Inspection on 05/07/05 for The Elms

This inspection was carried out on 5th July 2005.

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

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

Other inspections for this house

The Elms 18/07/06

The Elms 03/03/06

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 Val Flannery Announced 5 July 2005 8:50 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Elms Address Elm Drive Crewe Cheshire CW1 4EH 01270 584236 01270 250636 jayne.murphy@clsgroup.org.uk CLS Care Services Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Jayne Murphy Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Mental Disorder, excluding learning disability or dementia - over 65 (1) Female The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 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) 2 The service should, at all times, employ a suitably qualified and experienced manager who is registered wih the Commission for Social Care Inspection Date of last inspection 27/10/04 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 allows for access between the ground and first floor of the two storey building. All the bedrooms are single and have handwashing facilities. There are sufficient bathrooms and toilets located to meet residents needs. Communal lounges are located on both floors. A large dining room is located on the ground floor next to the kitchen. For those residents with mobility problems the home provides bath hoists, wheelchairs, grab rails and other lifting aids. Staff are on duty twenty four hours a day to deliver care to residents. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over seven hours on the 5th July 2005. 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 registered manager on the day of the inspection. During the inspection seven residents, two relatives, two district nurses, five staff and the hairdresser were spoken with. Nineteen service user, four relative, three general practitioner, three health and social care professional and two care manager comment cards were returned before the inspection took place. A number of service user and home records were seen. A partial tour of the building was carried out. What the service does well: The home provides information on the service offered. Care plans are in place which identify the assessed needs of residents; also included are details on how these needs are to be met. For example, the health and personal care needs are set out in detail. A medication procedure has been provided which ensures residents are given their medication as prescribed. Also included are procedures which guide staff on the administration of medication. An activities co-ordinator organises activities that reflect the interests of individual and groups of residents. Family and friends are welcome to visit the home and are able to discuss issues/worries on behalf of residents. Residents and others spoken with were positive in their comments about the manager and staff. They said staff are ‘very caring’ and work hard to improve the quality of life for residents. A number of staff have a lot of experience in caring for older people. They are encouraged to attend training courses to develop their caring skills. Procedures for dealing with complaints and adult protection issues are in place within the home. Residents and relatives said they are confident their concerns and worries would be taken seriously by the manager and acted upon. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 6 Bedrooms, lounges, dining room and inner courtyard are welcoming and homely and the environment is maintained to a high standard. The following is a selection of the feedback received in the comment cards: • ‘ Out of all the home I visit……this one is by far the best’ (General Practitioner) • ‘The facilities and environment are very good and the staff are excellent’ (Relative) • ‘Mum is very happy and very well cared for. All staff are great’ (Relative) • The staff are very friendly……..residents seem happy and comfortable’ (Health Professional) • We as a team….feel that it is one of the best run homes in this area’ (Health Professionals) The service user comment cards showed a general satisfaction with the level of service offered. What has improved since the last inspection? What they could do better: The home should continue to develop the service offered to residents. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 7 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 F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1/3/4/5/ Prospective residents and their relatives/other representatives are given information about the level of service offered by the home. Pre-admission assessments are carried out by staff from the home. This will help ensure the home can meet the residents’ care needs. EVIDENCE: A copy of the statement of purpose and service user guide to the home was on display in the entrance area. The relatives spoken with said they received information on the service offered by the home before a decision was made about moving in. A copy of the pre-admission assessment information, carried out by staff from the home, was seen on the six residents’ files inspected. Also available was a copy of the standard assessment documentation provided by the funding authority. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 10 Residents said they were visited by staff from the home before moving in and that their care needs were agreed with them. Residents, and relatives, were very satisfied with the level of care provided. They also said they were offered the opportunity to visit the home prior to moving in. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7/8/9/10 Residents’ health and personal care needs are set out in their plans of care. They are well looked after in respect of their health and personal care needs. Residents are treated with respect and their privacy is upheld EVIDENCE: A copy of the proposed new care planning format was seen during the visit. These will contain more information about the resident and how they wish to be cared for. The care plans currently in use showed that the health and personal care needs of residents are met. Two district nurses spoken with said the residents they visit are well looked after and that staff from the home will seek medical advice as necessary. They also said that staff are helpful and co-operative. Included in the plans of care were records of visits by doctors and other health professions and the reason for the visits. A sample of the records of medication administered to residents by staff was seen; these showed that residents are receiving their medication as prescribed. Satisfactory arrangements were seen on the administration of medication to residents by staff. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 12 Residents said that staff are ‘kind and caring’ and ‘will do anything for you’. Residents are consulted about their individual care plans are and are enabled to read and sign them. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12/13/14/15/ Residents are offered a stimulating and varied lifestyle. Relatives and friends are able to maintain contact with residents. Meals are well presented and offer choice and variety. EVIDENCE: A number of residents spoken with said they are encouraged and supported by staff to retain control over their daily lives. For example residents said they are able to getup/go to bed when they wish, choose where/when they have their meals and who they socialise with. This was also confirmed by the relatives spoken with. Relatives and others spoken with commented about the ‘relaxed’ atmosphere in the home and how residents seem to be happy. Residents said the food was ‘very good’ and that they are offered at least three choices at each 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. The residents spoken with, the statement of purpose and the plans of care showed that relatives/other visitors are able to visit when they wish. Relatives spoken with said they are made welcome by staff and that they are kept informed of accidents and other incidents involving residents. They also said staff are ‘very friendly and caring’. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 14 Activities are arranged by the activities co-ordinator for individual and groups of residents. Residents said they are asked about their preferences with regard to activities. Both residents and relatives they were happy with the activities offered. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16/18 Satisfactory arrangements are in place to respond to complaints and adult protection issues. The procedures ensures residents and others are enabled to raise concerns which will be responded to. EVIDENCE: Residents, relatives and others spoken with said they are comfortable about discussing any worries or concerns with the manager and staff. They said their complaints are taken seriously and acted upon. Details on how to contact the Commission for Social Care Inspection were available. The manager said no complaints have being received since the last inspection. CSCI have not received any complaints about the home since the last inspection. A comments and complaints file is on display in the entrance hall. CLS have provided an adult protection procedure, a copy of which is kept in the home. This includes a copy of the government guideline ‘No Secrets’. The staff spoken with are aware of the complaints and adult protection procedures and what to do if a problem arises. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 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 standard(s) 19/20/21/22/23/24/25/26 The home provides a 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 is well maintained and provides residents with a safe, homely environment. On the day of the inspection the home was clean and free from unpleasant smells. 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 has recently been revamped and provides a pleasant, secure area for residents and their visitors. All the bedrooms are single and contain hand-washing facilities. The rooms seen during the inspection contained residents personal possessions including The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 17 items of furniture, photographs and ornaments. Residents said the rooms suit their needs. They also said that staff keep the bedrooms ‘very clean and tidy’. Sufficient bathrooms and toilets are provided for residents; these are within easy reach of the bedrooms and communal areas. 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. New carpets have been laid in the entrance hall and in the corridors. Residents lounges have been re-decorated. This maintenance work has improved the appearance of these areas. Residents, relatives and other visitors said the home is always ‘clean and does not smell’. They also said the manager and staff ‘put a lot of effort into keeping the home looking nice’ The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27/28/29/30/ Staff recruitment procedures are in place which provide safeguards for the protection of residents. Staff are supervised and their care practice monitored to ensure residents are in safe hands at all times. EVIDENCE: Since the last inspection the care staff rota has changed. Instead of three care assistants on duty during the morning and afternoon/early evening there are now only two. The rotas showed the following: A.M One care team leader and two care assistants P.M One care team leader and two care assistants Night-time One care team leader and one care assistant. Support staff including home service manager, cook and domestic assistants are employed in sufficient number to meet the need of the residents. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 19 Four staff personnel files were seen during the inspection. These were satisfactory and contained details such as two references and criminal record bureau checks. The staff spoken with said they have access to NVQ training and other training opportunities provided by the organisation. Certificates were seen which showed staff have attended various training courses. Observed care practices showed that residents were confident in asking staff for assistance with various tasks. For example, requests for help with using toilet, dressing and seeking reassurance were given in a caring and sensitive manner by staff. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31/32/33/36/38 The home is managed efficiently and is run in the best interests of the residents. Staff are supervised and receive guidance to ensure the safety and welfare of residents. EVIDENCE: The registered manager has been employed by the organisation in a senior capacity for a number of years. She has obtained qualifications and attended training required for the day-to-day running of the home. Residents, relatives and others spoken with said the manager is ‘very good’ and that she ‘leads by example’. They also said she listens to their worries and concerns and takes action to ‘sort things out’. Residents said they are consulted about the running of the home, for example, décor, furnishings and fittings and activities. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 21 A partial tour of the building showed that health and safety issues are addressed. The residents plans of care included assessments on, for example, risk of falling and manual handling. The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x 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 3 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 Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 x 3 The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation None 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 None Good Practice Recommendations The Elms F51 F01 S6515 The Elms V229598 050705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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. 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