Care Home: Elderthorpe Residential Home

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What the care home does well The environment is clean, fresh and homely. Staff are very friendly, caring and welcoming. Relatives told us they are always made welcome. People told us, "Staff are very caring." "I get the care and support I need." "The home is always fresh and clean" Staff said " looking after the clients and making it their home for them to live in and to be there for them. " "This home provides a homely environment reassuring the clients that they are safe, cared for by staff members. They are asked what they would like to do and what food they would like. They have plenty of visitors. The home is kept well, clean and well maintained." What has improved since the last inspection? The documentation available to people including service user guide and complaint policy have been improved. This helps people to know what services to expect and what to do if they have any concerns. Medication is now more safely administered from tamper proof sealed cassette boxes. This helps to reduce the risk of people getting the incorrect medication. Staff have had training on nutrition and nutritional risk assessments are in place, to make sure that the home responds appropriately to people`s needs in this area. Risk assessments have been put in place for the building helping to ensure that heath and safety is promoted. A plan for refurbishment is in place. The provider has carried out a risk assessment to make sure that staffing levels reflect the dependency levels of people in the building. New assessments to help assess people`s needs have been put in place. The home has retained its "Investors in People" award demonstrating a commitment to staff training and development. What the care home could do better: Care plans should continue to improve and should be regularly updated with information from reviews and risk assessments. This will help make sure that staff respond to current needs and that people`s care needs are not overlooked. Adult protection training for staff should continue and any incidents should be referred following local safeguarding protocols. This will help make sure that people are kept safe from abuse.Staffing and dependency levels should be kept under review to make sure that there are always enough staff on duty. This will help make sure that people always get the care they need and that their health and safety is protected. The manager should notify the Commission of any events adversely affecting the heath and wellbeing of service users. This will help us make sure that the home is complying with the law and that they are taking appropriate action. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elderthorpe Residential Home 230-232 Bradford Road Shipley Bradford West Yorkshire BD18 3AN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sughra Nazir     Date: 2 3 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Elderthorpe Residential Home 230-232 Bradford Road Shipley Bradford West Yorkshire BD18 3AN 01274583375 01535583374 kevin.driscoll1@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Kevin Driscoll,Mrs Joanne Driscoll care home 16 Number of places (if applicable): Under 65 Over 65 5 16 3 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home 0 0 0 Elderthorpe is a large Victorian house in Shipley. It is not far from local shops and public houses. It is on a main road and well served by major bus routes from Shipley, Bradford, Bingley and Keighley. On road parking is provided at the back of the house and there is a designated parking area on site. The house has been converted to provide residential accommodation and personal care for sixteen people over the age of 65. Nursing care is not provided. Accommodation is provided on the ground and first floors in both double and single rooms. Stair lifts have been provided to the first floor. None of the rooms are en suite, but all have wash hand basins and commodes. There are enough communal toilet and bathing facilities for the number of people living in the home. There is ramp access to Care Homes for Older People Page 4 of 26 Brief description of the care home the home at the rear of the building for people with disabilities. Information about services provided at the home can be found in the Service User Guide. Copies will be provided on request. Current information about fees can be obtained from the home. 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: 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: We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual quality assurance assessment and sent surveys to staff and people living in the home. On an unannounced visit to the home we talked to people, their relatives, staff and the manager. We also checked some of the records, policies and procedures the home has to keep. We concentrated on the key standards and what the outcomes are for people living in the home, as well as issues which were raised at the last inspection. Care Homes for Older People Page 6 of 26 We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: Care plans should continue to improve and should be regularly updated with information from reviews and risk assessments. This will help make sure that staff respond to current needs and that peoples care needs are not overlooked. Adult protection training for staff should continue and any incidents should be referred following local safeguarding protocols. This will help make sure that people are kept safe from abuse. Care Homes for Older People Page 8 of 26 Staffing and dependency levels should be kept under review to make sure that there are always enough staff on duty. This will help make sure that people always get the care they need and that their health and safety is protected. The manager should notify the Commission of any events adversely affecting the heath and wellbeing of service users. This will help us make sure that the home is complying with the law and that they are taking appropriate action. 