Inspection on 24/05/05 for The Elms [Staunton]

This inspection was carried out on 24th May 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 [Staunton] 18/02/08

The Elms [Staunton] 15/10/07

The Elms [Staunton] 01/11/06

The Elms [Staunton] 14/11/05

The Elms [Staunton] 11/01/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Elms Staunton Coleford Gloucestershire GL16 8NX Lead Inspector Ruth Wilcox Announced 24 May 2005. 09.00 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service The Elms Address Staunton Coleford Gloucestrshire GL11 6BB 01594 834972 01594 837681 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) Brickjet Ltd Mr Christopher Whittington Care Home 31 Category(ies) of Old age (30) registration, with number Learning Disability (1) of places The Elms Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: The home will be registered to provide Personal Care only, until such time that a Manager with a Nursing qualification is registered with the Commission for Social Care Inspection; the home can then become registered to provide Nursing care. An Activities Co-ordinator will be appointed within 6 months from the date of the current certificate (ie: by 6/6/05). Date of last inspection 11th January 2005 Brief Description of the Service: The Elms is situated alongside the main road between Coleford and Monmouth in the Forest of Dean. The home is owned and managed as part of the Blanchworth Care group. The purpose built building is registered to accommodate 31 service users over the age of 65 years, who require personal care. The additional category for a person under the age of 65 years with a Learning Disability is for one specifically named service user only. The building is constructed on four-levels, has a shaft lift, and access to the building is ramped for wheelchair users. The ground floor accommodates the main office, reception, kitchen and laundry room. On the first floor, there is a large lounge/dining room and two smaller lounge areas, one being a pleasantly appointed conservatory. The upper floors have bedrooms, bathrooms and additional toilet facilities. All thirty-one rooms offer en suite facilities; with a hand basin and toilet. All rooms offer single accommodation. Spacious gardens surround the home and provide a pleasant area for service users to sit when the weather allows. The Elms Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector undertook this announced inspection over 6.25 hours. Care records and the facilities to meet health needs, the standard of meals, and the opportunities for social activities for the residents were inspected. Development opportunities for staff were looked at, as were some of their recruitment files. Quality assurance systems were reviewed, as were a number of documents relevant to the safe maintenance of the home. A tour of the premises took place, and staff were observed going about their duties whilst interacting with the residents. The care of three residents in particular was closely looked at. Eleven residents were spoken to directly to obtain their view of the care and services they receive in the home. There was direct contact with the home’s Manager, four staff, and the Blanchworth Director of Care, all of whom were open to the inspection process, and were most welcoming and helpful. What the service does well: The Elms provides a warm, comfortable family-type home for residents to live in. The home has an inclusive and friendly atmosphere, and provides a clean and well maintained environment. There is an evident commitment shown by the home Manager and staff to ensuring quality of life for the residents, and the good relationships that seem to exist between the staff and residents allow for close contact, enabling residents to raise and discuss any concerns they may have. There is a high level of satisfaction amongst the residents at this home regarding the standard of meals, the attitude of the staff, and the care they receive. There are good training opportunities for staff to develop the skills necessary for their role. The Elms 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 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 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 & 4. The home’s Statement of Purpose and Service User Guide provide prospective residents and their families with good information about the home to enable them to make informed decisions about it, and they may be assured that their particular needs may be met. EVIDENCE: A Statement of Purpose and Service User Guide have been produced for this home, copies of which were submitted to the Commission for Social Care Inspection as part of the home’s registration process some months ago. The Statement of Purpose is available to those wishing to see it, and a Service User Guide is issued to each prospective service user by the company office; updated copies of these documents must now be sent to the Commission. Pre-admission assessment, and the development of appropriate staff skills ensure that the home is able to meet the needs of the residents. The needs of Nursing clients will be met here when the home becomes registered to provide Nursing care, with qualified nurses on duty twenty four hours each day. The Elms 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. There is a much improved care planning system in place, which provides staff with the information they need to satisfactorily meet residents’ health and personal needs. EVIDENCE: There has been a considerable improvement in the standard of care plan recording since