Inspection on 30/11/05 for The Elizabethan Care Home

This inspection was carried out on 30th November 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Elizabethan Care Home 29/08/08

The Elizabethan Care Home 14/04/08

The Elizabethan Care Home 18/05/07

The Elizabethan Care Home 07/06/06

The Elizabethan Care Home 21/04/05

The Elizabethan Care Home 28/10/04

The Elizabethan Care Home 22/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE The Elizabethan Care Home 220 Old Bedford Road Luton LU2 7HB Lead Inspector Mr Pursotamraj Hirekar Unannounced Inspection 30th November 2005 10:20 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 Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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 Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Elizabethan Care Home Address 220 Old Bedford Road Luton LU2 7HB 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) 01582 720010 Heritage Care Homes Ltd Miss Erin Bermingham Care Home 21 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (23) of places The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users over the age of 65 years, not falling within any other category 21(OP), 10 of whom may have dementia DE(E) (10). No one falling within the category of DE(E) may be admitted to the home when there are 10 persons in category DE(E) already accommodated in the home. The home can accommodate a maximum of 21 service users of either sex. 21st April 2005 Date of last inspection Brief Description of the Service: The Elizabethan was registered to provide services for twenty-one older people, ten of whom who may also have dementia. Mr S Hussain had been the proprietor a number of years. He had changed the registered status to a company, Heritage Care Homes, two years ago. The company also operates two other care homes in the vicinity. The manager Miss Bermingham had been appointed several months ago. The service had improved significantly under her direction. The home was located in a pleasant residential suburb of Luton with convenient access to the towns amenities and transport links. The accommodation was distributed over three floors that were accessible via a staircase and a shaft lift. Each bedroom was for single occupancy although a few rooms were large enough to accommodate two persons who wished to share. A lounge and dining room were located on the ground floor. Toilet and bathing facilities were located on each of the floors. However, only two of the bathing facilities were in use. The garden to the front of the property was not accessible as it had a steep slope. The front entrance to the building was similarly restricted. Service users and visitors to the home therefore mostly used the door that led directly into the laundry from the side of the property. Service users could also use the patio doors that lead out from the rear lounge onto a paved area. The majority of the rear of the property was given over to a large parking area. Beyond this was a further large grassed area that was not in use. The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the unannounced inspection that took place on 30/11/05 and lasted hours. Mrs. L. Milton and Mr. P. Hirekar undertook the inspection. The method of inspection included discussions with five service users’, registered manager, one staff member on duty, visit to communal areas, visit to four service users’ bed rooms, ground floor toilet and case tracking, study of various documents and feedback to the registered manager. What the service does well: What has improved since the last inspection? What they could do better: The owner of the home has to take proactive steps to address the issues of staff shortages and allocate enough time for the home maintenance person to attend to repair and replacements of furniture, fixtures and other facilities accessed by the service users. Access to the home was still a problem for anyone who was unable to negotiate the steep slope to the front of the building. The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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. The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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 Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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): None EVIDENCE: The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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 & 10 The service users health and personal care needs were appropriately met, except one. EVIDENCE: The service users whose care plan was case tracked, the risk assessments have been carried out satisfactorily. However, the risk assessments outcomes needed to be incorporated into the care plans of service users. The manager had agreed to incorporate these. The manager had taken action in response to the previous requirement and had replaced the doctor, who now visits the home and gives written prescriptions of medicine. The home does not have their own policy for safe storage of oxygen cylinders and were currently following the guidance given by the British Oxygen Company – Suppliers. One service user whose situation was case tracked did not receive sufficient care to meet assessed needs dated 11/10/05 and 25/09/05 which, had recorded high risk. The manager had confirmed with the inspectors that the The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 Page 10 home does not have facilities and appropriately trained staff to meet the needs of this service user. In a letter dated 16/05/05 the representatives were informed by the manager that the home is not able to provide sufficient care to this service user and told them to move to an appropriate place. The representatives of this service user had ignored the letter. The service user continued to stay at the home without being cared for satisfactorily. The manager needed to be more proactive in moving this person to a more suitable placement in a timely manner. The service user is no longer at the home. The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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, 13, 14 & 15 Most of the service users were content with their daily life and social activities. However, adequate staff ratio would further improve care. EVIDENCE: The service users’ spoken to have expressed satisfaction with meal timings, the quality of meals and the pleasing environment that favour their choices, interests and needs. Service users using fortnight hair dressing opportunity were happy with the service. The meals served were balanced and wholesome. Reductions in the care staffing arrangements in the afternoon reported in the previous inspection report