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 set out 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 9 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need to decide whether the service is right for them. By carrying out a thorough assessment the home makes sure that staff will be able to meet peoples needs. Evidence: Information that tells people about the home and its services has been improved since the last inspection. The documents give clearer information about the services, layout and facilities available. This helps people make an informed decision about whether the home will suit their needs. The files we looked at showed detailed assessments of peoples needs are carried out before people move in. This helps the home make sure that they will be able to provide care to meet those needs. People or their relatives are always involved in the assessment process. Care Homes for Older People Page 11 of 26 Care Homes for Older People Page 12 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. The health and personal care people receive is based on their individual needs. Documentation should continue to improve to ensure needs are not overlooked. The principles of respect dignity and privacy are put into practice. Staff know how to look after people properly because they have detailed information that tells them about peoples abilities and needs. Evidence: Four care plans were looked at during the visit. The care plan format is clear and some plans give staff a detailed picture. We discussed extending care plans to make sure they cover all aspects of care and daily living for example the arrangements for oral care, social and religious needs. We also saw highlighted a couple of examples where the language in care plans could be made more professional. The manager said they are continuing to make improvements in these areas. Files we saw showed that monthly evaluations of peoples needs are carried out. We saw that care plans are not always updated to include information about changed care Care Homes for Older People Page 13 of 26 Evidence: needs as recorded in monthly reviews. Staff should make sure that care plans accurately reflect peoples current care needs. This will help ensure that peoples needs are not overlooked. Annual review reports were seen and it was clear that the person living in the home and their relatives were invited to be part of this process. The home now has a weighing machine that can be used by people who find it hard to stand or use a conventional set of scales. This now helps the home to keep better track of peoples weights and make any required changes to care plans. Staff have now had some training on nutrition and there was good evidence on files that this had been put in practice. We saw nutritional risk assessments and there were risk assessments in place identifying peoples dependency levels, pressure area and moving and handling needs. These assessments should be signed and dated in all cases to help identify when reviews are due. A healthcare professional told us, Residents always seem happy. Plenty of laughing and joking in the home which is good to see. Whether a query about a new resident or a referral the home is always keen to get in touch. The home now uses sealed and tamper proof cassette boxes to administer medication. This reduced the risk of people getting the wrong medication. We checked documents for recording administered medication and these were found to be complete. The home has appropriate policies in place for ordering repeat prescriptions, administration and disposal of medication. We saw that staff treat people with dignity and respect. People receive personal care in private. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have flexible routines and have access to some activities and food that meets their needs. They are supported to keep in contact with family and friends. Evidence: We saw that the home has a warm and friendly atmosphere. We saw that visitors are made welcome and are actively involved in activities and events at the home. There is a weekly activity plan displayed by the main lounge and staff on duty are responsible for making sure it is followed. It includes such things as reading the morning papers, talking about what is happening in the world various games watching films going out for a walk or to one of the local pubs and listening to music. The home has responded to feedback from people and arranged more traditional activities such as knitting and tapestry as well as implementing more sessions from a music for health provider. We saw that music and literature had been purchased for someone from a different background. We saw people and their relatives enjoying an Indian themed event. The home was decorated, staff wore costumes and the lunch served gave people opportunity to try Care Homes for Older People Page 15 of 26 Evidence: food from different cultures. We saw that staff who were not on duty had come in and relatives joined in fully with the event. People told us they really enjoyed the event. We saw a file showing that themed events take place very often and people enjoyed telling us about making Easter bonnets. People are supported to access local facilities such as a nearby public house, park and church facilities. A menu is displayed on the wall and people are asked what they would like to eat. During the visit we saw a buffet lunch served with a number of options. Staff told us that there are always choices available. We saw that people choose whether they eat in their bedrooms, or in the dining room or lounge. We saw a checklist asking staff to provide and record drinks given on an hourly basis. This is excellent practice and helps to make sure people are not at risk of dehydration. Care Homes for Older People Page 16 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 can be confident that their views will be listened to and acted upon. Staff have some training to keep people safe from abuse. Policies and procedures are improving. Evidence: The homes complaints policy has been revised to take account of changed timescales for response. The policy is displayed in the entrance hall. The home has introduced a short easy to understand written message on the inside of the door of persons bedroom telling them very simply how to make a complaint or if they have any concerns. The