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Care Home: Bindon & Elmcroft Residential Homes

  • 32-42 Winslade Road Bindon Sidmouth Devon EX10 9EX
  • Tel: 01395514500
  • Fax: 01395513586
  • Planned feature Advertise here!

  • Latitude: 50.689998626709
    Longitude: -3.239000082016
  • Manager: Mr Nicholas John Phipps
  • Price p/w: ~
  • UK
  • Total Capacity: 46
  • Type: Care home only
  • Provider: Bindon Care Ltd
  • Ownership: Private
  • Care Home ID: 3020
Residents Needs:
Dementia, Old age, not falling within any other category

Latest Inspection

This is the latest available inspection report for this service, carried out on 26th March 2010. CQC found this care home to be providing an Good service.

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.

For extracts, read the latest CQC inspection for Bindon & Elmcroft Residential Homes.

What the care home does well The service has produced comprehensive information that is made available to people who are considering making Bindon and Elmcroft their home. Trial visits to the service are encouraged and a senior member of staff from the home will usually carry out an assessment of individuals health and social care needs before anyone is admitted to the home to ensure their needs can be met. Not all people spoken to during this inspection were able to recall their admission to the home but all expressed satisfaction with the outcome. All people living at the service have individual care plans, risk assessments have also been completed identifying potential health risks and care staff complete daily reports to give a picture of how people are cared for and how they lead their lives. Medications are stored safely and only experienced, trained staff carries out the administration. Evidence was obtained in various ways through this inspection to show that those living at the home are treated in a dignified manner and their privacy is upheld at all times. Those who were able expressed complete satisfaction in the way they are treated by the staff. We saw staff assisting people in a friendly, caring and respectful manner throughout this inspection. The home provides activities and encourages and supports people to retain their independence and pursue interests and hobbies they had before living at the home. Good arrangements are in place to ensure family and friends are made welcome at all times and are kept informed and involved in the daily life of the home. The home provides a varied menu which people generally enjoy. The home has a range of policies and procedures that have been regularly updated and staff have been given training and instruction on the policies to ensure they are followed correctly. People living at the home are confident that if they have complaints or concerns, they will be taken seriously and action taken to address them. Good recruitment practices ensure people are safeguarded from abuse. Staff are provided with the opportunities to discuss their training needs and their thoughts relating to ways the service could develop and continue to improve, during supervision sessions. In response to the question "what does the home do well" people living at the home told us, " Looking after me, helpful, care every day and if required night time, high quality care", " everything, nice meals, girls are nice", " give me some company, the staff are so helpful to me", " always helpful and friendly staff, keeps residents clean and happy, the home is always tidy and clean", " very friendly and caring staff who work very hard in looking after the residents" and " Bindon is very good".In response to " what does the home do well", staff comments included "good quality care, good care planning, person centred, activities, training", "the home gives good care to the residents and meets their needs. Keeps my training up to date", " I feel the home provides well for all residents, from diets to birthdays and personal care and activities. I feel all residents are happy here and get on well with staff. all staff are always happy to help", "Bindon is a nice home and I do enjoy working here. Our residents are just like my family", " supports all residents medically, e.g doctors and nurses, activities are varied and daily, staff have good relationships with all residents", " looks after its clients and staff very well" and " checks on staff, eg police checks, supports residents medically, activities and carers are good at their role". Responses from health care professional In response to the question "what does the home do well" included "Friendly and respectful towards residents". What has improved since the last inspection? No requirements were made at the last inspection. A number of recommendations for good practice were made which the service has worked hard to meet. Care plans have been improved to give greater detail about daily routines - times of rising/going to bed, what personal care tasks the person can do for themselves and a detailed explanation of how the staff should help the person with those tasks they could no longer do for themselves. This includes tasks such as dressing, washing, cleaning teeth, and eating. This ensures staff are working in a consistent manner. Where creams or lotions have been prescribed the home now provides clear guidance to care workers on how,where when and why the creams should be applied. There is guidance on how to monitor the skin condition and what to do if the condition improves or worsens. A record is completed each time a cream or lotion has been applied. The care plans and daily reports are now used as a tool for the management team to monitor the care given by the care staff team and to check that the care plans have been followed and if the care plans need to be updated. Care plans now include information to enable staff how to recognise signs of pain and when to offer pain relief where medications have been prescribed by a GP on an `when required` basis. Care plans now explain how staff should monitor those people who may be at risk when they walk around the home, especially if they might walk into other people`s rooms, or if they may be at risk if they go outside the home on their own. The plans explain information about aggression, reasons for aggression, wandering, possible solutions for wandering and restlessness and how staff should guide and support in order to avoid situations. The home has developed a weekly timetable of activities to provide a greater range of individual and group activities. The activities are planned, whenever possible, using information in the care plans about each person`s interests. Hours allocated to