the last inspection, with a new recording system introduced. Each resident has an individualised plan of care, which is based on their assessed needs; three plans were closely inspected as part of a case tracking exercise. Care plans are well written, are regularly reviewed, and are evidently done in consultation with the resident and their family or representative. Plans demonstrate how personal and health needs are to be met, with clearly recorded interventions and support from outside health professionals and agencies. The Elms Version 1.10 Page 10 One particular plan could have included greater detail regarding the assessed needs for the tendency to wander and the help needed regarding hygiene needs. None the less, staff have evidently worked very hard to complete training, and master the new care planning system, and should be commended for the success they have achieved, which will ultimately benefit the residents in terms of clear direction for staff to meet their needs. The Elms 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 & 15. Good progress has been achieved in providing stimulating and entertaining activities to suit the needs of people living in the home. The home offers a reasonable standard of varied food to meet the residents’ nutritional needs, including catering for special diets. EVIDENCE: Despite attempts to recruit an activities co-ordinator, this has not yet been achieved. However, staff on duty each day have designated responsibility for the provision of social activity on that particular day. A varied programme of stimulating activities to suit the particular interests of the residents has now been developed, with which they can participate on an optional basis; a record is kept of each resident’s participation. Programmes demonstrate a range of social opportunities, most of which are on a group basis, though one to one social contact is also ensured. Staff were interacting socially with the residents in a very relaxed way, with different past times being enjoyed. The Elms Version 1.10 Page 12 Menus show a range of varied and nutritious meals available for residents, and observation of the lunch confirmed that they are also offered choice with their meals. Individual menu profiles have been devised, which are kept in the kitchen for the Cook’s reference. The lunch looked wholesome, and residents confirmed their enjoyment of it; they generally spoke positively about the quality and quantity of food provided for them, with one saying that the food is ‘marvellous’, and only one person saying that the food could be variable. Staff were assisting residents where necessary with their meals, with a range of eating and drinking aids provided where needed to meet the needs of that person. The dining room was attractively laid, and had a pleasant and calm atmosphere throughout the meal. The Elms 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. The home has a satisfactory complaints system, with evidence that residents feel that any concerns they may have are listened to and acted upon. Residents’ legal right to participate in the civic process is respected and upheld in this home. EVIDENCE: Information on how to make a complaint is included in the Service User’s Guide, with a copy of the complaints procedure displayed on the public notice board; it was recommended that this notice be displayed in a more prominent position on the board, to increase its accessibility. Residents confirmed that staff were always most attentive to them, and are eager to help them in any way. There are no formal complaints recorded in the register. The Manager had recently taken steps to ensure that residents had the opportunity to vote in the local and national parliamentary elections, with all of those interested having opted for postal votes; however, despite this many had chosen not to use their postal vote in the end. The Elms 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, 25 & 26. The standard of the environment within this home is very good, and provides residents with an attractive, homely, clean and safe place to live. EVIDENCE: The Elms has undergone a major refurbishment since becoming part of the Blanchworth Care Group of homes at the end of last year. Excellent progress has been made, with good quality décor, fabrics and furnishings provided to improve and enhance the overall accommodation for the residents. Residents’ safety has been ensured by the provision of radiator covers to eliminate any risk of a hot surface injury. Hot water blending valves have been fitted to ensure safe temperatures in places where an immersion risk has been identified, such as on the baths. Residents’ individual sinks are not blended, but would be done on the basis of risk assessment. There is one assessment for the home as a whole, and staff must ensure that risk assessment incorporates each resident on an individual basis. The Elms Version 1.10 Page 15 Appropriate control measures are adopted to protect against the colonisation of Legionella, and all upper level windows have a restricted opening in the interests of safety. The home is cleaned to a high standard, with appropriate levels of hygiene and infection control measures adopted throughout the home, including the laundry. The Elms 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) 27, 29 & 30. Staffing numbers and skill mix are adequate to meet the needs of the residents currently living in the home. Recruitment procedures ensure that full and appropriate safeguards are in place to ensure the protection of residents. The arrangements