Care Home: Edenhurst Care Home

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What the care home does well When we asked people living in the home what they felt the home did well, they said, "I am happy and settled at the home", "There are always activities, boat trips, meals out, theater and bingo", "The food is five star" and "The home is lovely I am very happy here." We received positive comments from health care professionals such as, "As soon as anyone enters Edenhurst you are always greeted with a smile and always offered a drink" and " I have always been impressed by the individual care the staff deliver and always with a pleasant, caring attitude." Comments from relatives included, "Edenhurst is exceptionally well run and the staff are very cheerful", "This is an excellent care home. The staff look after our relative very well in all aspects. They are friendly and welcoming whenever we visit and keep us informed", "The atmosphere is family like and the staff have worked here for years", "They couldn`t look after my relative better" and "It is the best care home I have ever visited, it is just like a family hotel." What has improved since the last inspection? Life profiles have been introduced to the care plans of people living in the home since we last visited. There was evidence that these profiles were being developed with input from the individual they were intended for. The life profiles included information on what is important to the person, what they have achieved in their life, special memories and stories as well as identifying the people that are important to them. The information in care plans is now more person centred. The home has a consistent record for meeting standards and people continue to tell us that they are happy and well cared for there. The management work well with us and keep us up to date with things that are happening in the home. What the care home could do better: They could provide disposable paper towels in areas where staff wash their hands such as staff wash areas, the laundry and the kitchen. Key inspection report Care homes for older people Name: Address: Edenhurst Care Home 11 Denmark Grove Alexandra Park Nottingham NG3 4JG     The quality rating for this care home is:   three star excellent 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: Lynda Dyer     Date: 0 3 0 2 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 26 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) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Edenhurst Care Home 11 Denmark Grove Alexandra Park Nottingham NG3 4JG 01159606595 01158477160 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Russell Bradley,Mrs Kerry Bradley care home 24 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 24 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either 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 Edenhurst Rest Home is situated in Alexander Park approximately two miles from Nottingham city centre. It is registered to accept up to 23 older people. The accommodation comprises of two separate buildings that have been linked together. Both annexes are accessible to all service users. The accommodation is on two floors and is serviced by a lift. There are three day rooms, two kitchens and two dining rooms. The private accommodation comprises mainly of single rooms, two of which Care Homes for Older People Page 4 of 26 Over 65 0 24 24 0 Brief description of the care home have en-suite facilities. There are also two double rooms and a visitors room. The gardens are well maintained and is also accessible to service users. Care Homes for Older People Page 5 of 26 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: three star excellent 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 focus of inspections undertaken by the Care Quality Commission is upon outcomes for people who live at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. The last time we visited this service was December 7th 2006. We, as it appears throughout the Inspection Report, refers to The Care Quality Commission. One inspector carried out an unannounced site visit to the home, which took place during the morning and included the lunch period. The Registered Manager assisted us during the visit and was very helpful and friendly. Care Homes for Older People Page 6 of 26 We have introduced a new way of working with owners and managers. We ask them to fill in a questionnaire about how well their service provides for the needs of the people who live there and how they can and intend to improve their service, this is called an Annual quality assurance assessment (AQAA). We received the AQAA back from the manager in good time. The form was completed well and gave us all the information that we asked for. We also sent out surveys called, have your say, to people who use the service, staff that work there and relatives. This meant we could get an idea of what people thought about the way the home was run. We received many positive comments in these surveys and we have included some of the comments in this report. We also reviewed all of the information we have received about the home since we last made a visit to them and we considered this in planning the visit and deciding what areas to look at. The main method of inspection we use is called case tracking, which involved us choosing two people who live in the home and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We spoke with the manager, three members of staff and four people who use the service to help us to form an opinion about the quality of the service being provided to people. We read documents as part of this visit and looked at the environment and facilities of the home to form an opinion about the health and safety of people who live there. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? 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 8 of 26 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 9 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that are admitted to the home have their needs assessed prior to admission, which means staff, will be able to plan for their individual needs and know how to care for them. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that people are assessed prior to admission and they can make regular visits free of charge to make sure their needs can be met. We looked at the records of the most recent admission and the records contained evidence that a full needs assessment had been completed prior to admission to the home. We spoke to staff working in the home and they told us that they always got to know Care Homes for Older People Page 10 of 26 Evidence: about the needs of people before they moved into the home. We spoke with one person living in the home about the admission process and they told us that they had looked around and then stayed for a while to see if this was the right home for them. One person living in the home told us, I came to look around before I decided to move in here and now I show other people around before they decide if they want to live here. The home does not offer intermediate care and so standard 6 does not apply. Care Homes for Older People Page 11 of 26 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. People living in the home have up to date and relevant care plans, which give guidance to staff to deliver the appropriate individual care and people are happy with the care they receive. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that good care plans are in place and health care needs are properly assessed and provided for. We received information before we visited the home that told us that people living there felt that their health care needs were being met. We also spoke with people living in the home on the day of the inspection and they told us that they were well cared for by staff. We looked at the care plans of two people living in the home and there was evidence that the health care needs of people living in the home are properly assessed and provided for. Care Homes for Older People Page 12 of 26 Evidence: The plans contained risk assessments around areas of daily living with information for staff on what they needed to do to manage the risks and to meet the needs of that person. The plans contained information that was important to the person that it was written for and took into account the Mental Capacity Act 2005. Life profiles have been introduced to the care plans of people living in the home since we last visited. There was evidence that these profiles were being developed with input from the individual they were intended for. The life profiles included information on what is important to the person, what they have achieved in their life, special memories and stories as well as identifying the people that are important to them. The information in care plans is now more person centred. The care plans were being reviewed regularly and there was evidence that the person for whom it was written was involved in its development. When we asked staff what the home did well, they said, Meets the needs of the residents and makes them happy, Meets the individual needs of our residents and The residents are put first and there is a good atmosphere. We spoke with a health professional and they told us that staff communication was very good with information about peoples health needs being passed on and treatment being recorded appropriately. We observed a member of staff administering prescribed medicines to people living in the home and they followed the correct procedures. There was also evidence that the requirements for the safe receipt, storage and disposal of medicines are being met and maintained. We observed plenty of positive interaction between staff and people living in the home and we saw that staff were respectful of peoples privacy and dignity. When we asked what the home did well, one health professional said, Everything, they treat clients with respect, dignity and individuality. Care Homes for Older People Page 13 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are given the opportunity to participate in recreational activities and maintain social contacts. People receive a nutritious and appetising diet with individual preferences being met. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that people have a good range of activities provided to keep them occupied and that they are encouraged to maintain contact with their family and friends in the community. They also told us that the menus are varied and fresh and people living in the home are asked if they want anything from the shops or anything different for their meals. We spoke with people living in the home regarding the activities available. One of them said that there are always activities and trips going on and that people spent lots of time in the garden during warmer weather. They told us that there was a party held every time there was a Birthday in the home and this was witnessed on the day of the inspection. Another person living in the home told us that they liked to keep busy and so staff or the manager takes them out shopping and supports them to help out in the garden Care Homes for Older People Page 14 of 26 Evidence: and the home. People spoke of trips they have had to the river, BBQs to raise funds for the home, trips to the library and entertainers that regularly visit the home. When we asked people living in the home what they felt the home did well, they said, I am happy and settled at the home, There are always activities, boat trips, meals out, theater and bingo, The food is five star and The home is lovely I am very happy here. We spoke with two people living in the home about having visitors and one person told us, When I get visitors we always go to my bedroom and staff bring a lovely tray with tea and biscuits for us all. We spoke with staff about the amount of activities provided by the home and they told that they felt there was enough to keep people occupied. They also felt that staffing levels allowed staff to spend time with people living in the home in a relaxed manner. People told us that they were able to choose how they spent their time and one person told us, I have a key to my bedroom and I can lock the door if I like. We observed lunch and it was a pleasant and relaxing experience for people living in the home. There was lots of interaction between staff and people living in the home and also friendly banter between the people living in the home. The meal served looked nutritious and very appetising. The cook told us that people living in the home meet weekly to decide the menu for the following week and that there is always two options to choose from, with further options if neither of those are wanted. We saw evidence of people being offered a choice of three meals on the day of the inspection. Staff were available to give discreet assistance to people who needed help with their meal. The dining tables were laid nicely with a choice of drinks, condiments and sauces and specialist utensils were provided, where needed. One person living in the home told us, They always come and ask us what we want for lunch and tea, the food is excellent and another said, The food is always good and is mainly home cooked. Care Homes for Older People Page 15 of 26 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 using the service feel able to raise concerns and complaints and can be confident that the manager will act on them. Staff know how to safeguard people living in the home from abuse. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that they are friendly and very approachable and that people living in the home, their relatives and staff feel that they can approach them anytime. The Commission has not received any complaints about this service since the last inspection and the manager told us that the home has not received any complaints since we last visited. People living in the home told us in the surveys they completed that they knew how to raise concerns and make complaints and staff told us that they knew how to respond to someone making a complaint to them. We saw the complaints procedure on display in the home and this was current, clear and accessible. One person living in the home said, I know how to complain but I have never needed to and I have been very happy since moving into the home. Another said, If I have any little niggles I just have to speak with the manager and it is sorted out very quickly. Care Homes for Older People Page 16 of 26 Evidence: The home has the current local safeguarding procedures in place and the management team have had training in the referral process and are currently cascading this training to the rest of the staff. We viewed two staff files and they contained evidence that staff are trained in how to safeguard vulnerable adults from abuse and when we spoke with staff, they gave a clear account of the safeguarding procedures. Care Homes for Older People Page 17 of 26 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. Good housekeeping procedures provide people with clean, pleasant and homely surroundings in which to live. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that the home is clean and comfortable and well maintained throughout and that a high standard of accommodation is offered. On the day of the inspection we were given a tour of the home by one of the people living there. They told us that the home had recently been decorated throughout with most areas also having a new carpet fitted. We found all areas to be very clean, tidy and fresh smelling throughout. We looked at the bedrooms of four people living in the home and we found that they were decorated to a good standard and were highly personalised with peoples own possessions and furniture. When we asked what the home did well, one health professional said, Provides a warm friendly, relaxed family centred environment for their residents and visitors. One person living in the home told us, The home is very bright and cheerful. Another Care Homes for Older People Page 18 of 26 Evidence: person said, It is always very clean. We saw evidence that staff have received training in preventing the spread of infection and we observed them putting these procedures into practice on the day of the inspection. We observed that terry-cotton towels are used throughout the home and we spoke with the manager about the potential for the spread of infection with this method of hand drying for staff. The manager told us that they would supply disposable paper towels in the staff wash areas, the laundry and the kitchen. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has good staff recruitment and training procedures, which means that people living at the home should be, as far as reasonably possible, protected from risk. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that the home has a low turnover of staff and that staff are well trained and competent in how they meet the needs of people living in the home. We received comments from relatives of people who use the service and it was evident that they continue to be very satisfied with the quality of the care delivered. Comments from relatives included, Edenhurst is exceptionally well run and the staff are very cheerful, This is an excellent care home. The staff look after our relative very well in all aspects. They are friendly and welcoming whenever we visit and keep us informed, The atmosphere is family like and the staff have worked here for years, They couldnt look after my relative better, It is the best care home I have ever visited, it is just like a family hotel and There is not a high staff turnover which means they know the residents well. One member of staff said, The atmosphere here is lovely and the staff are always Care Homes for Older People Page 20 of 26 Evidence: kind to people living here. Another member of staff said, We have good caring staff and are knowledgeable. We looked at the files of two members of staff working in the home and we found that they contained evidence that all of the required recruitment checks had been made prior to employment commencing. We spoke with staff and they confirmed that they had to wait for these checks before they started working in the home. The files also contained evidence that a recognised induction was being carried out on new staff and that the manager was supporting staff to access training in areas of health and safety and health care. Staff told us that they received training that helped them to meet the needs of people and that was relevant to their role. One member of staff said, There is always ongoing training here. We spoke with a health professional and they told us, The good thing about this home is that it is always the same staff, they seem to stay. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is evidence that the home is run in the best interests of the people that live there and that the manager supports a team of staff to deliver safe and effective care. Evidence: The manager told us in the homes Annual Quality Assurance Assessment that Edenhurst is a family run business and that people living in the home are treated as a part of the family. They also told us that the management team are experienced, competent, approachable and caring, making sure the home is well managed and that staff are supported. They told us that quality assurance audits are being undertaken regularly and that people living in the home are able to get involved in regular meetings. The registered manager has the recommended qualifications and has been registered as a manager for twenty two years. They attend regular training and forums provided for managers, to enable them to keep up to date with the changes in practice and legislation. Care Homes for Older People Page 22 of 26 Evidence: People living in the home praised the manager with comments like, The manager does a lot for the home and the staff, Russell is good fun and he makes me smile and He (The manager) makes sure everything is done right and that things are perfect. Quality Assurance Audits are done once a year, to see if people are happy with the quality of care provided and people living in the home have regular meetings. The surveys called Have your say that we sent out to people living in the home, their relatives and staff working in the home were returned to us with many positive comments. We have included these throughout the report. We also received positive comments from health care professionals such as, As soon as anyone enters Edenhurst you are always greeted with a smile and always offered a drink. They have the same staff who have been at the home for years so you have the continuity which is essential to any resident who may be a little confused, The waiting list speaks for itself and I have always been impressed by the individual care the staff deliver and always with a pleasant, caring attitude. The reports I have heard have always been positive. Well done! We asked staff what the home did well and they said, The owner deserves an award for what he does for the residents and for all of the staff, We have good knowledge and a reputation for caring and support and good training. We have good feedback from outside and people are recommended to look around our home, We could not do better than we are. Good caring staff and good managers and we are always willing to achieve any goals. Staff told us that the manager met with them regularly to talk about how they were working and to give them support and we saw records of these meetings. There are no financial records in respect of people living in the home the home as no money is kept on the premises for people living there. The provider pays for everything and then bills the individual or their representative. The records of health and safety servicing and testing were inspected to check that the home is properly checked and safe. These records provided evidence that servicing and tests are all up to date. We also saw evidence that staff are trained in areas of health and safety. Care Homes for Older People Page 23 of 26 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 24 of 26 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 26 Disposable paper towels should be provided in areas where staff wash their hands such as staff wash areas, the laundry and the kitchen. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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