Inspection on 03/03/06 for The Elms

This inspection was carried out on 3rd March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Elms 18/07/06

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 Ms Gill Matthewson Unannounced Inspection 3rd March 2006 10:30 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.V281864.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 Elms DS0000006515.V281864.R01.S.doc Version 5.1 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.V281864.R01.S.doc Version 5.1 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 or dementia) The service should, at all times, employ a suitably qualified and experienced manager who is registered wih the Commission for Social Care Inspection 5th July 2005 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 Elms DS0000006515.V281864.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over six hours on the 3rd March 2006 and an hour and a half on 9th March 2006. One hour was spent reading the previous inspection report and reviewing the service history of the home. Feedback on the findings of the visit was given to the operations manager. During the inspection seven residents, one relative and four staff were spoken with. A number of home records were seen and a full tour of the building was carried out. What the service does well: What has improved since the last inspection? The Elms DS0000006515.V281864.R01.S.doc Version 5.1 Page 6 The home continues to develop the service offered to residents. 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.V281864.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 Elms DS0000006515.V281864.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 Prospective residents and their relatives/other representatives are given information about the level of service offered by the home. EVIDENCE: A copy of the statement of purpose and service user guide to the home was on display in the entrance area and residents had individual copies in their rooms. Residents and a relative spoken with said they received information on the service offered by the home before they made a decision to move in. The Elms DS0000006515.V281864.R01.S.doc Version 5.1 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): 9 & 10 Residents are treated with respect and their privacy is upheld. They receive the medication prescribed by their doctor. EVIDENCE: A sample of the records of medication administered to residents by staff was seen; these showed that residents were receiving their medication as prescribed. At lunchtime a senior carer was observed administering medication to residents in an appropriate manner. There was a telephone available for residents’ use in a quiet area of the home and residents’ mail was delivered to their room unopened. Staff were seen knocking on bedroom doors before entering. Residents said that staff were kind and caring and maintained their privacy and dignity when assisting with personal care. One resident said “all the staff are exceptionally kind” and another said “nothing is too much trouble for them”. The Elms DS0000006515.V281864.R01.S.doc Version 5.1 Page 10 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. Residents have the opportunity to exercise choice and control in relation to all aspects of their daily lives. Relatives and friends are able to maintain contact with residents. Meals are well presented and offer choice and variety. EVIDENCE: Activities are arranged by the activities co-ordinator for individuals and groups of residents. Residents said they are asked about their preferences with regard to activities and were happy with the activities offered. A weekly activity programme was displayed on the door of the dining room. Activities were planned for four days of the week and included crafts, baking, bingo and exercises to music. On the first afternoon of the inspection a singer was providing entertainment for the residents. The statement of purpose indicated that relatives/other visitors are able to visit whenever residents wish. This was confirmed by the residents who said that their visitors were made welcome by the staff. A number of residents spoken with said that they are encouraged and supported by staff to retain control over their daily lives. For example, The Elms DS0000006515.V281864.R01.S.doc Version 5.1 Page 11 residents said they are able to get up/go to bed when they wish, choose where/when they have their meals and who they socialise with. Residents said the food was ‘very good’ and that they are offered at least three choices for the main meal. Menus seen showed that residents are offered a balanced diet. The cook said residents are asked on a daily basis for their choice of meals. Breakfast was served at 8.30am and residents could have a cooked breakfast if they wished. The main meal was served at 12.30pm and on the day of the inspection most residents had chosen fish, chips and peas. The meal was well presented and residents were offered second helpings. Tea was served at 4.30pm and consisted of soup, an assortment of sandwiches and mousse. Residents said they are also offered a light supper at about 7.30pm. The Elms DS0000006515.V281864.R01.S.doc Version 5.1 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): 16 Satisfactory arrangements are in place to respond to complaints. The procedures ensure that residents and others are able to raise concerns which will be responded to. EVIDENCE: Residents spoken with said they were comfortable about discussing any worries or concerns with the staff. One resident said he had raised a concern with a senior manager, who had listened to him and resolved the problem. Details on how to contact the Commission