Inspection on 10/01/06 for The Elms Care Centre

This inspection was carried out on 10th January 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 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 Elms Care Centre 06/11/08

The Elms Care Centre 30/11/06

The Elms Care Centre 20/07/05

The Elms Care Centre 07/12/04

The Elms Care Centre 31/08/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE The Elms Care Centre 108 Grenfell Avenue Saltash Cornwall PL12 4JE Lead Inspector Philippa Cutting Unannounced Inspection 10th January 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 Care Centre DS0000009168.V272821.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 Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Elms Care Centre Address 108 Grenfell Avenue Saltash Cornwall PL12 4JE 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) 01752 846335 The Aldington Group Limited Mrs Lorna Frances Cullen Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37), Physical disability (6), Terminally ill (6) of places The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users to include up to 6 adults with a terminal illness (TI) Service users to include up to 6 adults with a physical disability (PD) Service users to include up to 37 adults of old age (OP) Total number of service users not to exceed a maximum of 37 Date of last inspection 20th July 2005 Brief Description of the Service: The Elms is one of thee homes privately owned by the Aldington Group Ltd, director Michael Freeland. It provides care for up to 37 older people, the majority of whom have nursing needs. The home is situated in Saltash. Whilst at a distance from the main shopping streets of the town, there is a small supermarket is close by, or there is a bus service, which enables active service users to exercise some independence or assists relatives when visiting. Accommodation is provided on two floors linked by a shaft lift and stair lift. The majority of rooms are for single occupation, half of which have an en suite facility. There is a choice of communal sitting space downstairs, which comprises two lounges, a conservatory and front hall/sun lounge. There is a small garden and car parking in front of the home. The home presents as being well maintained and is clean and tidy inside and out with a display of seasonal flowers at most times. The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place during the day between 9.45am and 4.30pm. Records were reviewed, discussions held with staff, the registered manager and service users and the accommodation inspected. A large part of the inspection was spent observing interaction in the lounge where a number of frailer service users were sitting. This was generally felt to be good with attention being offered to service users who had particular needs. Of the service users who were brought to the lounge the majority did not arrive until 10.45am or later, when they were served a morning drink and made comfortable until lunchtime. Few were independently mobile and had to rely on staff responding to a call. Other more able service users said they preferred to spend their time in their rooms with a television, radio or newspaper for company. The accident record was studied and the records for four service users were then followed up in more detail. What the service does well: What has improved since the last inspection? What they could do better: The home has not responded to a time scale to advise the Commission on what action it will be taking regarding the out of order sluice. The Elms Care Centre DS0000009168.V272821.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 Elms Care Centre DS0000009168.V272821.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 Elms Care Centre DS0000009168.V272821.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): EVIDENCE: These standards were not assessed. The Elms Care Centre DS0000009168.V272821.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 Service users’ needs are assessed and recorded so that they receive the care that is needed. Other professional bodies are contacted to advise and supply any specialist advice that is required. Medication is handled correctly and accords with the home’s procedures. EVIDENCE: All service users have a care plan detailing their needs, which is reviewed regularly. The majority have been signed by the service user or relative to show agreement with the plan. Care staff record the personal care they give, as outlined in the care plan, in a tabulated form passing on any comments to the trained staff for attention. Records contained evidence that advice is sought from other professionals where a need is indicated with domiciliary visits and/or hospital appointments being arranged as appropriate. The trained staff administer medication. It is undertaken for the majority of service users although people can look after this aspect of their care with agreement. There are full procedures for ordering, storing and administering The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 10 medication with weekly audits to check that these are correct. The CD book was seen to accord with the register. The Elms Care Centre DS0000009168.V272821.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 Service users are provided with opportunities to exercise choice within their abilities. Contact with the wider community is encouraged by visits and outings (although these are temporarily on hold). Service users are provided with a balanced diet presented attractively and receive help if needed with their meals. EVIDENCE: The home is aware of the importance of social and mental stimulation for service users but there is currently no activities organiser so this post is being actively advertised. In the meantime staff try to spend time with service users and organise some activities. A bingo session was arranged during the afternoon with staff helping service users. This is good but the more able people who enjoyed outings in the home’s minibus are disadvantaged until these can be restored. Family & friends are encouraged to visit. One person called at lunchtime and helped her relative with her meal. Service users are encouraged to visit their family in their home if this is possible or for family accompany the service user to any hospital appointments if they wish. The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 12 Choice is offered as much as possible but this can be