regular activities are now safeguarded so that the activities person is not expected to carry out other duties during the allocated activities times. More activities are now provided in each building. A regular audit of all areas of the home is now undertaken which ensures all areas are kept clean, in good decorative order, safe, and well maintained. At the last inspection some toilet bowls were badly stained and action has be taken to address the problem. The home has considered ways of improving the ways people who suffer with dementia may have in finding their way around the home. Clear signs have been posted around the building some using symbols to assist people to find their way around and promote their independence. The home has improved procedures and equipment to ensure all laundry areas are clean, safe, and provide effective systems of infection control. The home has sought advice from the Fire Authority on safe systems of locking the exit doors to ensure people can get out of the home quickly in an emergency, and also ensuring that people who may be at risk of harm if they leave the home unescorted are safeguarded. What the care home could do better: No requirements were made as a result of this inspection. Two recommendations for good practice have been made. Where practicable people should be involved in reviews of their individual care plans or told of the outcomes. This is to ensure they have a say in how they live their lives. Continued improvement to care planning should continue to ensure that people`s health and social care needs are assessed, monitored and reviewed Key inspection report Care homes for older people Name: Address: Bindon & Elmcroft Residential Homes Bindon 32-42 Winslade Road Sidmouth Devon EX10 9EX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Michelle Oliver     Date: 3 1 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 35 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 35 Information about the care home Name of care home: Address: Bindon & Elmcroft Residential Homes Bindon 32-42 Winslade Road Sidmouth Devon EX10 9EX 01395514500 01395513586 rm.bindoncare@btconnect.com www.bindoncare.com Bindon Care Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 46 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) Date of last inspection Brief description of the care home Bindon and Elmcroft (together registered as Bindon Care) are situated approximately one mile from Sidmouth sea front and town centre. The home is registered to provide care to older people who may have dementia, a mental disorder or a physical disability. Elmcroft, the smaller of the two buildings, provides personal care for up to Care Homes for Older People Page 4 of 35 Over 65 0 46 46 0 2 3 0 3 2 0 0 9 Brief description of the care home eighteen older people who have dementia. Bindon, the larger of the two buildings, provides personal care for up to twenty eight older people who may have a physical disability or dementia. The home may also admit up to five service users with dementia between the ages of fifty five and sixty four years of age. The buildings each have level access to their front entrance and to all communal areas. Bedroom accommodation is situated on the ground and first floors, with a stair lift between. Some rooms have steps leading to them. The gardens are secure and well tended. Bindon Care domiciliary care agency is run from the premises. The Home and Agency share the same registered manager and administration. A copy of the most recent inspection report is held in the Managers office and can be seen on request. At the time of this inspection weekly fees ranged from £391 to £650. Care Homes for Older People Page 5 of 35 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that people who use this service experience Good quality outcomes. This inspection was undertaken over 13 hours in two day by one inspector. We spoke with people living there and staff and also spent time observing the care and attention given to people by staff. Prior to this inspection we sent surveys to 10 people living at the home, 10 staff and 5 health care professionals. Nine surveys were completed and returned to us from people living at the home, 7 from staff and 3 from health care professionals expressing their views about the service provided at the home. Their comments and views have been included in this report and helped us to make a judgement about the service provided. To help us understand the experiences of people living at this home we looked closely Care Homes for Older People Page 6 of 35 at the care planned and delivered to three people. Most people living at the home were seen or spoken with during the course of our visit and 4 people were spoken with in depth and a number of other people, to hear about their experience of living at the home. We also spoke with 11 staff, including the Directors, manager, deputy manager and administrator, individually. A tour of the premises was made and we inspected a number of records including assessments and care plans and records relating to medication, recruitment and health and safety. Currently fees charged at the service range from:£391- £ 650, or according to the assessed needs of individuals. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at /www.oft.gov.uk . Copies of the inspection report are available from the office. Care Homes for Older People Page 7 of 35 What the care home does well: The service has produced comprehensive information that is made available to people who are considering making Bindon and Elmcroft their home. Trial visits to the service are encouraged and a senior member of staff from the home will usually carry out an assessment of individuals health and social care needs before anyone is admitted to the home to ensure their needs can be met. Not all people spoken to during this inspection were able to recall their admission to the home but all expressed satisfaction with the outcome. All people living at the service have individual care plans, risk assessments have also been completed identifying potential health risks and care staff complete daily reports to give a picture of how people are cared for and how they lead their lives. Medications are stored safely and only experienced, trained staff carries out the administration. Evidence was obtained in various ways through this inspection to show that those living at the home are treated in a dignified manner and their privacy is upheld at all times. Those who were able expressed complete satisfaction in the way they are treated by the staff. We saw staff assisting people in a friendly, caring and respectful