Inspection on 18/07/06 for The Elms

This inspection was carried out on 18th July 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.

Other inspections for this house

The Elms 03/03/06

The Elms 05/07/05

The Elms 27/10/04

The Elms 18/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Sunny Bank (P.R.S.) Ltd

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE The Elms Elm Drive Crewe Cheshire CW1 4EH Lead Inspector Mr Val Flannery Key Unannounced Inspection 18th July 2006 09:30 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 Elms DS0000006515.V298035.R01.S.doc Version 5.2 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 Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Elms Address Elm Drive Crewe Cheshire CW1 4EH 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) 01270 584236 01270 250636 www.clsgroup.org.uk CLS Care Services Limited Jayne Murphy Care Home 40 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (1), Old age, of places not falling within any other category (39) The Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 40 service users to include:* No more than 39 service in the category of OP (Old age, not falling within any other category) * No more than 1 service user in the category of MD (E) (Mental disorder, excluding learning disability or dementia) The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 3rd March 2006 2. Date of last inspection Brief Description of the Service: The Elms provides care and accommodation for forty older people. Located on a residential estate in Crewe the home is close to shops, pub and is on the bus route to the town centre. A passenger lift and stairway allow for access between the ground and first floor of the two-storey building. All the bedrooms are single and have hand-washing facilities. There are sufficient bathrooms and toilets to meet residents’ needs. Communal lounges are located on both floors and there is a large dining room on the ground floor next to the kitchen. For those residents with mobility problems the home provides bath hoists, wheelchairs, grab rails and other mobility aids. Staff are on duty twenty-four hours a day to deliver care to the residents. The current weekly fees range from £343.34 to £400.00. Further details regarding fees are available from the manager. The Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This • • • key inspection report was written using evidence gathered from the Pre-inspection questionnaire Service history for the home Visit to the home on the 18th and 31st July 2006 The visit to the home was carried out over nine and half hours and involved talking with six residents, the home manage and six staff. A number of resident and home records were seen. A partial tour of the building was carried out. Feedback following the visit to the home was given to the registered manager on the 31st July 2006. What the service does well: The residents spoken with, and records seen, showed that the pre-admission process ensures prospective residents are made aware of the service offered by the home. Staff monitor the care needs of residents and action is taken to address any changes. Relatives and friends are able to visit the home at any reasonable time. Residents are cared for in an environment that is well-maintained and free from unpleasant odours. Residents are able to furnish their bedrooms with items of personal possessions. Care staff are employed in sufficient numbers to ensure the safety and well being of residents. The registered manager is keen to ensure residents receive the level of care needed to maintain their quality of life. Nine residents, two relatives, two general practitioners and one health, social care professional comment cards were returned. Five of the resident comment cards were completed with staff assistance and one with assistance from a relative. Comments included ‘I have no concerns with any aspect of care in the home’, ‘Very good all round care, thank you’. The returned residents’ comment cards showed that they satisfied with the service offered by the home. The Elms DS0000006515.V298035.R01.S.doc Version 5.2 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 Elms DS0000006515.V298035.R01.S.doc Version 5.2 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 Elms DS0000006515.V298035.R01.S.doc Version 5.2 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): 1/2/3/4/5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Pre-admission assessments prospective tresidents are carried staff from the home. The findings combined with information provided by the local authority (where appropriate) ensures the home is made aware of the needs of prospective residents. This information also determines if the home can meet these needs. EVIDENCE: The pre-admission records of three residents who have recently come to live in the home were seen during the visit. (Records of residents who have transferred to the home following the closure The Waldron’s, another CLS home in Crewe, were not included) These showed that the care needs of residents are identified prior to them moving into the home. Included in the assessment information were assessments covering risk of falling and risk of developing pressure ulcers. One of the residents spoken with said staff from the home had visited him before he had made a decision about moving in. Also that he had had visited the home, with relatives, prior to making a The Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 9 decision about moving in. Two other residents spoken with said they ‘knew about the home’ and they had received information about the service offered. The manager said prospective residents’ are given information about the level of service offered by the home. During the visit to the home a copy of the statement of purpose/service user guide was seen in residents’ bedrooms. The residents’ spoken with said they found the information ‘useful’ and that their relatives ‘liked to read it’ when they are visiting. A copy of the statement of purpose/service user guide was on display in the entrance area as was copies of previous inspection reports. The copy on display contained details on the services offered by the home. Contracts covering the level of service to be provided by the home are available. For those residents who are funded by the local authority service specific contracts are provided in addition to the organisations residency agreements. The pre-admission assessment documentation used by the home was not completed on one resident and was only partial completed on another resident. However, copies of the standard assessment documentation provided by the local authority were available (See Recommendation Number 1) The Elms DS0000006515.V298035.