manager told us that there have been no complaints since the last inspection. Any comments or issues raised by people or their familes are resolved very quickly. We discussed the home keeping a record of any significant family contact so that staff could refer back to these details if necessary. We saw that the home displayed uptodate information about new protection in place to safeguard peoples liberty. Staff receive some training on keeping people safe from abuse as part of their induction. The home has plans to access further training as it becomes available. We saw evidence on staff files of instances where reportable incidents were not referred using the local safeguarding protocols. The provider said that procedures for reporting incidents will be made more robust following the Care Homes for Older People Page 17 of 26 Evidence: inspection. Care Homes for Older People Page 18 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. People receive care in a home that is clean and maintained to keep them safe. Evidence: We saw that the home is clean and tidy and smelt fresh. The building was registered before April 2002 and therefore meets the room size requirements for care homes in operation before this date. People were happy with their rooms. Those seen showed that many of the period features of the house had been kept and that people had brought in some of their own belongings to personalise their rooms. The manager has obtained uptodate information about infection control and advice has been sought from the infection control nurse. As a result the home has colourcoded mops and cloths for use in different rooms to help keep people free from the risk of infection. The home has received a 5 star rating from environmental health confirming that high levels of cleanliness and hygiene are maintained. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive care from well trained staff. There are adequate arrangements to ensure recruitment is safe. Evidence: Following the last inspection a risk assessment was carried out by the provider to make sure that staffing levels take account of the dependency levels, layout of the home and peoples health and safety. The statement of purpose sets out the staffing levels and tells people before they move in that if their needs deteriorate they may have to move to a different home. We wrote to the provider to ask them to clarify the staffing arrangements for nighttime cover. The provider has told us that care will now be provided by one carer with an additional carer on sleepin duty in a flat above the home. There are currently 13 people resident at the home and the provider is aware that they must keep staffing levels under review if dependency levels change. We looked at 4 staff files. These showed that the home is carrying out all required checks to make sure that staff employed are safe to work with vulnerable people. We saw examples that showed gaps in employment history were explored and where necessary alternative or followup references were taken up. The provider told us that Care Homes for Older People Page 20 of 26 Evidence: they are reviewing their recruitment process to introduce measure to promote retention of staff. The manager keeps individual training records for each care worker. These include information about what they have done and what is planned for them to do. Training materials for induction conform to Skills for Care common induction standards. The home makes good use of training in alternative formats such as videos and questionnaires on care of the dying. The home has retained its Investors in People award which demonstrates a commitment to learning and development of staff. Staff told us, I feel I have plenty of training with my employer and have experience and If we have any problems we are free to speak to the manager. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive care in a well managed service offering robust procedures that safeguard their health and safety Evidence: The manager and provider share the role of managing the home. They have a clear understanding of each others responsibilities. strengths and areas for development. Both demonstrate a commitment to providing good quality care. The home has a residents charter which sets out peoples rights and expectations. Staff are required to sign and agree its contents. This is excellent practice. Information from the home stated that peoples finances are safeguarded by offering a lockable storage area. In addition records are kept of any money held on peoples behalf. Risk assessments of the environment have now been carried out and are regularly Care Homes for Older People Page 22 of 26 Evidence: updated. Information provided by the manager confirmed that all policies and procedures are in place. Safety checks are maintained and records kept. Guidance on submitting notifications to the Commission was shared with the provider. This will help us to make sure that the service is responding appropriately to any issues that arise. 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 7 Care plans should be improved to make sure they cover all aspects of peoples needs. Any changes noted in monthly evaluations or needs identified to meet identified risks should be recorded in care plans. This will help staff ensure that needs are not overlooked. The manager should make sure that staff continue to receive training on keeping people safe from abuse. Any concerns or incidents should be reported using local safeguarding protocols. This will help make sure that the home takes the right action to keep people safe from abuse. Staffing levels and peoples dependency levels should be kept under review to make sure that there are always enough staff on duty. The manager should make sure that notifications are submitted to the Commission of any events that adversely affect the health or well being of people living at the home. This will help us make sure that the home is is complying with the law and taking appropriate action to address any issues. 2 18 3 27 4 37 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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. 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