Inspection on 25/04/05 for The Elms Nursing Home

This inspection was carried out on 25th April 2005.

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 Nursing Home 20/10/08

The Elms Nursing Home 25/10/07

The Elms Nursing Home 22/06/06

The Elms Nursing Home 25/07/05

The Elms Nursing Home 01/09/04

The Elms Nursing Home 09/06/04

Similar services:

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Elms Nursing Home The Whitepost Health Centre Ranelagh Road Redhill RH1 6YY Lead Inspector Kathy Martin Unannounced 25 April 2005 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 Nursing Home Version 1.10 Page 3 SERVICE INFORMATION Name of service The Elms Nursing Home Address The Whitepost Health Centre, Ranelagh Road, Redhill, Surrey, RH1 6YY 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) 01737 764664 Dr P J David Mrs S P David To be advised CRH 49 Category(ies) of DE(E) Dementia - over 65 - 17 registration, with number OP Old Age - 44 of places PD Physical Disability - 5 SI(E) Sensory Impairment - over 65 - 1 The Elms Nursing Home Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1) Of the 49 (forty nine) persons accommodated, 44 (forty four) will be within the category OP 2) Up to 17 (seventeen) may also be in the category DE(E) 3) Only 1 (one) will be in the category SI(E) 4) Up to 5 (five) persons may be accommodated in the PD category within the age range of 40-65 years. 5) The home may offer day care providing this does not impinge on the accommodated service users. 6) Up to 4 beds may be used for respite care. Date of last inspection 1 September 2004 Brief Description of the Service: The Elms is a registered care home providing nursing care for 49 residents. The home can accommodate up to 44 older people (over 65 years) and 5 younger adults from 40-65 years. Up to 17 residents can be accommodated with a diagnosis of Dementia. The home is situated in a residential road in Redhill and is in the same site as another home separated from The Elms by internal doors. The Elms is owned and run by the Whitepost health care Group who also run other similar establishments. There are parking facilities and the home is close to local shops. Public transport can be accessed within walking distance to the home. The Elms Nursing Home Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection this year. There will be another inspection before the end of March 2006. The inspection was unannounced which means that the staff and residents were not aware beforehand. The inspector arrived at 10:00am and met with several residents and staff in different sections of the home. The home was generally well maintained and tidy. The residents were engaged in their daily routines of the day and receiving help from staff. The inspector also met with one of the relatives and all comments received from the residents were very complimentary of the home. They felt they were being looked after well. The inspector observed that the residents seemed relaxed. The interactions between residents and staff were courteous. The inspector wishes to thank all the residents, the acting manager, staff and the providers for their polite hospitality and assistance with the information that they provided for this report. What the service does well: The home has met all the requirements made at the last inspection in September 2004. The residents said the following comments: “the care is good”. “ the food is marvellous”, “I am doing activities”. The staff have worked well to support the acting manager since September 2004. Staff are receiving training relevant to their jobs. Resident’s relatives are encouraged to visit and share a meal with the residents. There are a number of residents’ relatives who come to the home very regularly. One relative said the following about a resident: “he is well looked after”. The Elms Nursing Home Version 1.10 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Elms Nursing Home Version 1.10 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 Nursing Home Version 1.10 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) 1, 3 and 4 There are procedures to welcome residents in the home. The home offers a wide range of information to the residents, their family and care managers to decide if the placement is good for them. Procedures for admission of new residents are good. EVIDENCE: The inspector looked at care plans for new residents admitted to the home and spoke to one recently admitted resident and a relative. It was obvious from the resident/ relative’s comments that the admission process was made in a sensitive manner and they were both given reassurance as to what the home can do for them. They were also given an opportunity to visit the home beforehand and meet others. The admission process takes a long time to make sure all is ready to receive the new resident. The written information on the admission notes was very good and gave all relevant past and current details. These are completed at the time of contact between the home and the prospective resident/ family and care manager. The Elms Nursing Home Version 1.10 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 10. A number of health care professionals are involved in the care of residents in The Elms to ensure they receive help in all aspects of daily living. The residents’ care is reviewed regularly. There is equipment to facilitate their care. EVIDENCE: 5 care plans were inspected. These were clearly written with all assessed needs in basic details. Risk assessments were also included (pressure sore, moving and handling and falls). One care plan did not have a nutrition assessment, which is required to help staff keep an eye on residents’ eating and drinking. It is recommended that more details of each assessed need be written in the care plans. Residents have a review of their needs by social services and notes from the review meetings were shown to the inspector. Relatives are encouraged to help in taking part in the care of the residents if the residents are happy with this. The records about residents’ days and how they spent the nights are recorded in the daily notes. There is evidence to suggest that residents saw the chiropodist, dentist and opticians as well as their doctors regularly. The Elms Nursing Home Version 1.10 Page 10 