronic method however not all records could be examined by the Inspector as some of the details were not legible. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 19 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, 37 & 38 The ethos of the home is positive. It is not clear that all aspects of the running of the home is only in the best interests of residents. Not all records required to be made available for the purpose of regulation are maintained in the home. EVIDENCE: Unfortunately the registered manager was not available at this announced inspection however the home’s two assistant managers facilitated the inspection. The atmosphere in the home was noted to be open and positive. Concerns were raised with the management team that not all aspects of the running of the home are undertaken wholly in the best interests of residents. [Please refer to standards 19-26] It was a recommendation of the previous report that the home should retain copies of maintenance certificates for the purposes of inspection. Such records QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 20 are not all maintained in the home but by Wakefield District Council, off site. It is therefore not possible for Inspectors regulating this service to be confident that such records are maintained. It would be helpful that a copy of all of all maintenance records are maintained in the home. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 21 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 2 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 2 14 2 15 x COMPLAINTS AND PROTECTION 2 3 3 1 3 3 x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 x 3 x x x x 2 2 QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 22 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 9 Regulation 13(2)(3) Requirement Any prescribed medication or preparation must only be available for use by/for the individual identified on the label A record must be maintained of all medicines kept in the home for individual residents. All allegations of suspected or actuall abuse must be followed up promptly and appropriate action taken. The registered manager must ensure that with reference to suspected or actual abuse the stated policies and procedures of the home are followed. Equipment provided at the care home for use by residents and/or persons who work in the home must be maintained in working order. The registered person must ensure that staff receives regular updated training to ensure the safety of residents and safe working practicesin the home. Timescale for action with immediate effect [4/8/05] with immediate effect [4/8/05] with immediate effect [4/8/05] with immediate effect [4/8/05] with immediate effect [4/8/05] with immediate effect and on going. 2. 9 3. 18 17(1)(a) & schedlue 3(3)(i) 12(1)(a) & 13 (6) 12(1)(a) & 13 (6) 4. 18 5. 22 23(2)(c) 6. 30 18(1)(a) 18(1)(c) (i) QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. Refer to Standard 2 13 14 14 26 37 38 Good Practice Recommendations Individual statements of terms and conditions[contract] should include detail of the room to be occupied. short stay residents should be helped to maintian contact with their loved ones. Residents should be given choice about where to take a bath. Where towels, flannels and toiletries are provided to residents they should be indentified as theirs and stored in the individuals private accommodation Facilities provided for resident use should be maintained in a clean and hygenic condition. The registered manager should maintain records of staff training needs by the implementation of a training matrix The registered person should ensure that documents in respect to the appropriate recruitment of staff and copies of maintinence records are available in the home for the purpose of regulation. 8. QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 24 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 QUEEN ELIZABETH HOUSE J51J01_S34425_Queen Elizabeth House_V232357_040805.doc Version 1.40 Page 25 - 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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