manner throughout this inspection. The home provides activities and encourages and supports people to retain their independence and pursue interests and hobbies they had before living at the home. Good arrangements are in place to ensure family and friends are made welcome at all times and are kept informed and involved in the daily life of the home. The home provides a varied menu which people generally enjoy. The home has a range of policies and procedures that have been regularly updated and staff have been given training and instruction on the policies to ensure they are followed correctly. People living at the home are confident that if they have complaints or concerns, they will be taken seriously and action taken to address them. Good recruitment practices ensure people are safeguarded from abuse. Staff are provided with the opportunities to discuss their training needs and their thoughts relating to ways the service could develop and continue to improve, during supervision sessions. In response to the question what does the home do well people living at the home told us, Looking after me, helpful, care every day and if required night time, high quality care, everything, nice meals, girls are nice, give me some company, the staff are so helpful to me, always helpful and friendly staff, keeps residents clean and happy, the home is always tidy and clean, very friendly and caring staff who work very hard in looking after the residents and Bindon is very good. Care Homes for Older People Page 8 of 35 In response to what does the home do well, staff comments included good quality care, good care planning, person centred, activities, training, the home gives good care to the residents and meets their needs. Keeps my training up to date, I feel the home provides well for all residents, from diets to birthdays and personal care and activities. I feel all residents are happy here and get on well with staff. all staff are always happy to help, Bindon is a nice home and I do enjoy working here. Our residents are just like my family, supports all residents medically, e.g doctors and nurses, activities are varied and daily, staff have good relationships with all residents, looks after its clients and staff very well and checks on staff, eg police checks, supports residents medically, activities and carers are good at their role. Responses from health care professional In response to the question what does the home do well included Friendly and respectful towards residents. What has improved since the last inspection? No requirements were made at the last inspection. A number of recommendations for good practice were made which the service has worked hard to meet. Care plans have been improved to give greater detail about daily routines - times of rising/going to bed, what personal care tasks the person can do for themselves and a detailed explanation of how the staff should help the person with those tasks they could no longer do for themselves. This includes tasks such as dressing, washing, cleaning teeth, and eating. This ensures staff are working in a consistent manner. Where creams or lotions have been prescribed the home now provides clear guidance to care workers on how,where when and why the creams should be applied. There is guidance on how to monitor the skin condition and what to do if the condition improves or worsens. A record is completed each time a cream or lotion has been applied. The care plans and daily reports are now used as a tool for the management team to monitor the care given by the care staff team and to check that the care plans have been followed and if the care plans need to be updated. Care plans now include information to enable staff how to recognise signs of pain and when to offer pain relief where medications have been prescribed by a GP on an when required basis. Care plans now explain how staff should monitor those people who may be at risk when they walk around the home, especially if they might walk into other peoples rooms, or if they may be at risk if they go outside the home on their own. The plans explain information about aggression, reasons for aggression, wandering, possible solutions for wandering and restlessness and how staff should guide and support in order to avoid situations. The home has developed a weekly timetable of activities to provide a greater range of individual and group activities. The activities are planned, whenever possible, using information in the care plans about each persons interests. Hours allocated to regular activities are now safeguarded so that the activities person Care Homes for Older People Page 9 of 35 is not expected to carry out other duties during the allocated activities times. More activities are now provided in each building. A regular audit of all areas of the home is now undertaken which ensures all areas are kept clean, in good decorative order, safe, and well maintained. At the last inspection some toilet bowls were badly stained and action has be taken to address the problem. The home has considered ways of improving the ways people who suffer with dementia may have in finding their way around the home. Clear signs have been posted around the building some using symbols to assist people to find their way around and promote their independence. The home has improved procedures and equipment to ensure all laundry areas are clean, safe, and provide effective systems of infection control. The home has sought advice from the Fire Authority on safe systems of locking the exit doors to ensure people can get out of the home quickly in an emergency, and also ensuring that people who may be at risk of harm if they leave the home unescorted are safeguarded. