Care Home: Elderwood Residential Home

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What the care home does well The home provides a good range of information to people thinking of coming to the home, so they can make an informed decision. The home makes a full assessment of a person`s needs before deciding if it can meet all those needs. The home draws up plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. Service users say that staff treat them well and treat them with respect. The staff are working hard to provide a stimulating atmosphere in the home, with appropriate social activities for service users. Service users are encouraged to keep in regular contact with family and friends. Service users are also encouraged to take as much control over their own lives as they are able, and make their own decisions. Service users were very complimentary about the food, and there is a balanced diet, with service users choice included. Complaints and concerns are taken seriously and are responded to properly. The home is kept clean and hygienic and free from odours. The home has enough staff to meet the needs of service users. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is very experienced and is providing positive leadership to the home. The home is being run in the best interests of the service users. Service users finances are protected by the home`s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home`s policies and systems. What has improved since the last inspection? The requirements from the last inspection visit have been met. Several areas within the home have been decorated, and several bedrooms have been refurbished to a high standard.Following a recent health and safety audit carried out by Darlington Borough Council, it was recommended that the home improve their system for daily recordings of service user`s needs. This has now been implemented. What the care home could do better: For some staff, the in-house fire training had lapsed. To maintain the health and safety of the service users and staff, it is essential that in-house fire training is kept up to date for all staff. The manager agreed to address this matter immediately. The manager said that the flooring in the kitchen and the laundry will be replaced soon. On completion she agreed to inform CQC. Key inspection report Care homes for older people Name: Address: Elderwood Residential Home Westmoreland Street Darlington Durham DL3 0FB     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: Jim Lamb     Date: 0 4 0 1 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 28 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 28 Information about the care home Name of care home: Address: Elderwood Residential Home Westmoreland Street Darlington Durham DL3 0FB 01325368256 01325350801 christine.papprill@anchor.org.uk www.anchor.org.uk Anchor Trust care home 40 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) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category 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 category: Old age, not falling within any other category - Code OP, maximum number of places: 40 Date of last inspection Brief description of the care home Elderwood is a care home providing personal care and accommodation for up to 40 older people. The home is one of a number of homes, throughout the country, run by the Anchor Trust. Elderwood is situated off North Road in Darlington. It is a two-storey building, which was purpose built in 1991. The home is accessible throughout and there is a passenger lift between floors. All bedrooms are for single occupancy and have en-suite facilities. There is a dining room and a lounge on each floor. The home also has a garden room. Care Homes for Older People Page 4 of 28 Over 65 40 0 1 6 0 1 2 0 0 9 Brief description of the care home Bath / shower rooms and separate WCs are also provided throughout the home. The weekly fees charged by the home are £431. Additional charges are made for hairdressing, newspapers, private chiropody and toiletries. Care Homes for Older People Page 5 of 28 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 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. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of Care Homes for Older People Page 6 of 28 people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, relatives, staff, the manager, and visitors, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable,and checked what improvements had been made since the last visit. We told the manager/provider what we found. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? The requirements from the last inspection visit have been met. Several areas within the home have been decorated, and several bedrooms have been refurbished to a high standard. Care Homes for Older People Page 8 of 28 Following a recent health and safety audit carried out by Darlington Borough Council, it was recommended that the home improve their system for daily recordings of service users needs. This has now been implemented. 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 9 of 28 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 28 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. Prospective service users are properly assessed prior to admission to the home. All are provided with information about the service, and this helps them to make a choice about where they want to live. Evidence: The homes Statement of Purpose and Service User Guide have been updated. These guides contained all of the information that is required to enable people to make an informed choice about where to live. Evidence was seen in service users files that service users or their representatives had signed a contract. The contracts were detailed and included a breakdown of the fees and who was responsible for paying them. The manager confirmed that visits to prospective service users takes place before their admission to the home, to carry out an assessment of needs. Four care plans examined contained notes from assessments made on these visits. Also, each service users care plans contained assessments from the placing authority that were responsible for commissioning the service users care at the home. Care Homes for Older People Page 11 of 28 Evidence: The home does not provide intermediate care Care Homes for Older People Page 12 