for Social Care Inspection were included in the complaints procedure, which was available in every room. A comments and complaints file was also available in the entrance hall. The operations manager had just received a complaint and was investigating at the time of the inspection. CSCI had received one complaint, but the operations manager was already investigating the issue raised in the complaint. The staff spoken were aware of the complaints and adult protection procedures and what to do if a problem arose. The Elms DS0000006515.V281864.R01.S.doc Version 5.1 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, 22, 24 & 26. The home provides a clean, safe and comfortable standard of accommodation for residents. Residents are able to bring personal possessions with them when they come to live in the home. EVIDENCE: The home was well-maintained and provided residents with a safe, homely environment. Communal lounges are provided on both floors; a large dining room is provided on the ground floor. An inner courtyard with seating and planted garden is accessible to residents. This area provides a pleasant, secure area for residents and their visitors. Sufficient bathrooms and toilets are provided for residents; these are within easy reach of the bedrooms and communal areas. The Elms DS0000006515.V281864.R01.S.doc Version 5.1 Page 14 For residents with mobility problems a range of lifting aids such as bath hoists, wheelchairs and grab rails are provided. Care call points are located in bedrooms and communal areas. All the bedrooms are single and contain hand-washing facilities. The rooms seen during the inspection contained residents personal possessions including items of furniture, photographs and ornaments. Residents said the rooms suit their needs. On the day of the inspection the home was very clean and free from unpleasant smells. There was a well-equipped laundry situated at the opposite end of the home to the kitchen. Sluicing facilities were also provided. The Elms DS0000006515.V281864.R01.S.doc Version 5.1 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 Staffing levels are sufficient to meet the needs of the residents. EVIDENCE: Since the last inspection the care staff rota had changed. Instead of two care assistants on duty during the morning and afternoon/early evening there were three. The rotas showed the following: A.M One care team leader and three care assistants P.M One care team leader and three care assistants Night-time One care team leader and one care assistant. Support staff including home service manager, activity coordinator, administrator, cook and domestic assistants were employed in sufficient number to meet the needs of the residents. The Elms DS0000006515.V281864.R01.S.doc Version 5.1 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): 35 Residents control their own money except where they state they do not wish to. Records of transactions need improving to ensure that residents’ financial interests are safeguarded. EVIDENCE: Most residents controlled their own money, but some had requested that CLS hold their funds. These were held in a CLS account, but individual balances were recorded and interest was added yearly. Some other residents had requested that CLS hold small amounts of spending money in the home’s safe. Records of credits and debits were documented and a balance sheet maintained for each resident. Residents signed for cash withdrawals from the safe. At the time of the inspection the operations manager was conducting an investigation into concerns raised about the management of residents’ monies. The Elms DS0000006515.V281864.R01.S.doc Version 5.1 Page 17 This involved a full audit carried out by the registered provider’s finance manager. A second inspection visit was carried out to look at records further and review the findings of the audit. The outcome of the investigation was that there had been no mishandling of residents’ funds, but there was a need to improve the records kept. For example, one resident, at their request, had chosen and paid for new bedroom furniture. There was a receipt for one item, but it did not identify what it was. There was no receipt for another item and the request for release of funds from the resident’s account with CLS did not identify what it was for. Also, some residents had signed cash withdrawal authority forms authorising the provider to pay money out of their accounts for various items identified without any further consultation. This was intended for regular payments for such things as hairdressing, chiropody and newspapers. The finance manager had identified that there was a need to include in this authority an upper amount of money beyond which further consultation would be required. See Recommendation 1. The Elms DS0000006515.V281864.R01.S.doc Version 5.1 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 3 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 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 X 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 2 X X x The Elms DS0000006515.V281864.R01.S.doc Version 5.1 Page 19 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 Refer to Standard OP35 Good Practice Recommendations Improved documentation in records of residents’ monies, which were identified as necessary by the company’s finance manager, should be implemented as soon as possible. The Elms DS0000006515.V281864.R01.S.doc Version 5.1 Page 20 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.V281864.R01.S.doc Version 5.1 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. 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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