The Elms Nursing Home Version 1.10 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 and 13 The arrangements for activities are reasonable given the many residents who are very frail. The home does encourage family/ friends to visit and spend time with the residents. EVIDENCE: Residents were seen engaged in an activity with staff in one of the lounges. There are residents who have formed friendships in the home and two were observed looking out for each other whilst in conversation with the inspector. Contact with family/ friends was encouraged. relative who comes to the home regularly. The inspector met with one There are a number of communal areas around the home where residents can meet with visitors, watch TV, read newspapers and join in activities organised in the home. The activities organiser was not working for a few weeks and an allocated carer was covering her hours to do activities for the residents until she returns. The Elms Nursing Home Version 1.10 Page 12 One younger adult resident told the inspector that he enjoyed the outings, he liked it when his relatives visited and he was also doing a training course. The Elms Nursing Home Version 1.10 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 and 18 The home has a good complaints procedure. The residents are encouraged to manage their money and meet with their relatives, social worker to ensure that their legal rights are protected. The staff are offered training in the protection from abuse, however procedures need to be followed closely and Standard 18 was not completely met on this occasion. EVIDENCE: The complaints procedure is good and gives all relevant details to residents/ family on how to complain. The home is currently dealing with one complaint, which is not yet resolved. There were issues relating to staff that the inspector required the home to refer under the vulnerable adults procedures. This will be discussed separately under those procedures that social services would follow up. The home did not inform the CSCI of those incidents and was required to do so under the regulations. All staff have to receive training in how to deal with abuse and how to protect residents and the home does provide this training. The Elms Nursing Home Version 1.10 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 and 26 The home was pleasantly decorated and generally well maintained. The home has a clinical feel to it especially with the toilets/ bathrooms and bedrooms with the long corridors. The communal areas are however more homelier in style. The home is maintained clean and hygienic. EVIDENCE: The residents have a choice of communal areas including a nice conservatory, which is a quiet area for residents to receive their visitors in private. There is a rolling programme of maintenance to take care of all redecoration. All equipment used for residents are maintained regularly and contractors completed logs to say this was done regularly to ensure they were in working order. The gardens are well kept. There are benches dotted around the back for the residents to sit. There were no health and safety issues relating to the premises identified during this inspection. The home employed staff for the general cleaning. The Elms Nursing Home Version 1.10 Page 15 The Elms Nursing Home Version 1.10 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) 30 The home offers training for all staff employed. There need to be more staff qualified to at least level 2 NVQ. EVIDENCE: Some update training is needed every year and the home provides this. The training offered includes moving and handling (to protect staff’s backs and also for safe moving of residents), First Aid, basic food hygiene, protection from abuse and health and safety. Other training offered also includes medication management and wound care for the registered nurses. There is a training manager in place to organise training for all staff and who also helps with the adaptation nurses who are employed in the home. The home needs to provide more NVQ training for the care staff. The inspector saw the training programme for the year, which is very good. The Elms Nursing Home Version 1.10 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 and 38 The acting manager has worked hard to maintain control of the home whilst a new manager was being employed. The home has now employed a new manager. This Standard is not met until the CSCI has registered the new manager. Residents’ health, safety and welfare was promoted by staff training and procedures, although on occasions the CSCI is not kept informed of untoward incidents as per Regulations. EVIDENCE: The acting manager will revert to the deputy post when the new manager commences work. She will be expected to send her C.V to the CSCI and also apply to register with the CSCI. The procedures for health and safety were inspected and found to be comprehensive. Staff received training in health and safety issues. The training logs evidenced this. The Elms Nursing Home Version 1.10 Page 18 The home was required to keep the CSCI informed of all incidents/ accidents that may affect the well being of residents. The Elms Nursing Home Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 4 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 2 2 x x x x x x 2 The Elms Nursing Home Version 1.10 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 38 Regulation 37 Requirement keep CSCI informed of all events that affect the wellbeing of residents staff allegations of misconduct Refer under the Vulnerable Adults Procedure any allegation of abuse Maintain nutritional assessments for the service users who are likely to lose weight or have a problem with their nutrition. Submit NVQ level 2 training plans for the year to the CSCI Timescale for action immediate 2. 3. 18 7 13 (6) 14 (2) immediate 4/6/5 4. 30 18 (1) (a) 4/6/5 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 Ensure more details are available on care plans on each assessed need The Elms Nursing Home Version 1.10 Page 21 Commission for Social Care Inspection The Wharf Abbey Mills Business Park Eashing Surrey GU7 2QN 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 Nursing Home Version 1.10 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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