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 10 of 35 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 35 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving to Bindon and Elmcroft benefit from being provided with information to assist them in making a decision and from being assurred that their assessed health and social care needs can be met by the service. Evidence: The service has produced a Statement of Purpose and a Service User Guide, which have been updated since the last inspection, to provide information about Bindon and Elmcroft for people who may be considering making the service their home. Both are clear and informative and we were told that they would be made available in a format to meet individual needs i.e large print. We spoke to several people during this inspection and although many were unable to recall their admission all expressed satisfaction with the care provided at the service. Care Homes for Older People Page 12 of 35 Evidence: Prior to this inspection we sent surveys to 10 people living at the home to establish their views on the way they live their lives at Bindon and Elmcroft and we received responses from nine. In response to did you receive enough information to help you decide if this home was the right place for you 5 people confirmed they had, 3 didnt know and one person stated they had not received enough information . Information provided by the service prior to this inspection include plans for continued improvement including developing a welcome package for each new person on their admission, which will provide them all the necessary details of important things such as meals , activities on offer, staffing information, complaints procedures, fire drill plans, and other relevant issues. The services policy is that people are only admitted to the home following a pre admission assessment of their individual health and social care needs to ensure that the service can meet these assessed needs. This assessment will be undertaken by the manager or a person trained to undertake assessments, or if this is not feasible the service will obtain information from other health care professionals who have been involved in the persons care. People considering moving into the home are invited to visit the home as often as they wish, to have a meal and to meet other people living at the home before they make a decision to make Bindon and Elmcroft their home. To enable us to assess how the health and social care for these people are met at the service we looked, in detail, at files for 4 people living at the home. The policy of the service is that each person has an individual file, the purpose of which is to help staff providing care to better understand individual needs. The service has devised a thorough assessment of needs form, which when completed provides comprehensive information about individual health and social care needs. Information includes medical history, communication needs, dietary needs, daily routine, bedtime routine, weekly diary, help needed with individuals care, daily plan of care, risk assessments etc. The service does not admit people who require intermediate care. Care Homes for Older People Page 13 of 35 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning provides staff with the information they require to meet the needs of individuals in a safe and respectful manner, while promoting their dignity and independence. Further development of care planning will ensure that peoples health and social care needs will be met in a person centred manner. Evidence: All people living at the home, who responded to questionnaires, felt confident that the home always[7] or usually [2] met their needs. I response to what does the home do well one person wrote looking after me, helpful, care every day and if required night time, high quality of care and another very friendly and caring staff who work hard in looking after the residents. Staff who responded to questionnaires confirmed they are always [6] or usually [1]given up to date information about the needs of people they support or care for. Care Homes for Older People Page 14 of 35 Evidence: All people living at Bindon And Elmcroft have individual files, which include information relating to the admission, assessments of their health and social care needs, assessments of risks and care plans.These files are comprehensive and well organised making it straightforward for staff to access information about individuals and to ensure they are kept upto date. Care plans are the end point of the assessment of the persons health and social care needs and should show what care must be delivered in accordance with the service user plan for that individual. The plan becomes the yardstick for judging whether appropriate care is delivered to the individual and will reflect changes as regular assessment of the person shows changing needs. Detailed planning, recording and reviewing peoples care makes sure that staff are up to date with changes, people receive appropriate care to achieve positive outcomes and care given is person centred. Care planning at Bindon and Elmcroft is made up from an assessment of a persons daily activities,including, for example ,washing, dressing, mobility and continence. We looked at 3 care plans and saw that information recorded was comprehensive and person centred and included a separate record of each care issue, such as mobility, communication, diet, skin care, emotional well being, and guidelines on how the staff team are to manage these separate issues. Plans included details of what a person could actually do for themselves and chose to continue to do to retain their independence and also what their aims or goals were. Details had been recorded of how people chose to have care delivered, their likes, dislikes and whether they had been involved in the initial drawing up or reviewing of their individual plan. Plans of care are reviewed regularly; however there was not always evidence that people are involved in this review of their care. Those people spoken to could not remember being involved in this but were confident that they are well cared for and their needs are met by the home. Assessment of potential risks to people living at the home is undertaken as part of the care planning process and kept under review. This includes the risks of falling and nutrition. All people living at the home are weighed monthly to ensure that their nutritional needs are met. Care Homes for Older People Page 15 of 35 Evidence: We saw a record that indicated that a person had lost at least 7 kilograms in 2 month. A care plan, dependence on home to provide nutrition detailing how this persons nutritional need would be monitored had been drawn up, however staff had not acted on the apparent loss of weight. This means that this person may be at risk of their nutritional needs not being met. Staff told us that the person had not noticeably lost weight, their appetite had not decreased and that perhaps the scales being used were not accurate. We discussed our concerns that this had not been checked when a considerable change of weight had been noted and that the person had a medical condition which indicated close monitoring of their weight. We looked at care plans for another person who had recently been admitted to hospital for an operation. Although we saw information provided by the hospital when the person was discharged, a plan of how this care was to be delivered and monitored had not been completed. Staff had recorded some observations in the daily report for