of 28 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 care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: Each service user has his or her assessed needs met by an individual care plan. There was a good match between identified needs (including risk assessments) and corresponding care plans. Care plans are comprehensive, detailed and holistic, in that they cover social, spiritual and emotional needs, as well as their physical needs. In one example seen, staff had accurately identified that an individuals interests included gardening and cooking, and the care plan included helping the service user to access all these. Each service user has a monthly re-evaluation of the care plans, to make sure they are still up to date and relevant. A thorough assessment of the physical health needs of each person takes place Care Homes for Older People Page 13 of 28 Evidence: before/on admission, and monthly, thereafter. One service user who is prone to falls did have a detailed moving and handling assessment completed. Another service user who needs lots of encouragement to eat had a very detailed nutritional assessment completed. risk assessments were detailed and comprehensive about service users health and social care needs, providing clear guidance to staff. They were subject to regular review and evaluation, involving service users, relatives and social workers where appropriate. All service users nutritional needs are routinely assessed. Care plans cover all assessed needs, including health care needs. Mental health needs are assessed as part of the overall dependency assessments, more detailed assessments would be carried out by mental health workers, where necessary. All visits to and from health professionals are clearly recorded in the care record. There was evidence of the full range of community health professionals, as well as specialist referrals, as needed. Each service users weight is recorded monthly, and action taken where there is significant weight loss/gain. The home uses the monitored dosage system for its medications. The Medication Administration Records (MAR) was being well completed, with no blank entries. All senior staff have had training on how to use the medication system. They have also had external Safe Handling of Medicines training. Each persons section in the MAR has a photograph of the person, to make sure that the right medicines are being given out. All personal care and medical examination/treatment is carried out in private. Plans have been approved to relocate the medication storage to a large spacious room on the first floor. Service users confirmed that they are treated with respect at all times and have their Care Homes for Older People Page 14 of 28 Evidence: privacy respected by the staff. Staff were seen to treat service users with respect and kindness. One service user said,The staff are very good, nothing is to much for them. This is a lovely place and i am very happy here. Another said,I have been here for 3 months months, and i have settled in very well, the staff are very helpful and kind to me. Care Homes for Older People Page 15 of 28 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. The service users are offered a good quality lifestyle, which includes social contact, and activities. Evidence: There is a relaxed, informal and friendly atmosphere in the home. Routines are flexible and allow the people living at the home to make decisions about everyday things such as when to rise and retire to bed. Care plans and conversation with service users showed how people are encouraged and supported to be as independent as possible, subject to their individual plan and risk assessments. Meals are served at set times although there is a great deal of flexibility to suit individual needs and wishes. Records of food served show a varied and balanced diet is provided with alternatives always being available should someone wish not to have the dish of the day. People living in the home said the food is very good, they said they were often consulted about menus. People living in the home are encouraged and supported to lead meaningful and stimulating lives and are offered a range of activities: bingo. board games, film nights, handicrafts, gardening, trips out e.g. shopping and visits to local places of interests. Care Homes for Older People Page 16 of 28 Evidence: The service users make good use of the landscaped gardens, there are sitting areas that are frequently used during the summer months. Photographs of events and outing are displayed throughout the home. The views of people living in the home are sought on a daily basis through informal conversation and at regular service users meetings, during which people are consulted about the general running of the home, and suggestions for improvements are sought. Service users told the inspector they are happy living here and commented about the friendly and homely atmosphere. They made many very positive comments about the staff and said they were always helpful and kind. Local clergy visit so that people living in the home can take part in an act of religious worship if they wish. Two visitors spoke to the inspector: each made very positive comments about the home and expressed satisfaction with the way that their relative was being cared for. Care Homes for Older People Page 17 of 28 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. The complaints management is effective, and this results in the service users being protected from harm and abuse. Evidence: Information about complaints is displayed on notice boards around the home and in the homes Statement of Purpose and Service Users Guide. The people spoken to by the inspector confirmed they were aware of how to raise any concerns or complaints. Although nobody spoken to had any cause for complaint, all expressed confidence that any complaints they might have would be taken seriously. Service users and families views are obtained through regular contact and an open door policy. Service users / Family Meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. Staff meetings are also held. One person spoken to said, Ive never had to make a complaint, but if there is a problem I speak to the staff or the manager. Another person said, If anything is wrong they sort it out for me. The organisations policy and procedure documents relating