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ health and personal care needs are set out in their care plans. This gives staff the information they need to ensure residents’ care needs are met. EVIDENCE: Six residents’ were spoken with during the visit to the home. They said staff treats them ‘very well’ and they are ‘satisfied with the help they receive from staff’ with personal care tasks. The residents’ said staff talk to them about their care needs and ask them ‘if they are happy with the care they receive’. One resident said ‘he likes it here but that it is not like home’ Records seen on four residents showed that plans of care have been developed that set out how they wished to be cared for. Included were details on visits by doctors, district nurses and other healthcare professionals. Letters were seen that showed that residents were supported by relatives or staff from the home to attend hospital appointments. During the visit healthcare professionals were seen visiting residents. The Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 11 CLS have provided a policy and procedure for staff on the administration of medication to residents. The pre-inspection questionnaire included a list of staff responsible for administering medication. During the visit to the home satisfactory arrangements were seen for staff administering medication to residents. Two of the residents spoken with said they prefer the home to look after their medication. Three residents who transferred to The Elms following the closure of The Waldron’s, which was another CLS home in Crewe, were spoken with. They said they were ‘sad’ to leave The Waldron’s as they had lived there for some years. However, they said they had ‘settled very well’ and that ‘staff were very helpful and friendly’. The Elms DS0000006515.V298035.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are offered choice and are enabled to have control over their daily lives. They are also able to maintain contact with family and friends. EVIDENCE: Four of the residents spoken with said they are ‘happy with the way the staff helps them’ with their daily living and that ‘they are able to come and go as they please’. They also said that it makes them felt safe ‘having staff around all the time’. Four residents plans of care were seen during the visit. Three residents said speaks to them and asks them if they are ‘happy in the home’ and if ‘there are things they want but are not getting’. There is a notice board located in the entrance area that lists the activities on offer. Residents said they can choose to join in the activities and are ‘told about trips and what the activities co-ordinator has arranged for that day’. Since the closure of The Waldron’s one of the activities co-ordinators has transferred to The Elms. One of the residents who has recently come to live in the home said he is on the ‘committee that sorts out activities’. Residents The Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 13 talked about going to the pub every Wednesday and also how they have been to Blackpool on a number of occasions. The home has computer that is available for use by residents. Residents said they are able to receive visitors in their bedrooms or in the communal lounges. Plans of care contained family histories and information on residents’ next of kin. The staff spoken with said relatives/friends are able to visit the home at any reasonable time and would be made to feel welcome. The residents said the quality of the food offered ‘ is very good’. One resident said ‘I’ve not had a bad meal’ since he came to live in the home. They said they are offered choices at mealtimes and that staff do help those residents’ who may need assistance with their meal. The mealtime observed during the visit was relaxed and residents were able to eat their meal at their own pace. Staff were seen helping residents with their meal. Copies of the menu were provided as part of the inspection process. These showed that choices of meals are offered to residents on a daily basis and that menus are changed on a weekly basis. A number of residents commented on the change of ‘atmosphere’ since the arrival of nine residents from The Waldron’s. They, and a number of staff spoken with, said the residents from The Waldron’s ‘all seem to come at once’ and that their admission to the home was ‘rushed’. They commented that it would have been better to ‘do it more slowly’. The Elms DS0000006515.V298035.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents, and other visitors to the home, have access to a complaints procedure that enables them to raise issues of concern. There is an adult protection procedure in place that ensures residents’ are protected from abuse and neglect. EVIDENCE: Four residents were spoken with during the visit to the home. They said they, or their relative, know who to complain to and that their concerns are taken seriously and acted upon. They also said the manager’ will sort out their problems’. A copy of the complaints procedure, including details on how to contact the Commission for Social Care Inspection, was on display in the entrance area. A copy of the statement of purpose/service user guide, that has details on how to complain, is also kept in resident’ bedrooms. CSCI have not received any complaints about the home. Staff spoken with said they would refer any complaints to senior staff in the home. Staff spoke with said they would refer any concerns/complaints/allegations to the senior staff on duty. In March ’06 CSCI received a letter in which a concern was raised about staff employment procedures. Following investigation these concerns were not substantiated. CLS have provided a policy on protecting residents from abuse or neglect. This includes the government guidelines ‘No Secret’. Copies of the procedure are kept in the home. One member of staff spoken with was not aware of the The Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 15 procedure for reporting adult protection concerns (See Recommendation Number 2). The Elms DS0000006515.V298035.