limited where people are frail. Lunch was observed. Some people were seated at tables in the conservatory so that they could talk and enjoy some company; others needed help with their food and a third group chose to have their meals in their rooms on a tray. Those that were fed were seen to receive help in a calm and unhurried way, being encouraged to both eat & drink. The sweet was not to one person’s taste so it was removed and three alternatives tried before finding one that was liked. Walking round the home after lunch it was seen that one person had fallen asleep and eaten very little. The registered manager said later that a carer had removed the tray, having made sure that it was not wanted, and alerted her to the fact that the service user had eaten very little. Other service users said that the food was generally good; they were given a choice of menu and had enough. The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 13 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 Any concerns or complaints are acted upon quickly and abuse is not tolerated. EVIDENCE: The home keeps a record of any concerns or complaints and the action taken to resolve it. The complaints procedure is attached to the statement of purpose & service users guide and is available in the home. Staff have received training with regard to the protection of vulnerable adults (PoVA). This is ongoing for new staff. The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 The Elms provides warm well-maintained and comfortable accommodation for the service users. EVIDENCE: The home is well maintained both internally and externally. Service users’ rooms are personalised to each person’s taste and those who had chosen to spend the day in their room said they were satisfied with their accommodation. The home has housekeeping staff who are responsible for maintaining the home in its satisfactory standard. The communal rooms on the ground floor were warm with a variety of seating. The inspector was unable to decide whether people in one of the lounges were interested in the television programmes that were on but the sound was not intrusive. Equipment to ensure safety, comfort and independence was seen in the home. The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 15 Protective clothing – aprons & gloves – are provided in each room for ease of use, with disinfectant hand gels placed throughout the home. The ground floor sluice however is still non functional and has been so for at least two years. This needs to be dealt with to enhance the home’s infection control procedures. The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 16 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 The staff group were seen to work together as a team. They were aware when someone was occupied and dealt with things that cropped up. The care staff were seen to give service users time and they reported any observations that gave them concern to the trained staff. EVIDENCE: The correct recruitment procedures are in place to ensure that references and Criminal Records Bureau checks are provided for all new staff prior to starting work. National Vocational Qualifications training is supported by the home and there is a good take up by staff. The home’s assessor visited during this inspection. She indicated that her current candidates were making satisfactory progress. Seminars and training sessions are organised for trained staff with carers attending as well if the topic is pertinent. The home sometimes ‘borrows’ care staff from one of the other homes within the group if there is a shortfall on the rota. Care must be taken that if this occurs these staff do not work over long hours and become tired. The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 17 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): 36,37,38 The records are maintained in accordance with legislation. Those that were inspected in detail were satisfactory. Some points relating to accident recording were discussed with the registered manager. EVIDENCE: Not all the standards were inspected on this occasion. Staff receive regular supervision. The registered manager said this was felt to be a positive occurrence. The registered provider visits the home regularly but still fails to forward his reports to the Commission for Social Care Inspection, other than in batches periodically. The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 18 The accident record was looked at in some detail. All accidents whether minor or otherwise are recorded which is good practice. The comments in the section regarding action to prevent a reoccurrence were discussed with the registered manager. Saying that someone should ‘ring the bell’ before attempting to move is obviously correct but in some cases the service user cannot do so for whatever reason. In such instances more thought is needed as to how a reoccurrence could be prevented. Fire training and recording is up to date, alarms are sounded regularly & fire doors checked. Staff were seen to use equipment for moving and lifting service users competently, explaining to the service user concerned what was going to happen. Hot water & surfaces have been addressed to prevent the risks of burns. The home is audited by an independent consultant who reviews all aspects of health & safety. The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 19 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 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 3 18 3 3 3 3 3 3 3 3 2 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 X X X X X 3 3 3 The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 20 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 OP26 Regulation 16(j)(k) Requirement The registered provider is required to provide information to the Commission about the intention to repair or replace the faulty sluice. Copies of the registered provider’s monthly inspections should be forwarded to the CSCI as they are compiled, rather than in batches. Timescale for action 01/02/06 2 OP37 26 01/02/06 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 OP37 Good Practice Recommendations The action to prevent the reoccurrence of an accident needs to be given more thought when this is recorded in the accident book. The Elms Care Centre DS0000009168.V272821.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Care Centre DS0000009168.V272821.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!