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Inspection on 21/02/06 for The Elizabeth Anne Nursing Home

Also see our care home review for The Elizabeth Anne Nursing Home for more information

This inspection was carried out on 21st February 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.

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

Staff members are multi skilled, and staff communication is good with daily handovers and regular staff meetings. The staff team work very hard towards providing best practice in relation to all aspects of their duties. Adaptations and equipment at the home suit the needs of the service users. The home is well run by a competent experienced senior team. Service Users confirmed they liked the food at the home, and a varied and nutritious diet is provided with alternatives available.

What has improved since the last inspection?

The ownership of the registered company has changed hands at the end of 2005, and currently the staff group at the home remains stable ensuring continuity of care for the Service Users. Training is ongoing at the home.

CARE HOMES FOR OLDER PEOPLE The Elizabeth Anne Nursing Home 64 Edgar Road Cliftonville Margate Kent CT9 2EQ Lead Inspector Sandra Crosby Unannounced Inspection 21st February 2006 12:30 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 The Elizabeth Anne Nursing Home DS0000026092.V280737.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. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Elizabeth Anne Nursing Home Address 64 Edgar Road Cliftonville Margate Kent CT9 2EQ 01843 221375 01843 232280 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) Cliftonville Nursing Homes Limited Moira Jack Care Home 30 Category(ies) of Dementia (30), Mental disorder, excluding registration, with number learning disability or dementia (27) of places The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Patients detained under the Sections of the Mental Health Act may not be admitted to the home, except for (1) Service User whose date of birth is 09/07/28. 27 beds are registered for the admission of nursing patients 30 beds are registered for the admission of residential clients Patients admitted under the category of Mental Disorder must be aged over 50 years. To admit one (1) Service User whose date of birth is 01/01/1933. 2. 3. 4. 5. Date of last inspection 14 November 2005 Brief Description of the Service: The Elizabeth Anne Nursing Home is a large detached premises, with 24 single and 3 double bedrooms. One of the double and ten of the single bedrooms have en-suite facilities and most have television points. Accommodation is on three floors and there are two shaft lifts. There is a call bell system in operation at the Home. The Home aims to ‘provide an environment and programme of care to Service User’s which will reinforce normal acceptable behaviour, aiming to diminish confusion and encourage Service User’s to move from dependency to independence through clear guidelines for their care’. The Home is located close to the seafront, local shops and bus route in Cliftonville. There is an external grassed area to one side of the property where Service User’s may sit out in the warmer weather. The representative who takes main responsibility for the Elizabeth Anne Nursing Home that is owned by Cliftonville Nursing Homes Limited is Bill Leadbeater. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and carried out on Tuesday 21 February 2006 between 12.30 and 14.30. Since the last announced inspection at the home the ownership of the Company has changed hands. The Inspector spoke with the Registered Manager, and the Senior Carer. The focus of the inspection was to check on compliance with the one requirement and recommendations made at the announced inspection visit. Various records were seen. The Inspector during the accompanied tour of the home at the announced inspection visit, spent time talking with Service Users, they said they liked the staff that were said to be friendly and helpful, and they enjoyed the food provided at the home. Three Service User Comment Cards were received at the Commission Office, and these provided positive comments about the home. The Pre-inspection Questionnaire completed by the home prior to the announced inspection and information provided by Service Users and staff at the time of the inspection, has been used in this report. The home has met the requirements made in the last inspection report, and shows commitment towards meeting the National Minimum Standards. What the service does well: Staff members are multi skilled, and staff communication is good with daily handovers and regular staff meetings. The staff team work very hard towards providing best practice in relation to all aspects of their duties. Adaptations and equipment at the home suit the needs of the service users. The home is well run by a competent experienced senior team. Service Users confirmed they liked the food at the home, and a varied and nutritious diet is provided with alternatives available. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Elizabeth Anne Nursing Home DS0000026092.V280737.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 The Elizabeth Anne Nursing Home DS0000026092.V280737.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): 1,3,6 The homes Statement of Purpose and Service User Guide provide Service Users and prospective Service Users with the information they need to make a decision about moving into the home. Service Users move into the home knowing that their needs can be met and that their independence will be maximised and promoted. It is not the general policy of the home to admit Service Users on a short-term basis, and this standard was judged as not applicable at this inspection visit. EVIDENCE: Standards 1 and 3 were judged as standard met, and Standard 6 was judged as not applicable at the announced inspection visit dated 14 November 2005. These standards were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 9 The Inspector was provided with an updated copy of the Statement of Purpose and Service User Guide for the home. Completed pre-admission paperwork was seen as part of the Service User Plan, together with Care Management assessment as appropriate. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9,10 The care planning system meets the requirements of the national minimum standards and regulations. It is indicated that the health needs of Service Users are well met. The systems for medication administration are good with clear and comprehensive arrangements being in place to ensure Service Users medication needs are met. Personal care is offered in a way to protect Service Users privacy and dignity. EVIDENCE: Standards 7,8,9 and 10 were judged as standard met, at the announced inspection visit dated 14 November 2005. Standards 7 and 9 were partially inspected at this visit, Standard 7 remains as standard met and Standard 9 was judged as nearly met. Standards 8 and 10 were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 11 Three Service User Plans were examined and improvement seen in the comprehensive records now recorded. The Service User Plans contained all information as required by the standards and regulations. From information contained with the Service User Plans, it is indicated that Service Users Health needs are met, and other professionals are contacted as appropriate in order to meet Service User needs. The medication records were mainly signed for and up to date, although a small number of gaps in the recording was discussed with the Registered Manager. The medications storage was not seen at this inspection visit. It was found at the announced inspection that the temperature of the area in which the medications was stored was higher than would be acceptable for some medications, and the Registered Manager agreed to take action in relation to this issue. The Registered Manager said that the use of a fan had been implemented in the medication storage area, and that she had been in contact with the pharmacist in relation to the temperature that medications need to be stored at. It was observed at the announced inspection visit that Service Users privacy and dignity are respected. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15 Service Users indicated that the lifestyle they experience in the home met their expectations. Service Users are able to maintain contact with family and friends together with access to the local community as they wish. Service Users are enabled to exercise choice and control over their lives. The meals in the home are good offering both choice and variety, and catering for special diets. EVIDENCE: Standards 12,13,14 and 15 were judged as standard met, at the announced inspection visit dated 14 November 2005. These standards were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. Service User’s told the Inspector that the pace of daily life in the Home is relaxed and unhurried. People said that they could choose when to get up, The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 13 when to go to bed and how to spend their day in between. Written evidence was also seen in the Service User Plans. A person has been employed to undertake diversional therapy sessions, and is currently actively carrying out a programme of activities. The home also invites outside entertainers, and has the usual party functions for example Halloween Party. Links with family and friends are maintained. Visitors are welcome at all reasonable times. The home has a designated quiet room for private conversation. The Inspector was told that Service User’s who are able go out and about independently. The Registered Manager said that she makes every effort to encourage and to assist Service User’s to retain control of their financial affairs. The records of the food provided were seen and showed that a varied and nutritious diet was available to Service User’s, with alternative choices available. As there were only five weeks of records available, an alternative way of record keeping was discussed with the Registered Manager. Service User’s spoke positively about the food provided at the home, and confirmed that choices are available. The Inspector saw that he main Dining Room was well presented, with tablecloths, place mats and appropriate cutlery. Meals are taken in the main Dining Room or in the Service User’s bedroom if preferred. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 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 the following standard(s): 16,18 The home has a satisfactory complaints system with evidence that Service Users feel that their views are listened to and acted upon. Staff indicated a knowledge and understanding of Adult Protection issues that protects Service Users from abuse. EVIDENCE: Standards 16 and 18 were judged as standard met, at the announced inspection visit dated 14 November 2005. These standards were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. The complaints procedure was seen as part of the Statement of Purpose and Service User Guide. The complaints book was seen for the home, and the Preinspection Questionnaire completed by the home states that there has been one complaint made in the last twelve months. There is a policy document in the Home that commits everyone to do with the running of the Elizabeth Anne Nursing Home, to guard against any incident in which a Service User might experience abuse. The Pre-inspection Questionnaire completed by the home states that Adult Abuse Awareness has been one of the training courses undertaken by staff in the last twelve months. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 15 The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 16 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): 19,20,21,22,23,24,25,26 The standard of the environment within the home is good providing Service Users with an attractive and homely place to live. The garden areas are attractive and well maintained. The home was clean and pleasant at the time of the inspection visit. EVIDENCE: Standards 19,20,21,22,23,24,25 and 26 were judged as standard met, at the announced inspection visit dated 14 November 2005. These standards were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. In general the premises are presented to a good standard. On the outside the fabric of the property looks mainly to be in good order. On the inside most areas are well decorated, comfortably furnished and clean. There is ongoing redecoration and refurbishment. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 17 The premises provide adequate communal space and these areas are well presented. Adequate toilet, washing and bathing facilities are provided to meet the needs of Service User’s. The Home has a Parker Bath and two well designed walk in shower facilities. Equipment is provided as per individual assessed needs, including hoists, mattresses, grab rails etc. There is two passenger lifts at the Home. A call bell system is provided for every room. It was seen during the accompanied tour of the home that bedrooms were furnished and equipped to assure comfort and privacy. The furnishings within the bedrooms were arranged in order to meet the assessed needs of the Service User. Rooms are centrally heated and it was seen that radiator covers are in place. A number of secondary heaters were seen attached to walls in bedrooms, and the Inspector has been told previously that the Fire Safety Officer is aware that these heaters are being used in the Home. On the days of the inspection visits, the premises were found to be clean and mainly free from any stale odours. Any areas of concern were discussed with the Registered Manager, who agreed to address this issue. The Laundry Room was very tidy and provides adequate facilities. The washing machine has specified programmes as required to meet disinfection standards. Since the last inspection visit a new flooring finish has been laid in the Laundry. It was seen during the accompanied tour of the premises that a number of bedroom doors are lockable, but not all are fitted with locks. The Registered Person has written to the Commission and received a reply in relation to this issue. It is acknowledged that for the registered category of the home it may not be in the best interests of all Service User’s to have a lock fitted on their bedroom door, however the standard states that ‘doors to Service User’s private accommodation are fitted with locks, and a key provided other than to Service User’s whose risk assessment showed this to be inappropriate. For this reason the Inspector is only able to judge this Standard as nearly met. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 18 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): 27,28,29,30 Staff are multi-skilled ensuring good quality care and support, and staff morale is good resulting in a workforce that works positively with Service Users. The staffing level at the home was sufficient at the time of the inspection visit to meet the needs of the current group of Service Users. The procedures for the recruitment of staff meets the requirements of the standard, and as such offers a safeguard in order to protect the people living in the home. Staff training is ongoing at the home. EVIDENCE: Standards 27,29 and 30 were judged as standard met, and Standard 28 was judged as nearly met at the announced inspection visit dated 14 November 2005. These standards were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. The staff rota was seen, and indicated that there are sufficient staff on duty to meet the needs of the current group of Service Users. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 19 Three staff files were seen, and contained all relevant documentation. It was discussed that contracts of employment need to be dated and signed by both parties. The Pre-inspection Questionnaire states that one member of the care staff currently holds an NVQ Level 2 certificate, and the RMN on duty said that one member of staff has nearly completed the NVQ Level 2, and that 3 members of care staff have just started the NVQ Level 2. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 20 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): 31,33,35,36,37,38 Service Users benefit from a well run home, and the health, safety and welfare of service users and staff are promoted and protected. The practices at the home mainly promote and safeguard the health, safety and welfare of the people using the service. A documented system is in place to ensure that Service Users financial interests are safeguarded. Staff supervision is in place with written records kept. A quality assurance system is in place at the home. Systems are in place in relation to the safe storage of records. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 21 EVIDENCE: Standards 31,33,35,36 and 37 were judged as standard met, and Standard 38 was judged as nearly met at the announced inspection visit dated 14 November 2005. These standards except for Standard 38 were not inspected at this inspection visit, and the information below refers to the judgement made at the announced inspection visit. Staff training is ongoing at the home, and the Pre-inspection Questionnaire provides a list of the courses undertaken this year. The Inspector also saw the staff-training matrix in the office area of the home. The Fire Log Book was seen, and all regular weekly and monthly monitoring checks were appropriately signed as being carried out. Although there was evidence that Fire Drills are undertaken at the home, there was no list of names of staff that had attended and this issue was discussed with the Registered Manager. Since the announced inspection visit, a copy of the required current electrical certificate for the home has been sent to the Commission. The accident records were viewed at this inspection visit. The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 22 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 23 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 OP9 Regulation 13(2) 17(1)(a) Sch 3 Timescale for action The registered person ensures 21/02/06 that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling administration and disposal of medicines Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 The Elizabeth Anne Nursing Home DS0000026092.V280737.R01.S.doc Version 5.1 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. 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