this person,following their discharge but this did not provide a dependable monitoring tool.This lack of care planning could potentially result in peoples health needs not being monitored or met and were told that the service aims to continue to improve the quality of information included in care plans. The home monitors peoples dental and optician checks and chiropodists are used according to peoples needs. This means that they benefit from the involvement of health care professionals to ensure that health care needs are met. Medication is generally well managed at the home. Medicines are stored securely and records were generally accurate, up to date and indicated that medication is generally appropriately administered. All staff that handle medicines have received training in the safe handling of medication, which ensures that people living at the home are cared for by competent, well trained staff. The service has taken note of what was required as a result of the last inspection and records now include a description of all medication, which people may need only in certain circumstance, for example medication for pain relief. A record of all new medication or changes to medication such as increases in dosage or the withdrawal of medications, the reason for the change and the name of the doctor who has prescribed it is maintained. This ensures that a record of any changes is maintained and provides accurate, current information for visiting doctors, admissions to hospitals and for staff use within the home. The ethos of the service is that people are encouraged and supported to look after their own medicines if they wish and are able to do so. Lockable facilities would be Care Homes for Older People Page 16 of 35 Evidence: provided in a rooms for the safekeeping of medicines, if a person chose, and was assessed as competent and safe, to look after their own medicines. Assessments of peoples ability to safely manage their own medicines are undertaken, which include whether they are aware of the reason they were prescribed the medicine, what the effects of not taking it, or taking too much might be or whether they could read the labels or open the containers At the time of this inspection one person living at Bindon and Elmcroft was looking after their own medicines and they told us how this increases their independence. People living at the service felt that their privacy was respected and we saw staff knocking on doors and waiting to be invited in before doing so and offering personal care in a discreet manner. People benefit from regular opportunities to make their changing needs known. Staff confirmed this when they told us that people speak openly to staff and staff have good communication with all those living at the home and with members of management to whom they report any concerns. Throughout this visit people spoke to management and staff openly about their wishes and choices about what they wanted to do or assistance they needed. Staff confirmed that people living at the service are encouraged and supported to live their lives as they choose and to make their own decision and choices. Care Homes for Older People Page 17 of 35 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines are flexible and people are supported to exercise control over their daily lives. Social activities meet peoples expectations and preferences and people enjoy a balanced diet, which takes into account the likes and dislikes of individuals. People benefit from contact with their family and friends, which is encouraged and supported by the home. Evidence: Six people returning surveys told us that there were always activities at the home they could take part in and three people felt this was usually the case. Comments made in surveys included Plenty of trips out and another they could take residents out for a walk or walks. The service employs 2 Activities Co-ordinators who, we were told work together to increase ideas and also spend more time doing one to one sessions with the residents that cant, or prefer not to, leave their rooms.The manager told us staff are energetic and enthusiastic about the variety of activities offered at the home and encouraging and supporting people to take part. Care Homes for Older People Page 18 of 35 Evidence: Some people living at the home do not wish to take part in organised activities. When asked how staff prevented these people from the potential of being socially isolated staff told us that they spend time with people on a 1 to 1 basis to chat or be involved in personal interests or hobbies. Staff told us they encourage all residents to become involved, whether it be full participation or merely as a by-stander, and confirmed they respect peoples wishes and their right to choose not to engage in any activity and remain in privacy of their own room. During this inspection several people took part in making Easter cards,playing games, others enjoyed watching videos which resulted in reminiscing about their past lives and some formed groups and chatted. Information relating to peoples social care needs is also undertaken as part of the care planning process. We noted that one person continued their interest in cross stitching and cooking since they moved to the service. The service has installed a personal computer in the home,which is linked up to the internet in the library area for people to use for their own leisure and reference purposes. During the week one of the two the activity co-ordinators will assist anyone who needs it in the use of this service. The manager discussed evidence from recent research that suggests it is likely that elderly people who use a computer report fewer depressive symptoms. Since the last inspection a monthly tea dance with live music and singing from a reputable entertainer, has been introduced at the service, which, we were told is a reminder of the good old days. Also, donkeys from a local sanctuary visit the home which is enjoyed by people living at the service. The service has recently restarted church services in the home following discussion with the residents and local clergy. People living at the service are also encouraged to pursue activities such as walking around the local area or for taking a daily trip out in their car. One person told us they are encouraged to carry on visiting their doctor and other health care professionals on their own in their own car.The person told us this supports their independence, which was their main aim when they moved to the service and also which they were assurred, prior to their admission, was one of aims of the service. There is no restriction