to adult protection provide information and guidance to staff. A copy of Durham & Darlington Adult Protection Committees Inter-Agency Adult Protection Policy & Procedures on abuse and the Care Homes for Older People Page 18 of 28 Evidence: protection of vulnerable adults is available in the home. The home also has a copy of the Department of Healths NO SECRETS. Additional staff training about abuse and the protection of vulnerable adults has taken place for all staff staff during the last 12 months. Care Homes for Older People Page 19 of 28 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. The home provides a comfortable and safe environment for those living there. Evidence: The premises maintain a very pleasant and homely atmosphere. All parts of the building seen were very clean and suitably equipped. The communal areas have been decorated with attractive wallpaper, and this makes these areas appear more homely and attractive. There is an ongoing programme of decoration and refurbishment and several bedrooms have been refurbished to a high standard. There is lots of photographs of recent events art work displayed around the home. There are plans to create a reminiscence lounge, and service users and their relatives will be involved in its design. The management team intend to implement orientation boards and improved signage throughout the home, the latter will help service users to find there way around the home more easily. Care Homes for Older People Page 20 of 28 Evidence: The home is also considering memory lane boxs, these will be located outside each persons bedroom door and will be unique to each individual, and again, these will help service users to identify their own bedrooms more easily. The grounds are well maintained and are used regularly by service users. A number of service users spoke positively about their bedrooms and the accommodation in general. Overall, this is a highly attractive environment that provides a very comfortable and safe place for service users. The home has policies and procedures on hygiene and control of infection. Staff receive infection control training. There is suitable hand washing facilities throughout the building. Disposable gloves and aprons are provided for staff use. Arrangements are in place to dispose of clinical waste. Care Homes for Older People Page 21 of 28 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. There is enough staff employed, and appropriately trained to meet the needs of service users and safeguard their welfare. Evidence: The home currently has 25 service users. There are enough staff employed to meet the service users needs. In addition to the manager and the deputy manager, there is 1 senior and 3 care staff from 8am to 8pm From 8pm to 8am there is 1 senior and 2 care staff on duty. The personnel records of four staff were examined. All four had completed application forms, the dates of employment were clear, making it easy to follow a clear employment audit trail. The manager also completes an audit check list and this ensures that all the necessary checks have been completed prior to commencing employment. All had the required two work references, (crb) criminal record bureau check, documentary evidence of identity, induction and training and development information. The manager confirmed that, if there are any concerns about the content of a CRB Care Homes for Older People Page 22 of 28 Evidence: disclosure, these are discussed with her area manager. The organisation employs a training and development officer, and all staff have an annual training matrix drawn up, this covers all mandatory training needs, and other core training needs, such as control of infection and Adult Protection. Individual staff members have his or her individual training needs analysis on their personal file. These have recently been revised to cover developmental as well as mandatory and core training. The manager said that, mental capacity and deprivation of liberty training will be arranged during the next 12 months. It was noted that the in-house fire training had lapsed for some staff, the manager agreed to address this immediately. Care Homes for Older People Page 23 of 28 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. The management arrangements are working well, and the service continues to improve outcomes for service users. Evidence: The registered manager has the required qualifications and experience to run the home. There is a range of quality systems in the home. There is an annual survey of the views of the service users and their families. The findings are collated and an action plan drawn up to address any areas of concern. The home also has a detailed business plan in place. There are also regular meetings held with both the service user groups and with the staff group. These are minuted and action points listed. Care Homes for Older People Page 24 of 28 Evidence: Both individual and central supervision records were studied. These records show an appropriate bi-monthly pattern of supervision, with an annual work performance appraisal. All staff receive annual health and safety training. This is good practice. Checks of the fire log book showed that all the required checks and tests of equipment and systems take place at the proper intervals, However some in-house fire safety training needed to be updated for some staff. The homes accident book is kept up to date and information is fully recorded. Each accident is reviewed after 24 hours to check the outcomes of the accident and any treatment given. There is a monthly audit of accidents, and a detailed audit of all falls. Servicing and maintenance records are comprehensive and well maintained. Care Homes for Older People Page 25 of 28 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 26 of 28 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 30 The manager must ensure that all staff receive in-house fire training within the required timescales : six months for day staff, and three months for night staff. This will ensure that all staff are fully competent in all aspects of fire procedure, and maintain a safe environment for service users. Care Homes for Older People Page 27 of 28 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 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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