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Sufficient private and communal space is provided to meet the needs of residents. EVIDENCE: On the day of the visit the home was free from unpleasant smells. The residents spoken with said the ‘home is tidy and clean’ and that the domestic staff work’ very hard’. Communal lounges are provided on both floors. These are close to resident’s bedrooms and were seen being used by residents’ during the visit. A large dining room is located on the ground floor next to the kitchen. This is also used for group activities such as bingo. All the bedrooms are single, the rooms seen contained residents’ personal possessions, for example, pieces of furniture, televisions and family The Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 17 photographs. Residents confirmed that they were offered a key to their bedrooms. Lockable cupboards are provided in the residents’ bedrooms. Bathrooms and toilets are located around the home and within reach of bedrooms and communal areas. A number of residents have been assessed as requiring staff help when using these areas. Hoists, bath-lifting aids, grab rails and wheelchairs are provided for residents with mobility problems. Care call points are located in bedrooms, bathrooms, toilets and communal areas. Residents have easy access to a secure courtyard that is located within the home. On the day of the visit areas within the home, particularly the communal lounges to the front of the building were very hot. Staff were advised to contract the maintenance department of CLS and request that additional fans are provided to keep the lounges cool for residents (See Recommendation Number 3). Four residents said they could choose to be in the communal areas with other residents or be by themselves in their bedrooms. The Elms DS0000006515.V298035.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Training, and support, is provided for staff on caring principles and safe working practices that will ensure the well-being and safety of residents. EVIDENCE: The staffing rota seen during the visit showed that there is normally one care team leader and three care assistants on duty during the morning/afternoon/evening. There is one care team leader and one care assistant on duty during the night. The rota also showed that there are sufficient support staff including domestic assistants, cook, kitchen assistant and maintenance assistant employed by the home. Six residents were spoken with during the visit. They were very positive about the help and support they receive from the staff. Comments included staff are ’brilliant’ and will do’ anything for you’. A number said they feel safe knowing staff are around all the time. Staff were seen helping residents’ with personal care such as using the bathroom, dressing and eating. This was carried out in a sensitive and caring manner. Three staff personnel records were seen. These showed that checks are carried out on staff included Criminal Record Bureau checks, health checks and two references are sought. The Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 19 Staff spoken with said they receive training that included induction training when they first came to work in the home. Also that they are expected to complete their NVQ training. On the day of the visit the company’s NVQ coordinator was visiting a member of staff regarding completion of their NVQ. Records provided by the home manager showed that thirteen care staff have completed their NVQ and five are in the process of completing. During the visit staff commented on the new company uniform and how it was ‘to warm’ and that they were going to complain to management. Staff spoken with said they receive support and guidance from senior staff in the home and that they are able to seek advice on care issues. The Elms DS0000006515.V298035.R01.S.doc Version 5.2 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): 31/33/35/36/38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The manager is committed to providing clear leadership throughout the home and improving the communication with residents’, staff and other visitors to then home. EVIDENCE: During the visit to the home six residents, six staff from the home and two from CLS central office, the registered manager and the home service manager were spoken with. Residents said the manager is approachable and will sort their problems out. They also said the home is well run and that they feel they have chosen the right home to live in. Staff spoken with said meetings are held with the manager where they are given the opportunity to discuss care and staff related issues. For example, The Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 21 the manager said following concerns raised by staff about residents’ care needs she is now encouraging care team leaders to take responsibility for decision making, particularly in relation to care related issues. The manager said, that following recent issues raised about the management of residents’ personal finances, CLS have updated the policies and procedures on managing residents’ finances. During the visit the weekly fire alarm test was carried out. The procedure seen, which involved staff meeting at a central point and checks being carried out to ensure all fire doors had closed automatically, was satisfactory. A copy of a customer satisfaction survey was on display in the entrance area. The feedback from residents’ and relatives showed that they were generally satisfied with the service offered by the home. The Elms DS0000006515.V298035.R01.S.doc Version 5.2 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 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 The Elms DS0000006515.V298035.R01.S.doc Version 5.2 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. Standard Regulation Requirement 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. 2 3 Refer to Standard OP3 OP18 OP19 Good Practice Recommendations CLS pre-admission assessments should be completed for all residents. All staff should receive refresher training on the adult protection procedure Staff should take action to ensure the temperature in the lounges is kept at a safe and comfortable level for residents’. The Elms DS0000006515.V298035.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Elms DS0000006515.V298035.R01.S.doc Version 5.2 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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