on visiting times at the home and throughout the day visitors came to the home and were made to feel welcome. We spoke to a person who enjoys Care Homes for Older People Page 19 of 35 Evidence: playing bridge and told us their friends have been encouraged to visit regularly to play cards with them in the dining room. Four people living at Bindon and Elmcroft, who responded to surveys, felt that staff always listened and acted on what they said, five said this was usually the case. We saw people being given choice throughout the day, for example what they wanted to eat and drink, where they sat, what clothes they wore and people said that they were able to choose when they got up or went to bed. Surveys showed that people always[5] or usually [4] enjoyed the food served at the home. People we spoke with all said how good the food was. They described the choices available and were full of praise for the chef, who is experienced and knowledgeable about peoples dietary needs and preferences. Comments in response to surveys returned from people living at the service included Good food, first class, the food is good, and nice meals. One person, in response to what could the home do better commented Teas. I get very tired of never ending soup and sandwiches. I had a lovely salad yesterday. We discussed this with the person who made the comments and were told they had discussed this with the manager and the chef and teas have now improved greatly. People can choose where to have their meals and many people choose to eat in the dining room. The atmosphere in the dining room at lunchtime was convivial; tables were nicely laid with napkins, flowers and condiments. Staff were available to assist people in a discreet manner where needed. The lunchtime meal was unhurried, very nicely presented and appeared to be well balanced and nutritious. Snacks and hot or cold drinks are available at any time day or night and because there is a very long time period between tea served at about 5-5.30 and breakfast the following morning between 8am and 10am supper, offering a choice of sandwiches, snacks, fruit or other items of people may choose, is provided in the early evening. People considering making Bindon and Elmcroft their home are encouraged by the providers, management and staff to do just that and are encouraged to bring any items that would make them feel more at ease and at home. Information provided by the service prior to this inspection indicates that included in their plans to continue improvement at the service a wider selection of meals is going to be planned and more selections of fresh fruits, pre cut if required, at tea breaks or as a dessert instead of, or as an alternative to, the usual puddings or biscuits are to Care Homes for Older People Page 20 of 35 Evidence: be made available. Care Homes for Older People Page 21 of 35 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be confident that any issues raised will be taken seriously and that they, and staff, are protected from abuse by robust policies and procedures Evidence: Bindon and Elmcroft has a complaints procedure which is simple, clear and accessible; a copy is included in the homes Statement of Purpose, Service User Guide and is displayed at the home in the entrance hall and in each persons private room. People living at the home confirmed they know who to speak with should they have any concerns or complaints but most were aware of the actual complaints procedure. Of the 9 people who responded to surveys 6 confirmed they were aware of how to make a formal complaint, 2 stated they did not and one person did not respond to the question. The manager operates an open door policy and this is stressed to people when they move to the home and their relatives and friends. The manager told us that they encourage people to approach any member of staff if they have any concerns, so that these can be looked into as soon as possible. The manager said even if there is a niggle I want to hear about it. The service has received 2 complaints during the last 12 months. Both were taken Care Homes for Older People Page 22 of 35 Evidence: seriously and acted upon following the complaints procedure. All staff spoken to during this inspection were aware of the adult protection procedure in place to protect people living at the home and said they had received training to help them recognise any poor practice or evidence of abuse and all were aware of their responsibility to report any concerns. People living here felt well cared for and described staff as kind, caring, polite and friendly. Care Homes for Older People Page 23 of 35 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Bindonn and Elmcroft provides a comfortable, clean and well maintained environment for those living in, working at and visiting the home. Evidence: Bindon and Elmcroft was originally several separate terraced houses,all of which, apart from one, having been converted to form one large building.The house which is at the end of the converted terrace only has access from outside, although people who live there take part in all of the facilities and activities in the other houses. Where the houses have been converted into one building there are some steps where the floor levels differ, which may cause difficulties for people with mobility problems.However, a stair lift facility has been fitted to all stairs leading from the ground to the first floor throughout the building. This has been made clear in the homes brochure. We talked to the manager about what happens if people develop mobility problems after they have moved in and we were assured that the home will offer a more suitable room if necessary (according to availability). Each person living at the service had their own single occupancy bedroom. The manager told us that some rooms could be occupied by two people but they had a policy of only accommodating more than one person in a room if they both had specifically chosen to share a room (for example, married couples, or close friends), Care Homes for Older People Page 24 of 35 Evidence: which demonstrates good practice. During our visit we carried out a tour of the communal areas home including bathrooms and toilets, and we also visited 8 bedrooms, with the consent of the occupiers. Most bedrooms have ensuite toilet facilities, and some bedrooms also have level access showers. People have been encouraged to bring items of furniture, pictures and belongings to make their rooms feel homely, and we saw many rooms that people had personalised and made homely as they chose. Individual accommodation is decorated and furnished to a high