Inspection on 15/03/06 for The Leonard Elms Care Home

This inspection was carried out on 15th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 Leonard Elms Care Home 15/07/09

The Leonard Elms Care Home 16/01/07

The Leonard Elms Care Home 07/04/05

The Leonard Elms Care Home 07/12/04

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

CARE HOMES FOR OLDER PEOPLE The Wilfred Leonard Care Centre Brinsea Road Congresbury North Somerset BS49 5JH Lead Inspector Juanita Glass Unannounced Inspection 15th March 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 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 Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Wilfred Leonard Care Centre Address Brinsea Road Congresbury North Somerset BS49 5JH 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) 01934 853834 01934 622704 The Elms Nursing Home Mrs Helen Susan Enticott Care Home 36 Category(ies) of Dementia - over 65 years of age (36) registration, with number of places The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th April 2006 Brief Description of the Service: The Wilfred Leonard Care Home is registered to provide dementia care, with nursing, for up to 36 older people. The home is in a rural setting on the edge of the village of Congresbury. Visitors to the home would require their own transport. There is a large car park. The Wilfred Leonard Care Home adjoins The Elms Nursing Home. Both homes are owned by Mr Bliss, but are registered separately. Mrs Helen Enticott is the registered manager of the Wilfred Leonard Care Home. The home is purpose built and opened in May 2004. It was designed with the needs of the client group in mind, using advice from dementia care specialists. Accommodation is provided on two floors. All of the bedrooms are for single occupancy, and have en suite toilet and wash hand basin. A passenger lift ensures easy access to all areas of the home. An enclosed courtyard in the centre of the property offers attractive, and secure outside space. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a very positive inspection, which took place over 7 hours in the presence of the manager Mrs Endicott. Documentation held in the care home was reviewed, this included care records for five residents. However the focus of this inspection were the outcomes for residents. Although this was an unannounced inspection comment cards had been received from six relatives, 10 residents and one visitor were spoken to during the day. Comments received were varied; most relatives’ cards complemented the level of care and the understanding of dementia needs. However one comment card did raise issues regarding the level of activities in the home, and communication between staff and relatives. The relative making these observations wished to see more meaningful activities carried out with the residents and felt it would be helpful if the home ran a relatives group or held a relatives meeting. Of the 10 residents spoken to four were able to express an opinion, whilst the others were observed to be relaxed, happy and had an easy rapport with the staff. Two of the three recommendations made at the last inspection had been met, and the manager was in the process of recruiting an activities organiser who would be introducing a program of activities, which would be meaningful for the current resident group. One requirement was made during this inspection with specific emphasis on the recruitment procedures carried out in the home. What the service does well: The home continues to have a relaxed and informal atmosphere. The one visitor spoken to the said that he had a very good relationship with staff, and had been observed helping his relative to eat lunch. A very friendly but professional approach towards the visitor and the resident was observed. Residents were observed to be at ease with staff and were able to move freely and safely around the home. As stated in the last inspection report the home is purpose-built. It was designed specifically for dementia care, and reflects current research findings and good practice. The home is bright and airy and the standard of housekeeping is very good. The layout of each floor helps residents to find their way around, but draws their attention away from areas, which may put them at risk (e.g. laundry and sluice rooms). Staff spoken to on the day also showed a clear awareness of the needs of the residents in the home. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 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 Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 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 and 5; 6 does not apply Family members and advocates are provided with adequate information about the home, and the services it offers. Residents’ needs are thoroughly assessed before admission to the home. All residents have a contract or statement of terms and condition. Family members are encouraged to visit the home prior to admission. EVIDENCE: The manager carries out visits to prospective residents, either at their own home or in hospital to carry out an assessment of their needs. Records reviewed during this inspection showed that the assessment carried out is comprehensive and covers all areas relevant to dementia needs. Care records also contained copies of care management plans, which had been obtained from the placing social workers. Residents were not able to comment on the admission procedure. Care records also contained signed copies of contracts or statements of terms and conditions between resident’s family/advocates and the home. Records also showed that family members had been invited to visit the home prior to making the decision to place their relative there. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 9 The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 The health and personal care needs of residents are well met. There is a friendly, informal atmosphere in the home, with evidence of a good rapport between residents and staff. The administration and storage of medication meet current guidelines. EVIDENCE: Records reviewed on the day showed care plans were provided for each individual identified need. They provided staff with clear guidance on how to meet the residents needs and showed evidence of regular review and update. Staff were observed during the day to demonstrate a good awareness of these needs. The one relative spoken to said they were kept informed of any changes, and felt staff were aware of their relatives needs. Most of the residents spoken to were unable to express an opinion however those who could supported the observational evidence that staff treated them with dignity and respect and have a clearly friendly rapport with them. Other residents were observed to be at ease with staff, they were relaxed neatly dressed and attention had been paid to their hair and nail care, all the gentlemen seen were clean-shaven. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 11 The manager confirmed that they received very good support from local GPs and the specialist mental health team; care records showed evidence of residents being assisted to attend outpatient appointments, opticians and chiropodists. The medication administration records were well maintained, and drugs were securely stored. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Flexible routines of daily living give residents’ a choice in how they spend their day. Visitors are actively welcomed into the home. The home needs to introduce a programme of meaningful activities. EVIDENCE: It was evident during the day that residents are encouraged to exercise their own personal choice on how they spend their day. One lady had chosen to go back to bed and stay in her nightdress until well after lunchtime. Whilst others chose to either sit in one of the communal areas, remain in their room or move freely around the home. Care records contain a brief summary of individual likes and dislikes. The manager confirmed that interviews had taken place for an activities organiser and that the post would be filled fairly soon. It was agreed that a full review of activities provided at the home would be carried out at the next inspection. One comment card received from a relative stated that they felt there were not adequate activities carried out in the home. The home operates a four week menu, which is varied, and appears nutritionally sound. Although a choice is not documented on the printed menu, it was apparent that an alternative meal was available on request. The lunch The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 13 served during the inspection looked and smelt appetising, and residents’ comments were all complimentary. On the day of the inspection the manager and staff had just introduced the residents to eating in a designated dining room rather than the lounge areas. This appeared to be successful and residents liked the idea of going to the dining room for a meal. The mealtime was observed to be relaxed and unhurried tables were laid with attractive linen and crockery, and staff were available to offer verbal prompts and assistance when necessary. Staff were observed to be offering residents adequate fluids throughout the day and jugs of squash were available in the communal areas. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 14 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 and 18 The complaints procedure in the home is satisfactory. Staff demonstrate a good awareness of adult protection issues EVIDENCE: The visitor consulted during this inspection said they felt confident they could raise any issues or concerns with the manager. Comment cards also indicated that relatives felt they could approach the manager with concerns and that they were aware of the complaints procedure within the home. No complaints have been received since the last inspection. Staff were not formally interviewed during this inspection however those spoken to demonstrated a good awareness of adult protection procedures. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22 and 26 Wilfred Leonard Care Home has been commissioned and designed to a commendable standard. The layout and décor of the home reflects the advice of dementia care specialists and recent research. This attention to detail is most effective. The standard of housekeeping is commendable EVIDENCE: The accommodation is arranged around a square courtyard, with a raised garden. Staff spoken to confirmed that they had planned to carry out planting in the raised flowerbeds in the spring to brighten up the area. Residents are able to freely walk around the corridors and communal areas. Several residents were observed using the lift to walk around the lower floor. Corridors are painted in contrasting bright colours, staff confirmed that even The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 16 very confused residents were able to find their rooms or toilets when directed using the colours. The furniture and fittings are of a good standard and of a domestic appearance. The standard of housekeeping in the home was noted to be particularly good. The home continues to be commendably clean, tidy and free from offensive odours. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 17 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 and 30 The numbers of staff on duty are adequate to meet the needs of the current resident group. Residents are not protected from abuse by the current recruitment procedure. Staff receive induction and training to equip them to work in a dementia care setting. EVIDENCE: The staffing rota showed evidence of adequate levels of staff in the home over the last four-week period. On the day of the inspection staff were observed to be busy but to have time to chat with residents. Those residents who could express an opinion said there were always enough ‘girls around to look after them.’ staff were not formally interviewed however they confirmed that they did not feel overworked due to low staffing levels. Staff personnel records reviewed for the most recently employed showed that POVA first confirmations had not been received prior to them working in the home; this places residents at risk of abuse and a requirement was made. Since the last inspection the home has employed trained nurses who are registered mental nurses, they have also employed care staff who have experience in dementia care. Records maintained by the home also showed that staff had received induction when they first took up the post, training in dementia care and have been assisted in attending training in areas specific to the needs of the resident The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 18 group. Trained staff are encouraged to maintain their personal development programme. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 19 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, 32, 36, 37 and 38 The manager is fit and competent to run the home, and adopts an open and approachable ethos to management in the home. Records kept in the home were well maintained, up-to-date and available for inspection. All staff are appropriately supervised. Health and safety with in the home is satisfactory. EVIDENCE: The manager Mrs Enticott, has achieved her Registered Managers Award, and is a qualified registered nurse. Staff spoken to said they felt adequately supported by the manager in their post and that they could approach her with issues or concerns. The visitor spoken to said they felt the manager was very easy to approach, and comment cards received supported this. One comment The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 20 card suggested that the manager needs to introduce a relatives group or relatives meetings. Staff personnel records showed that regular supervision was carried out and a comprehensive record was maintained on issues raised and training needs identified. Staff spoken to confirmed that supervision sessions were carried out on a monthly basis. All records required by regulation were available for inspection, and regulation 26 reports are forwarded to the CSCI monthly. A review of the firelog maintained in the home showed that all checks were being carried out in line with current guidelines. All records required to show appropriate health and safety measures have been carried out were up-to-date and available for inspection. The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 21 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 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 4 X X X 4 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 3 3 X X X 3 3 3 The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 22 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 OP29 Regulation 19 (4) Requirement The home must obtain a POVA 1st confirmation before new staff commence employment. Timescale for action 15/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Wilfred Leonard Care Centre DS0000045770.V285841.R01.S.doc Version 5.1 Page 24 - 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. 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