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Inspection on 10/11/05 for The Elms Residential Home

Also see our care home review for The Elms Residential Home for more information

This inspection was carried out on 10th November 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There was evidence of good relationships between staff and residents with staff really listening and consulting with residents. The care provided is very good with the associated care records held. The indoor areas used by residents are very comfortable and homely. Residents are consulted about life at the home with events and trips planned to meet their needs. Residents interviewed gave many positive comments about The Elms. The cook spoke of buying fresh food from local suppliers, free-range eggs and meat and providing choice and variety. Staff are trained and well supervised.

What has improved since the last inspection?

Improved record keeping of medicines for residents with the Registered Manager undertaking regular spot checks of the medicine ensuring accuracy and validity. Improved daily hygiene practices in the kitchen area are now evident. A new call bell system is in place ensuring residents safety and comfort.

What the care home could do better:

Some residents raised concerns around the suitability of the new cups. The Registered Manager will be looking into this in consultation with residents and with a view to obtaining alternative cups. Some minor works required around a bathroom and the kitchen floor to ensure safety and hygienic standards.

CARE HOMES FOR OLDER PEOPLE The Elms Residential Home 111 Melbourne Road Ibstock Leicestershire LE67 6NN Lead Inspector Helen Abel Unannounced Inspection 10th November 2005 08:30 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 Residential Home DS0000063308.V265363.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 Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Elms Residential Home Address 111 Melbourne Road Ibstock Leicestershire LE67 6NN 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) 01530 260263 01530 260263 The Elms Residential Home Limited Mrs Helen Rachel Wiggs Care Home 18 Category(ies) of Dementia - over 65 years of age (6), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (18) The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No one falling within category MD(E) may be admitted into the home where there are 6 persons of category MD(E) already accommodated within the home. No one falling within category DE(E) may be admitted into the home where there are 6 persons of category DE(E) already accommodated within the home. No person to be admitted to the home in categories MD(E) or DE(E) when six persons in total of these categories/combined categories are already accommodated in the home. To be able to admit the named person of category DE named in variation application number V26450 dated 3rd November 2005. 28th June 2005 4. Date of last inspection Brief Description of the Service: The Elms is situated on Melbourne Road in the village of Ibstock. The home is within walking distance to most amenities and shops within the village. With a bus stop just outside the home, it is easily accessible both by car and public transport alike. The home offers spacious accommodation to 18 older persons and is a large modernised building with half an acre garden, mature trees and shrubs. There is ample car parking space available. The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took around 4 hours and was unannounced. A full tour of the premises took place with some staff and care records inspected as well as some policies and procedures. The inspector interviewed staff, six residents and a visitor. The Registered Manager was present throughout the inspection. The Inspector was present as a hot and cold breakfast was being served of porridge, cereal, toast and fruit. What the service does well: What has improved since the last inspection? What they could do better: Some residents raised concerns around the suitability of the new cups. The Registered Manager will be looking into this in consultation with residents and with a view to obtaining alternative cups. Some minor works required around a bathroom and the kitchen floor to ensure safety and hygienic standards. The Elms Residential Home DS0000063308.V265363.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 Residential Home DS0000063308.V265363.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 Residential Home DS0000063308.V265363.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): 2,3,4,5 As assessment system for new residents is fully implemented. EVIDENCE: The Registered Manager conducts assessments for new residents. Visits are offered to new residents, with written information made available and terms and conditions agreed and completed before entering the home. The most recent inspection report is displayed in the entrance hall for easy access. The Elms Residential Home DS0000063308.V265363.