standard and a maintenance programme is in place which is proactive and any repairs or decorating that is required is actioned either that day or as soon as practicable. A maintenance log is used by staff and checked by the maintenance officer every morning. Information provided by the service prior to this inspection stated that during the last three months a number of bedrooms have re-decorated and new carpets have been fitted to 5 bedrooms and floor covering to adjoining bathrooms. Adapted equipment such as grab rails, bannister rails or bath chairs are provided within the home for people who may have problems with mobility. The service has three separate laundry rooms, and each one is small and cramped. During the last inspection of the service laundry facilities were judged as poor and although there has been some improvement the actual rooms the facilities are sited in can not be changed. All staff we spoke to during this inspection were aware of the limitations and associated potential risks of cross infection presented by the current laundry facilities and were aware of good hygiene policies and procedures, which we saw staff following throughout this inspection.The service has also completed an audit of the infection control systems in the home which, it is planned, will be reviewed annually. The manager and provider told us more room for staff to complete the laundry duties would be beneficial as the present laundry rooms are very tight for space. However the current system with three small laundry areas does give us flexibility if machines require servicing. We were told that the service are considering plans to move the laundry facilities into a large outbuilding in the rear garden or as an extension to part of the existing building and are presently looking at the different benefits and relative costs. The reason for this is that there would be more room for the staff to work in and would Care Homes for Older People Page 25 of 35 Evidence: allow for the temporary storage of the clothing to be right next to the machines for much easier access. Improvement undertaken by the service since the last inspection includes moving storage of clothing from a hallway outside one of the laundry rooms to a separate lockable room upstairs. This has removed what could have been an obstruction and a hazard to peoples safety and has made the temporary storage of the clothing more hygienic and easier to work with. The house-keeping team has been increased from two to three members,since the last inspection, to ensure high levels of cleanliness and hygiene of the home are maintained and to ensure the home free of offensive smells. Our overall impression of the home was that it was fresh, bright, comfortable, and well maintained. A number of areas have been redecorated in the last year and most areas were in good decorative order. The gardens have been carefully tended and colourful spring flowering shrubs could be seen from many bedroom windows. There were paths and sitting areas for people to enjoy the garden during warmer weather. Our overall impression of the home was that it was fresh, bright, comfortable, and well maintained. A number of areas have been redecorated in the last year and most areas were in good decorative order. Care Homes for Older People Page 26 of 35 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff employed are competent in their roles to ensure that people living at Bindon and Elmcroft are safe and well cared for. Recruitment practices ensures that they are also protected from potentially unsuitable staff. Evidence: The service is registered to accommodate 42 people and at the time of this inspection 36 people were living at Bindon and Elmcroft. We were told that throughout the day the service aims to have 5 carers on duty at Bindon, where the majotity of people live, and 3 at Elmcroft.Included in this number 4 staff throughout the day will be senior carers and at least one member of staff, during the day and night, will have up to date training in first aid. Also during the day the manager, activity co ordinators, chef, domestics and maintenance staff will be on duty. Throughout the night 4 wakingstaff, are on duty, including 2 senior carers. Care Homes for Older People Page 27 of 35 Evidence: As part of this inspection we looked at the staff rota maintained at the home and noted that this staffing level was being followed and the level of staffing appeared to meet with the aims of the service at this time. In response to the question are staff available when you need them 7 people who responded to surveys felt there always were and 2 usually enough staff available to meet their needs. In response to surveys 2 staff thought there was always, 2 usually, 1 sometimes and 2 never enough staff available to meet the individual needs of people living at the service. Comments made by staff in response to what could the home do better included More staff on each shift so we can spend proper time with our residents, not enough staff, more staff to provide all needs of our residents and we can spend quality time with our residents, I feel at times we could do with a few mopre staff and another the home could do with more staff , even though the staff is short at times, do still put the care needed to the residents. Staff spoken to during this inspection told us that they were usually kept busy but always had time to stop and speak to people.Throughout this inspection we noted that staff were busy but met peoples needs in an unhurried manner and were kind and respectful at all times. Comments received from a health care professional included much improved since new managers arrival but need more staff as they have some very dependent residents. We discussed these comments and our observations with the provider and manager and were told that additional staff would be allocated to meet the changing needs of people living at the service. All staff agreed they are given training that is relevant to their role, helps them understand and meet the individual needs of people, keeps them up to date with new ways of working and provides them with enough knowledge about health care and medication. All newly employed staff undergoes a period of training when they start working at the home to enable them to get to know the residents, the homes philosophy of care, safety procedure, care procedures, and the general layout of the home. The time Care Homes for Older People Page 28 of 35 Evidence: taken to complete this training will depend on past experience and individual ability. Training is a priority at Bindon and Elmcroft and training matrix has been