Inspection on 09/08/05 for Sutton in the Elms Nursing & Residential Home

This inspection was carried out on 9th August 2005.

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

Sutton in the Elms Nursing &... 22/04/08

Sutton in the Elms Nursing &... 08/08/06

Sutton in the Elms Nursing &... 13/11/05

Sutton in the Elms Nursing &... 10/12/04

Sutton in the Elms Nursing &... 20/07/04

Sutton in the Elms Nursing &... 22/03/04

Sutton in the Elms Nursing &... 10/08/03

Sutton in the Elms Nursing &... 19/11/02

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

CARE HOMES FOR OLDER PEOPLE Sutton in the Elms Nursing and Residential Home Leicester Road Sutton in the Elms Leicestershire LE9 6QF Lead Inspector Paula Dutton Unannounced 9 August 2005 09:30 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. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Sutton in the Elms Nursing & Residential Home Address Leicester Road Sutton in the Elms Leicestershire LE9 6QF 01455 286577 01455 286578 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) DRE GRoup Limited Angela Lonsdale Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39), Physical disability over 65 years of age of places (10), Physical disability 55 yrs (10) Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10/12/04 Brief Description of the Service: SUtton In the Elms Nursing Home is a purpose built modern property designed to accommodate up to 39 people over the age of 65years. The home is registered to admit up to 10 people with physical disabilites who are over 55 years of age. The property is situated in a rural village of Sutton Elms which is near to Broughton Astley village. This area can be easily reached via the M1 motorway and main routes. The rear of the property offers ample parking spaces and views of the countryside. All areas of the premises are accessible for people with mobility impairments. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during one day. The registered manager was available throughout the inspection. Discussion took place with the manager about the services offered. A selection of three residents’ individual records were viewed including care plans, assessments, daily notes, medication records, observation charts and moving/handling assessments. One resident spoke directly with the inspector. Two other residents expressed their opinions to the inspector during a tour of the premises. A number of bedrooms were viewed including rooms belonging to the three residents whose records were viewed. Staff were observed working with residents and some staff were briefly spoken with about the care they offered. This process is known as ‘case tracking’. What the service does well: What has improved since the last inspection? A good deal of work has been undertaken to improve a range of services: • • • • • • Equipment has been purchased for residents’ safety and comfort. Two lifts have been fitted to either end of the premises. A patio and garden pots have been purchased offering raised flower beds. A new system of supervision has been introduced to staff. Care plans have been redesigned. An Activities Coordinator has been appointed and a programme of activities started. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 6 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. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.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 Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.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) 3, 4, 5 Information is exchanged ensuring residents can make informed decisions. EVIDENCE: On entering the building to reception information is readily available about the services provided and the Residents’ Charter of Rights. Discussion with the manager confirmed all residents are offered the opportunity to state their needs and preferences during an initial assessment in their own homes or in hospital. Evidence was seen of copies of assessments completed by outside professionals including those receiving Continuing Care. The manager offers admission for a trial period once consideration has been given to whether or not the home can meet a person’s needs. Relatives or representatives are welcomed to view the home at any time without appointment. Observation found relatives and representatives visiting residents during the inspection. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10 The management and delivery of care is to a good standard ensuring residents’ health, safety and welfare. EVIDENCE: Three residents’ personal records were viewed. Evidence indicated care plans recorded each care needs and showed detailed instruction to staff as to how to meet those needs. Care plans addressed high risk issues including moving and handling and swallowing difficulties. Discussion took place with the manager about risk assessments to accompany care plans for high risk issues. The manager stated this was currently being reviewed within the home. Evidence was seen of equipment provide to meet specific health care needs including pressure area management needs. The manager stated the owner was very committed to providing equipment to ensure residents were safe and comfortable. The administration of medication records were mostly well managed with all medications given but some not signed for as given. This did not compromise residents’ health and was an administrative oversight. All medication was securely stored. Observation found two members of staff to assist a resident to move using a hoist. This task was completed in an unhurried, safe and sensitive manner. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 10 A resident was observed to be assisted to move in a wheelchair with only one footplate in use. Wheelchairs are stored without footplates attached and the manager had clearly instructed staff to ensure footplates must be attached at all times when in use. This did not compromise the resident and the manager stated this matter would be addressed with individual staff. Observation found staff addressed residents respectfully and knocked on doors before entering. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 15 Choices are offered to residents ensuring residents exercise control over their lives. EVIDENCE: A programme of social activities and planned trips out were displayed on the notice board. A resident confirmed trips out into the community did occur and he had thoroughly enjoyed them. A canal trip was planned for all residents wishing to go. A resident stated visitors are often in the building. Observation found visitors could meet with residents in their rooms or in communal areas. The manager has recently appointed an Activities Coordinator (6 hours per week) to work with care staff in providing activities including therapeutic activities. Observation of the kitchens found they were tidy and organised. A choice of hot meal is provided each day and a menu displayed the choices. Meals were taken in dining areas or in residents’ rooms depending on choice. The dining areas were clean, tidy, homely and welcoming. There were adaptations for use including beakers, plate guards and adapted utensils. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Residents’ rights are upheld and residents are protected when vulnerable. EVIDENCE: The manager demonstrated a very good working understanding of the rights of older people to undertake daily activities within a risk management framework. Discussion took place about the ability of residents to make choices. The manager had a copy of the Department of Health’s guidance document entitled ‘NO SECRETS: Mistreatment of Vulnerable Adults’ available for all staff to read. Independent advocacy services were advertised on the noticeboard to promote residents’ independence. This is good practice. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26 The environment is designed and maintained to an excellent standard. EVIDENCE: A tour of the premises found all areas of the home were homely in appearance and accessible. Two new lifts have been fitted to ensure residents’ freedom of movement and safety. There is a Parker assisted bath and an electrically assisted bath with chair. All toilets were fully fitted with aids and adaptations. Radiators were not fitted with guards because these radiators are designed so that low surface temperatures are always ensured to prevent any risk of scalding. Individual bedrooms were larger than the national minimum standard and all but two rooms had ensuite facilities. A call bell system was fitted throughout the premises. This offered discreet call to staff who were directly alerted in the location they were working in. This system lends itself to closer team work and an efficient way of promptly answering calls. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 14 The laundry was tidy and very well organised with machines and equipment provided for the prevention of cross infection. The standard of cleanliness and hygiene was excellent. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 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 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 There are sufficient numbers of staff provided at the home. EVIDENCE: A rota records and reflects the number of staff on duty for each shift. There are two Registered Nurses leading the morning shift with eight carers. There are five carers for the afternoon shift working under the guidance of nurses. During the night shift there is one Registered Nurse and three carers awake throughout the shift. The home has used staff supplied by an agency. In the event of requesting an agency worker the home asks for staff who have already worked at the home so that continuity can be maintained. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 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 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) 31, 32, 33, 36, 37, 38 The home is organised and managed effectively so that residents’ health, safety and welfare are maintained. EVIDENCE: The manager demonstrated a firm commitment to achieving the National Minimum Standards. Discussion with the manager about the running of the home showed the manager has a very good working knowledge of the needs of older and vulnerable people. Observation found staff were able to approach the manager for advice and support relating to their tasks and how best to meet the needs of residents. The manager stated she operates an open door policy. Observation found support and advice was readily provided to relatives and representatives of residents. Relatives and representatives were able to approach the manager. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 17 A survey has been conducted to gain the views of residents, relatives, representatives and other stakeholders. This process is being completed and the manager stated the outcomes would be published. The manager has introduced a system of formal and recorded supervision for all staff. Evidence was seen of the new system which has been introduced to the day staff. The manager stated supervision should occur every two months. The home has a comprehensive system of risk assessments to address all aspects of health and safety. Evidence was seen within individual care plans of high risk issues being assessed such as use of bedsides and falls. The manager stated equipment has been purchased to ensure a safe working environment. These items included four new hoists (Oxford Midi and Mini). Since the last inspection two new lifts have been installed. A resident stated he was able to use the lift every day. Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 N/A 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 N/A 15 4 COMPLAINTS AND PROTECTION 4 4 4 4 4 4 4 4 STAFFING Standard No Score 27 3 28 N/A 29 N/A 30 N/A MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score N/A N/A 3 3 3 3 N/A N/A 3 3 3 Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 19 not applicable 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 Not applicable 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 Not applicable Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX 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 Sutton in the Elms Nursing and Residential Home C51 C01 S1927 Sutton in the Elms V230723 090805 Stage 4.doc Version 1.40 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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