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): 10,11 Residents are treated with respect and their right to privacy is upheld. EVIDENCE: The Registered Manager confirmed the staff Induction and practice around resident’s rights for dignity and privacy. Staff were observed being respectful and kind when talking with residents and care giving. Some residents had chosen to stay in their bedrooms longer in the morning and their choice and right for privacy was upheld. The Registered Manager confirmed wishes around death and dying are discussed with residents and family members and recorded in the care plan. The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All these outcomes have been inspected at the last inspection. EVIDENCE: The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 11 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): 16,17 Residents complaints are listened to and taken seriously EVIDENCE: Residents gave the following comments: “I have no complaints. The meals are fine with a choice at every meal. I go to the shops with staff. A hairdresser comes in to do my hair” “The cups make your tea go cold quickly” “I prefer the white cups to the new cups” The new cups were discussed with the Registered Manager with a view to make changes in consultation with residents. The complaints procedure is displayed in the communal lounge notice board for residents. The Registered Manager confirmed during the recent elections residents were supplied with voting papers and some residents went to the nearby polling stations. The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 12 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): 19,23 The home is generally well maintained, homely, safe and comfortable. EVIDENCE: The home was clean and comfortable. Resident’s bedrooms were individualised and reflected resident’s furniture and personal effects. One resident said, “The owner of the home decorated my room for me in the colours I liked. They are always cleaning and dusting here.” An identified en-suite bathroom requires repair to the floor as this has been left exposed to the bare floorboards, and presents a safety hazard to the resident. Attention should also be given to the kitchen vinyl flooring in corners where food debris has built up and has not been hygienically maintained. The conservatory overlooks a large green lawn and attractive established garden. A resident pointed out to the Inspector a bird table in the garden that was a birthday gift from a family member. “Blue tits, green finches other birds come to my bird table. Bonfire night was on my birthday and we had a bonfire and fireworks in the garden. We sat and watched from the conservatory” The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 13 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): 27,29,30 Resident’s needs are met by the numbers and skill mix of staff. The recruitment policy is generally satisfactory, with a good training in place to support staff’s competence. EVIDENCE: There is a wide range of training aviable to staff. Some staff are on a distance learning dementia care training, as well as working towards national vocational qualifications in care and management. Senior staff that administer medicines have gained accredited training and are now looking to progress to a higher level for medicine training. Adult protection training is due to commence the following week of the inspection. There is a skill mix of staff with many staff working at the home for some years and are confident and competent in their jobs. The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 14 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): 31 to 38 Residents live in a home which is run and managed by a Registered Manager who is fit to be in charge, and able to discharge her responsibilities fully. The health, safety and welfare of residents are on the whole sufficiently promoted and protected. EVIDENCE: The Registered Manager demonstrates a good understanding of her roles and responsibilities as well as the needs of residents at The Elms. One resident said, “I have got no complaints about staff and management of the home.” The Registered Manager spoke of being open and approachable and described examples of how residents will seek her out, to tell her something and ensuring she takes any actions asked of her and always giving an indication as to how long the changes will take to carry out. The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 15 There are regular trips out to the local shops or places of interest for residents. The afternoon of the inspection there was a clothes party for residents to choose and buy clothes from and; a visitor from Sweet Delight was also due to come in and sell traditional sweets such as humbugs and bonbons. One resident had received some beauty treatments from a regular visiting beauty therapist. Another resident was celebrating a birthday and was being baked a cake of his choice by the cook. All these activities confirm the home is run in the best interests of the residents. The Registered Manager and a senior staff member share and manage staff supervision with record keeping held, and health and safety checks in order; ensuring policies and procedures promote and protect the residents. Information around new asbestos legislation was passed to the home following on this inspection. The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 16 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 2 x x x 3 x x x STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 13 Requirement The Registered Person shall ensure thata) All parts of the home to which residents have access are so far as reasonably practicable free from hazards to their safety. a) Unnecessary risks to the health or safety of residents are identified and so far as possible eliminated: b) An identified en-suite bathroom floor requires repair as this has been left exposed to the bare floorboards. Attention should also be given to the kitchen vinyl flooring in corners where food debris has built up and has not been hygienically maintained. The seal around the flooring is coming away. Timescale for action 10/12/05 The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 18 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 OP16 Good Practice Recommendations To resolve the complaint around cups to the satisfaction of residents. The Elms Residential Home DS0000063308.V265363.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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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