Inspection on 20/07/05 for The Elms Care Centre

This inspection was carried out on 20th 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 Care Centre 06/11/08

The Elms Care Centre 30/11/06

The Elms Care Centre 10/01/06

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 20 July 2005 09:30 a.m. 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 Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Elms Care Centre Address 108 Grenfell Avenue Saltash Cornwall PL12 4JE 01752 846335 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) The Aldington Group Limited Mrs Lorna Frances Cullen Care Home with nursing 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Physical disability (6) Terminally ill (6) The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 07.12.04 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 in 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 D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection starting at 9.45am. The registered manager was available and able to discuss any issues that were pertinent. Records for service users and staff were inspected as well the fire log and accident book. The home’s compliments/concerns & complaints book was seen. The medication procedure was observed. A walk was made round the premises where some building work was in progress and other alterations to widen doorways had been finished. Service users and some visiting relatives were met. Those with whom the inspector spoke were satisfied with the care that they received. One person commented that whilst she did not want to be in a home she felt The Elms was second best to being in her own home. The home had 10 unfilled beds at the time of this inspection. The registered manager commented that the home had had a number of very sick people who were no longer with them and the slight reduction in the workload - although probably temporary – was not unwelcome. Staff were seen to spend time sitting down talking to with service users. What the service does well: What has improved since the last inspection? A new dining area has been organised to provide the opportunity for meals to be a more social occasion for the more able service users. Alterations to certain doorways have made access for equipment such as hoists much easier. This has acknowledged the increasing need to use equipment to The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 Page 6 help the service users and the staff all commented on the improvement that the alterations had made. 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 Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 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 standard(s) 2,3,4,5. Service users entering the home have been assessed and provided with information to ensure that their needs can be met. EVIDENCE: The registered manager said that she or her deputy visit and assess people before offering accommodation at The Elms to ensure that the person’s needs and the home’s care are compatible. Information about the home was seen to be available in service users’ rooms in the service users guide. People are welcome to visit before deciding whether or not to stay but in reality it is usually families who do this on behalf of their relative. Service users have contracts outlining the terms and conditions in the home. A number of people have a short stay at The Elms under a local health care initiative to help people recover from minor illnesses. This is overseen by the community nursing service in conjunction with the home’s staff. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10,11 Service users are provided with the care and support they need. This is set out in individual care plans. EVIDENCE: All service users have a care plan prepared detailing their needs and the care required to meet these. The records showed that help from other agencies is sought as needed. This can include therapists, the Macmillan service, social workers etc. The records are completed by the trained staff and the carers. It was noted that in some records it was not clear whether all aspects of personal care (for instance teeth cleaning) had been accomplished. The main tasks had been achieved and signed for. The areas left unsigned are also important, even if only to identify that there has been a difficult. The registered manager said she would ask staff to ensure that the records were completed accurately. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 Page 10 Medication is administered by trained staff. Generally service users do not look after their own but this is acceptable after an assessment of a person’s ability to undertake this safely. There are full procedures for all aspects of medication and a regular audit is undertaken. Any controlled drugs (CDs) are stored, recorded and signed for correctly. A number of letters from families were seen expressing their thanks for the care their relative had received during their last illness and death. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 The Elms aims to promote choice for service users. It recognises that the opportunities for this vary according to people’s abilities. EVIDENCE: The activities organiser is shared between The Elms and her sister home so she was not in the home at the time of this inspection. There was a newsletter that related what had been happening in the home and outlined some plans for the future. There is scope for more activity but it would need to be low key as many of the service users are now frail. A number of the more able people chose to spend much of their time in their own rooms where they could watch their own television and radios etc. rather than the ones in the lounges. Some service users were out at a day centre which, on their return, they said they enjoyed. Visitors were seen coming and going during the day; they chose whether to visit people in their rooms or in the main lounge. This depended in part where the service user was at the time of their visit, although staff would have moved someone if requested. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 Page 12 People are offered a choice at meal times and staff were seen to be sitting quietly with those who needed help. The home has rearranged its dining facilities so that there is now an area where people can sit together at meal times so that this has become a more social event. A number of service users choose to have their meals in their own rooms and this is organised satisfactorily. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 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 standard(s) 16,17,18 The home is alert to the need to protect its service users from abuse and takes any concerns or complaints seriously. EVIDENCE: The home keeps a log of any concerns, comments or complaints and their resolution. A complaint was made via the Commission for Social Care Inspection which was passed to the responsible individual to investigate. The home has procedures in place for the protection of vulnerable adults (POVA) and has had occasion to request a meeting on a service user’s behalf. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22,23,24,25,26 The environment is generally well maintained. Minor alterations to the building are in progress to facilitate service users’ care. EVIDENCE: At the time of this inspection some minor building work was taking place. This is designed to improve the access in one part of the home and create a large shower facility. There was some noise but the service users did not appear to be distressed by this. Where the access was impeded by work during the day, alternative arrangements had been made with the service users concerned. Other work has been done to widen some bedroom doors to allow for easier access with chairs and hoists etc. Further redecoration is planned once the structural work is finished. Service users’ rooms reflected the occupants’ taste and interests. Specialist items to aid nursing and care were seen in various rooms. Repairs to one The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 Page 15 sluice have still not been completed; this has been outstanding for some time now. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 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 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 The staff group is organised to meet service users’ needs and they are kept updated with relevant training. EVIDENCE: The rotas provide for sufficient staff to be on duty at all times with the numbers being increased during periods of peak activity. The care staff are a stable group as the majority have worked in the home for a considerable time. They are encouraged to gain National Vocational Qualifications as well as the basic training such as moving and handling, health safety etc. The home organises training sessions on topics of particular and specialist interest for the trained staff. Carers can attend these as well if they are relevant. All statutory checks are carried out before a new person starts work and references obtained. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 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 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) 31,32,33,35,35,36 37 The management of the home is organised to take account of the best interests of the service users and staff. The registered manager is supported by an Administrator and the responsible individual. EVIDENCE: The registered manager is a trained nurse and she is currently working towards managerial qualifications. She is supported by her deputy and other trained staff for day to day care, with the responsible individual and the company’s administrator visiting regularly. All staff receive regular individual supervision, which helps identify any issues including training requests. An independent person talks to service users and their relatives each month to get a sample of their views and opinions about the standards and care provided by the home. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 Page 18 Limited savings can be looked after for safekeeping for service users but generally families are encouraged to manage their relative’s finances. The records required by statue are kept but the responsible individual is reminded – again - that copies of his monthly reports need to be forwarded to the Commission for Social Care Inspection. The fire log and accident books were seen. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 3 3 3 3 x 3 3 3 x The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 Page 20 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 26 Regulation 16(j)(k) Requirement The registered provider must advise the Commission of the time scale to repair or replace the fauty sluice. The registered provider must arrange for copies of his monthly inspections to be forwarded to the CSCI on a more regular basis. Timescale for action 31.08.2005 2. 37 26 31.08.2005 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 7 Good Practice Recommendations Care staff should ensure that the care records accuratey reflect all aspects of care given and identify any areas where there are problems in doing this. The Elms Care Centre D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 D52-D04 S9168 The Elms Care Centre V226548 U 200705 Stage 4.doc Version 1.30 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. 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