have been addressed partially by increasing to 4 staff members in the morning and 3 staff members in the afternoon, which is still not an adequate ratio. The service users continue to maintain contact with their friends, representatives, relatives and family. The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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 the following standard(s): None EVIDENCE: The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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 the following standard(s): 19, 20, 21, 23, 24, 25 & 26 Service users live in a safe, comfortable, hygienic environments with some shortfalls in their bedrooms. EVIDENCE: The requirement from the previous inspection time scale of 30/04/05 and 31/07/05 to provide suitable ramp to the entrance door to the home and access via front garden were not met. The manager informed the inspectors that the owner told her that the home might not get planning permission. However, there was no evidence provided on this inspection to show that an application had been made to the planning department for their permission. The other requirement from the previous inspection time scale of 30/11/04 and 30/06/05 to provide the maintenance person sufficient times to carry out maintenance work of the home have not been actioned yet. The maintenance person is currently, visiting once in every three weeks and available on emergency calls. The manager’s request has been not actioned by the owner. The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 Page 14 The maintenance register indicated that the work at home is pending from October 2005. A couple of tiles in the ground floor toilet had come off the wall. The maintenance person was telephoned to fix the broken handle in the ground floor toilet during the inspection. A tour of the communal areas and the service users’ bedrooms found that, 4 service users’ bedroom wardrobes do not lock; handles on the wardrobe doors were broken. One service users bedroom was over powering with an unpleasant odour; bed mattress had waterproof coating and had slight unpleasant smell. One-service users’ bedroom had two T.V one on the table and the other on the floor and a cigarette end in the basket near the washbasin loaded with tissue paper. The home must undertake risk assessment with regard to smoking in the bedrooms and disposal of cigarette ends. The lounge and the dining areas were neat and tidy. The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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, 28, 29 & 30 Staffs on duty have appropriate skill mix and were competent to attend to the needs of the service users’. However, shortage of staff prevents service users to access to timely care. EVIDENCE: The previous inspection requirement to provide sufficient staff to meet service users’ assessed needs including recreational and social needs and assistance in having meals and roster care staffs on duty during the day at a minimum ration of 1:6 or part thereof was not met. One service user was assisting a very dependent service user to take meals, whilst having her own. After few minutes of serving the lunch, a member of the staff was assisting the very dependent service user to have meals. But in the middle of the meals the staff member left the service user to attend some other work. The service user had to wait till the staff member returned to assist in having the meal. The outstanding home maintenance work from October 2005 is also a cause of concern. These are clear evidences of staff shortage and therefore, this requirement must be attended to as a priority. The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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 & 38 The manager is knowledgeable, competent, and had control over the affairs of the home. However, the manager has to assert with the owners to protect the interests of the service users. EVIDENCE: The manager is competent and continued to improve the quality of care through appropriate management functions and staff supervision. However, the manager had not performed adequately in the case of a service user who continues to stay in the home. Despite, the home not having adequate facilities and services to meet the demanding needs of the service user. The manager had neither written to the local authority expressing inability to provide services nor terminated the contract with the service user. The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 Page 17 The manager confirmed that the service user is privately funded and family did not cooperate in moving the service user to an appropriate place. The manager’s terms and conditions of employment have been reviewed and the manager is happy with the revised emoluments. The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 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 X 17 X 18 X 1 3 3 X 3 1 3 3 STAFFING Standard No Score 27 1 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X X X X 3 The Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 13(4b), 15(1)(2) 12 (1)(a) (b) 23(2)(n) Requirement All outcomes from risks assessments of service users needed to be incorporated into the care plans. The home must ensure proper provision for health, welfare and appropriate treatment of service users. Provide a suitable ramp to the entrance door to the home and to the access via the front garden.(Previous timescale of 30.04.05 and 31.07.05 had not been met). Provide the maintenance person with sufficient time to carry out the maintenance of the home.(Previous timescale of 30.11.04 and 30.06.05 had not been met). Repair furniture in various sites where it is chipped and worn (Previous timescales of 31.07.04 and 31.12.04 had not been met in full) Provide sufficient staff to meet service users assessed needs including recreational and social needs and meals served at times DS0000045208.V267325.R01.S.doc Timescale for action 15/12/05 2. OP8 15/12/05 3. OP19 15/02/06 4. OP19 18(1a), 23(2C) 15/01/06 5. OP24 16(2) 15/01/06 6. OP27 18(1)(a) 15/01/06 The Elizabethan Care Home Version 5.0 Page 20 7. OP31 10 (1) required. In this instance roster care staff on duty during the day at a minimum ratio of 1:6 or part thereof.(previous time scale of 21.05.05 not met) The home must provide having 15/12/05 regard to statement of purpose, needs of service users carry on with sufficient care, competence and skill. 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 Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Elizabethan Care Home DS0000045208.V267325.R01.S.doc Version 5.0 Page 22 - 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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