for induction and continued professional development of staff are good, enabling them to have a good understanding of their roles. EVIDENCE: Only 19 residents were living at the home on the day of this inspection. The staff group on duty appeared efficient, cohesive, and committed to meeting the needs of the residents in a timely and sensitive manner. Residents were comfortable, contented and were well attended by the staff. They spoke very positively about the staff team, indicating that they are kind and caring. One person said that the staff ‘are marvellous’, and another said that she was ‘lucky to be here’. It should be reported that the provision of staffing and the skill mix will change in the near future, once the home’s registration changes to accommodate nursing clients. In the mean time, the home’s Manager is very well informed, and is committed to providing a good quality of life for the residents. The Elms Version 1.10 Page 17 A random selection of staff files was chosen for inspection. Each record contained evidence of the required pre-employment checks. Criminal Records Bureau disclosures and POVA checks are carried out, though copies of disclosures were not directly seen on this occasion. Written verification of why they had ceased to work in their last place of employment involving vulnerable adults was seen in one case; the Director of Care agreed that the home must establish a formal way of capturing this information from referees in all cases where it applied. New staff receive a structured induction training within the first six weeks of employment with additional in-house training, and foundation level training within the first six months. There are regular opportunities for staff to have a range of mandatory and optional training, in order that they have the necessary skills for their work. There is also an evidently strong commitment to the NVQ programme. The Elms Version 1.10 Page 18 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) 32, 33, 35 & 38. The Manager has a supportive, open and inclusive management approach, which benefits all living and working in the home. The systems for resident consultation in this home are to date informal, though evidence certainly indicates that their views are both sought and acted upon. Systems are in place to ensure that the interests, health, safety and welfare of the residents are safeguarded. EVIDENCE: There appears to be very positive and inclusive relationships fostered at The Elms between the residents and the staff. The Manager is very accessible to all, and contributes greatly to the overall inclusive and family-type atmosphere that is evident; he has introduced a key worker system, which has benefited all the residents. The Elms Version 1.10 Page 19 In addition to this, there has recently been a resident meeting, the minutes of which demonstrate that their views are sought and listened to; a staff meeting has not been held for 5 months, though there is an intention to conduct one soon. A formal satisfaction survey has not been conducted at this home yet, and will be scheduled for early next year, as part of the overall plan for this group of homes. The Manager takes time each day to talk with residents allowing them the opportunity to have any discussions they wish about the home. He is also accessible to visitors, and Comments and Suggestions cards are displayed in the home for anyone to complete if they wish. The emphasis seemed to be very much on ensuring quality for the residents, with levels of satisfaction and happiness high amongst all of those seen during this visit. There is provision for residents to place personal money and valuables with the home for safekeeping if they wish, with some taking advantage of this service. Detailed and transparent records are maintained for each person, though the good practice of two staff signatures acknowledging any transaction carried out on a resident’s behalf, in cases where they are unable to sign themselves, has only recently been implemented. There was considerable evidence that health and safety issues are addressed well in this home, with written policies, procedures and risk assessments, provision of necessary equipment and staff training. All necessary maintenance of equipment is undertaken in a timely fashion. The Elms Version 1.10 Page 20 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 2 x x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 2 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x x 4 3 x 3 x x 3 The Elms Version 1.10 Page 21 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 1 Regulation 5(2) Requirement The revised copies of the Statement of Purpose and Service User Guide must be sent to the Commission for Social Care Inspection. The home must ensure that the risk assessment for ensuring safe hot water temperatures at outlets includes individual resident assessment. When recruiting new staff, the home must obtain written verification of the reason why the person ceased to work in their last position (if it involved contact with vulnerable adults or children) Timescale for action 30 June 2005 2. 25 13(4.a) 30 June 2005 3. 29 19, Schedule 2(4) 30 June 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 16 Good Practice Recommendations The Complaints Procedure should be displayed in a more prominent and accessible position on the notice board. The Elms Version 1.10 Page 22 Commission for Social Care Inspection Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 Version 1.10 Page 23 - 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!