developed since the last inspection which includes mandatory training, infection control, palliative care, safeguarding adults, and training related to the management of dementia was being arranged for the end of April, at the time of this inspection. Both the Manager and Deputy manager are to be trained as trainers which they feel will make the necessary training much easier to arrange and undertake. All care staff at the service have achieved or are undertaking an NVQ at level 2 or 3. Records of training undertaken are kept for all staff. We looked at three recently employed staff files. All included evidence that the home had conducted a robust recruitment procedure. Files included details of past employment, application form, training certificates, health declarations evidence of identity, police checks and references. Staff files are stored in locked cabinets and are only accessible to management staff. This procedure means that people living at the home are protected by the homes recruitment procedure. Care Homes for Older People Page 29 of 35 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Bindon and Elmcroft is well managed and run in the best interest of those living there. Evidence: At the time of this inspection the manager of Bindon and Elmcroft, who has 30 yrs of experience of working with and managing people, is supported by a deputy manager, an administrator and the Directors of the Company, who are both available to discuss matters on a daily basis.The Manager, who has been employed at the service since November 2009, operates efficient management systems and strongly believes in clear demarcations of authority and accountability. We were told that the manager is currently completing their application to the Care Quality Commission to be registered as the manager for the home and to complete a Level 4 Leadership and Management certificate. Staff spoken to confirmed that they felt well supported by the current management at the Home. Care Homes for Older People Page 30 of 35 Evidence: The Directors of the Company visit the home often and during their visits spend time talking to people living there and staff. It is during these conversations that people are encouraged to let them know their views and wishes. People living and visiting the service are given the opportunity of having a say in the running of their home. Quality assurance questionnaires are sent to people living at the home, relatives, visitors and health care professionals.A formal Quality Assurance audit was undertaken in February 2010, the outcomes have been collated and are going to be made available . The home is visited one a month by one of the Company Directors who undertakes an unannounced inspection of the service and presents a written report of their findings to the manager. This forms part of the homes quality assurance system, which gather peoples views relating to the running of, and the quality of life experienced at the home. Also,residents, staff and senior staff meetings are held regularly at the service, during which, we are told, the care service appraises the care offered and the standards of the staff team as a whole The service is also monitored through our quality assurance scheme. Staff told us that since the last inspection they receive regular supervision. They said they found it positive as it provided an opportunity for them to talk about their work and training needs.All staff we spoke to clearly described good infection control procedures and confirmed they had received recent updates in the procedures and that they had all had up to date training in relation to Moving and Handling and safeguarding adults. Staff involved in food preparation confirmed that they had food hygiene qualifications. The home does not hold cash on behalf of people. If people need items to be paid for on their behalf such as hairdressing or toiletries the home will pay for the items and invoice them or their representative on a monthly basis. Risks to people living at the service are individually assessed and documented with an agreed plan in place to minimise risks where possible. During our tour of the building no immediate hazards were identified. Since the last inspection, when it was found that the front door remained locked when the fire alarm went off advice was sought from the fire authority on the most suitable method of locking the exit doors to prevent people who may be at risk from leaving the home Care Homes for Older People Page 31 of 35 Evidence: without staff realising or accompanying them. the front door is now fitted with a device that will open automatically when the fire alarm sounds. The temperature of hot water in bathrooms is checked before a person is bathed to ensure they are protected from the risk of scalds.Windows checked on the first floor had been restricted to prevent accidents, and radiators were covered to prevent burns. Fridge and freezer temperatures are recorded which is good practice. Any accident involving people living or working at the home are recorded. Accidents are thoroughly investigated and an accident analysis undertaken where appropriate. Records are securely stored in lockable filing cabinets, and those seen were up to date. We were told that records would be made available to people living at the home, or their representative with their consent. Information received from the Manager prior to this inspection indicates that all policies and procedure required are in place at Bindon and Elmcroft and these are updated regularly. Information also confirms that all equipment, fire, gas, electrical and lifts are maintained and serviced as required to meet safety standards all of which contributes towards ensuring that Bindon and Elmcroft is a safe place for people to live. Care Homes for Older People Page 32 of 35 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 33 of 35 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Continued improvement to care planning should continue to ensure that peoples health and social care needs are assessed, monitored and reviewed. Where practicable people should be involved in reviews of their individual care plans or told of the outcomes. This is to ensure thay have a say in how they live their lives. Appropriate action should be taken when their is an apparent change in individuals health. This relates to an apparent loss of weight not being appropriately reviewed. 2 7 3 8 Care Homes for Older People Page 34 of 35 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 35 of 35 - 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!

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