Care Home: Elgin Lodge

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What the care home does well Elgin Lodge provides a homelike, calm and welcoming atmosphere for people that live there. People that live at Elgin Lodge are encouraged to live their own lifestyles and make decisions about what they do. People that lived at Elgin Lodge said they liked living their and that staff were warm and friendly. Comments received were, "This has been the happiest place I have ever lived in. I could see myself living here for many years or growing old here. The staff are really supportive". Other comments received were, "Living here is really nice. I decide what I do with my day and come and go as I please". Care staff practises were seen to be good with staff relating well to people that lived at the home so were treated with dignity and respect. Staff encouraged people to make decisions about helping around the home or joining in activities. The people that lived at Elgin Lodge were comfortable living in their home and were experiencing a comfortable quality of life. People that lived there were seen to come and go as they pleased throughout the visit. The owner had a commitment to staff training and staff said training was varied and good so staff were competently trained to meet the needs of people living at Elgin Lodge. The manager of Elgin Lodge was experienced and had a relaxed way in which she did her job. People that lived at Elgin Lodge said the manager was a good listener and knew what to do if they were unwell. People that lived at Elgin Lodge said they felt confident they could talk to the staff if things were bothering them. People that live at Elgin Lodge have access and support from health professionals so their health is looked after. What has improved since the last inspection? The manager has introduced safer arrangements for people that live at Elgin Lodge to have their personal money accounted safely for them so they know how much they have in safe keeping. The home is now a smoke free living place so people that live at Elgin Lodge have to smoke outside. The wall at the back of the house has been repaired so is safe. What the care home could do better: Improve the care plans of people that live at Elgin Lodge so they include information on their personal and lifestyle routines and details for staff on how agreements and choices are decided so staff are aware of how to support and encourage their independence and take control of their lives. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Elgin Lodge 25 Elgin Drive Wallasey Wirral CH45 7PP     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: Anthony Cliffe     Date: 1 3 0 1 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. the things that people have said are important to them: They reflect 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 30 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Elgin Lodge 25 Elgin Drive Wallasey Wirral CH45 7PP 01516393074 F/P01516393074 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jane Richardson Type of registration: Number of places registered: Pinpoint Developments Limited care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: 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 categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 8 Date of last inspection Brief description of the care home Elgin Lodge is registered to provide personal care, support and accommodation for eight adults with a mental disorder. Bedrooms are situated on two floors and comprise of six single and one shared bedroom. Four of the bedrooms have en suite facilities and several rooms have views across the river Mersey. The home is a two storey detached property set in a residential part of the Wirral on New Brighton promenade. The home is within a five-minute drive of Liscard town centre, which has a good selection of shops, banks and a post office. A local bus service is within easy reach of Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 8 Brief description of the care home the home. Information about the home can be obtained directly from the home or by contacting the manager. The fee for staying at Elgin Lodge is 365 pounds per week. Care Homes for Adults (18-65 years) Page 5 of 30 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: References to we or us represent the Commission for Social care Inspection. This unannounced visit took place on the 13th January 2009 and lasted over seven hours. One inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Some weeks before the visit the manager was asked to complete a questionnaire called an Annual Quality Assurance Assessment (AQAA) telling us what they thought they did well, what they needed to do better and what they had improved upon since the last visit, to provide up to date information about the service provided. This helps us to determine if the management of the home see the service they Care Homes for Adults (18-65 years) Page 6 of 30 provide in the same way we do and if our judgements are consitent with home owners or managers. We provided questionnaires for people that use services, staff employed at the home and social and health care professionals involved in their care to find out their views about the service the home provides. During the visit various records and the premises were looked at. People that use services were spoken with and gave their views about the service. We also received questionnaires from staff that said the home had good recruitment procedures and staff received good support and training. In March 2008 we did an annual service review of the home, which told us the home was still providing a good service but had also made further improvements. An annual service review is a summary of our knowledge about how a service that has not had a visit in the last year. It is also how we decide if a service is still as good as we thought it was since the last visit or annual service review. 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 set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 30 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Information is provided for people that use services and gathered about their needs so they can decide if Elgin Lodge is suitable to meet their needs. Evidence: Information about Elgin Lodge was available to people that use services. The information available was called the services users guide and statement of purpose. This was available with the report of the last visit we did and some information the manager had provided on local amenities and services such as doctors, dentist and the library. The information available told people that use services about the arrangements for their care and the facilities and services available in the home so they knew what the costs of their care covered and if the home could meet their needs. The information was available to anyone that wanted to live there and could be requested from the manager or owner. The information could be made available on request in different ways such as large print. The home had arrangements in place so people that may want to live there could be Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: provided with information and an opportunity to look around the home. This was called the admission criteria. People that may want to live at Elgin Lodge would usually be recommended by a psychiatrist, social worker or community nurse. The person making the recommendation for someone to live there will usually complete forms called a care assessment and the manager from Elgin Lodge will also visit them to ask questions and gather information about their needs so they can decide if the person was suitable to live at Elgin Lodge. Moving in usually involved people that may want to live at Elgin Lodge visiting the home to get to know the other people that lived there to see if they developed relationships so they could live together. Before the visit six people that live at Elgin Lodge sent surveys to us and four said they received information before they moved in. No one had moved into Elgin Lodge in the last two years so we were not able to look at this information. We were able to look at the documents that the home used to gather information on people that use services. This told us that the home gathered information about keeping people safe, managing finances, mental, physical and psychological health, social care, housing needs and decision making. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 that use services are encouraged to make decisions and take healthy risks about their lifestyles but further improvements are needed in how information about them is used so decisions about their lifestyle choices are, understood, acknowledged and supported. Evidence: Before the visit took place the manager provided us with information in the AQAA on how people that use services were asked about how they wanted their care to be arranged and how they were involved in their care and support. The AQAA said that people that use services were appointed a key worker who helped them draw up a care plan. We examined the care plans of two people that use services. Information was obtained about their lives so staff had information about them their needs, and lives before they moved into the home. We could see the home had gathered a lot of information on Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: people that use services. The information included copies of the local Primary Care Trust care programme, a system of support provided by the local Primary Care Trust mental health services to support people with long term mental health needs. The care plans seen and conversations with people that use services and staff demonstrated that the health and personal care needs of people that use services were met and their privacy and dignity respected. The information the home had about people that use services contained details of their needs, routines and lifestyle choices. Care plans written by the home we examined did not reflect the level of information that had been gathered about people that use services. Care plans contained important information about their needs and this showed that philosophy of the home was to provide care and support to people that use services in a person centred way but their care plans were not written in a person centred way so did not reflect the personalisation of their care as they did not contain information about how people liked their support to be arranged, what level of support they needed and how they liked to be supported. Person centred planning is a really good way for people to take control over their lives. Person centred thinking helps staff that care and support people that use services to listen to them and get what they need and want. A person centred plan contains information on what is positive about people that use services. For example what people like and admire about them and their gifts and talents. Information should be included about who and what is important to people that use services from their view point, as well as what people want for the future. A person centred plan should have information about how people that use services want to be supported to stay healthy, safe and well. This is called a support plan and should be detailed enough to provide a living description of how people want to be supported, how they make decisions and says who will do what by when. For example if someone needed help with personal care but could otherwise care for them self or is someone lacked motivation to care for them self then how did staff support the person. We could see that people that use services were involved in creating their care plans as they signed to agree to the information contained in them so knew what was written about them but we could not see if people that use services had contributed to what was written about them or if they agreed with the things that were written. There was some information about how people made decisions but no information about their capacity to make decisions or if decisions they made were safe or not and how these were respected and supported. For example decisions that may not contribute to them remaining healthy. We saw information in the care plans of people that use services that provided Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: information on keeping them safe. The information provided staff with a description of the type of things to look out for that indicated the mental health needs of people that use services was deteriorating. The information provided staff with clear guidance on what to look out for so they could recognise if someones mental health was deteriorating so they could take action early so they could ensure the person received the right support or treatment. The manager and staff had worked at the home for a significant number of years so had positive relationships with people that use services. people that use services described the home as like living with a family. The manager was able to provide good examples of how staff supported people that use services to maintain a healthy lifestyle while respecting their decisions to take risk that may impact upon their health so supported people to take risks of their choice. People that use services were positive about the relationships they have with one another and the support they received from the staff team. In discussion they said that were able to manage their own money and keep their and take their own medicines. People that use services said they could have meetings to talk about how the home was managed but said they did not always want to have them. Care Homes for Adults (18-65 years) Page 15 of 30 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 that use services are supported to maintain personal relationships and make choices about their lifestyle and leisure activities so they have control over their lives. Evidence: The care plans of people that use services contained information on what support they needed so staff could provide help when required. For example in maintaining a level of independence by doing their own laundry, keeping their bedrooms tidy, helping with household chores, making a snack and choosing their daily routines. People that used services gave examples of the things they decided to do such as they went out alone or with support from staff when needed into the local town, to the library, pub and for walks. People that use services said they made decisions about when they got up and went to bed, helped in preparing meals, tidying the home, maintaining the garden area, doing their laundry, writing shopping lists and going for the shopping with staff. Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: People that use services said that they were able to maintain family relationships and go to see their families or they visited them at the home. People that use services were seen to pursue their own daily interests and could choose to spend time with one another or in privacy. They said they could pursue their own leisure activities and use community based resources. Some of the people that use services use a national mental health charity for support and this offers a support centre in the community. Care plans contained details of the interests and hobbies of people that use services as well as support they received from professionals to help them understand their mental health problems and find ways to manage their mental health by developing their confidence. People that use services could have one to one activities or join in activities based in the home so had a choice of how they spent their leisure time. Some activities take place daily as they are enjoyed by everyone. For example people that use services enjoyed doing a word game and crossword everyday with the staff. Otherwise weekly activities in the home are planned from the guide. The guide included exercise and relaxation. People that use services were provided with information about local events and said they went to the local pub and liked to sit out in the homes garden area and look out over the river Mersey. Surveys returned to us before the visit by people that use services said that the always chose what to during the day, evening and at weekends and staff always listened to them and acted on what they said. We shared a meal with people that use services. Everyone said they enjoyed the meal which was a hot light meal. People that use services helped set the tables, prepare the meal and wash the dishes. They helped themselves to a dessert. One person that used services likes to make drinks for people that use services, staff and visitors. There were drinks making facilities for people that use services in the main lounge area. There was a menu displayed for all to see what choices were available. The menu is changed every four weeks so the preferences of people that use services are included. The kitchen contains information on the types of food that people preferred or disliked. A staff member was responsible for changing the menu with people that use services so their preferences were included into it. The menu included a variety of choices for breakfast and cooked breakfast at weekends. People that use services prepare their own breakfast. Care staff were responsible for cooking meals and were helped by people that use services. Care Homes for Adults (18-65 years) Page 17 of 30 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 that use services personal, physical and emotional needs were met. The policies and procedures in the home for medicine administration were followed so people that use services were supported to take their medicines safely. Evidence: We could see that the preferences of people that use services were central to the homes philosophy and this was reflected in the attitude and approach of staff to people living at Elgin Lodge. Care records of people that use services included details of the health and social care professionals involved in their care and the level of contact and support they received from them. Care plans, risk assessments and daily records showed that staff acted on recommendations from professionals and kept in touch with them when necessary so they were aware of the changing needs of people that use services. The manager demonstrated the homes commitment to working with health and social care professionals by talking about how they had supported people that use services to take risks and make decisions about their lives which may not support a healthy lifestyle Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: but had supported them to have stability in their mental health. This included supporting people to take responsibility for their medicines and alcohol consumption. People that use services had been supported to attend training on their health conditions so could take responsibility for their actions in maintaining good health. The home had a designated person to order, return and monitor medicines. Clear records were maintained. medication policies and procedures were in place so staff had guidance on their responsibilities for supporting people to manage their medicines or be able to or manage it correctly for them. Medication storage facilities were available for people that use services to keep their own medicines securely so it was stored safely. The storage area contained the policies for medicine administration and specimen signatures for the staff responsible for the management and administration of medicines so staff were aware of their responsibility and accountability for managing and administering medicines. We looked at the arrangements for the ordering, receipt, administration and disposal of medicines and found no errors so people that use services received their medicines safely. Care Homes for Adults (18-65 years) Page 19 of 30 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 that use services are protected by the complaints and safeguarding procedures in place so they can be confident their concerns will be listened to and acted upon and they will be protected from neglect or abuse. Evidence: A copy of the homes complaints procedure was available to people that use services displayed in the main hallway so they had access to it. The complaints procedure was discussed with people that use services and they said they knew how to use it and if unhappy were confident enough to talk to staff and were sure their complaints would be dealt with. There had been no complaints received by the home since the last visit and we had not received any either. Surveys returned by people that use services said they knew who to speak to if they had concerns and knew how to use the complaints procedure. Staff had completed training in safeguarding adults In 2006, 2007 and 2008. the manager confirmed that further training will be taking place in the near future. A staff member on duty at the time of the visit said he had safeguarding adults training in 2007 and the manager had discussed further training. He said despite the staff team being a small one with no turnover staff took safeguarding seriously. He said that he did regular sleep in shifts and if he needed he had contact numbers for Wirral Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: safeguarding adults team. All staff had access to the same information so staff knew who to contact if they wanted to report suspicions of neglect or abuse. No staff had been recruited since 2004. The manager said she was looking into all staff having a Criminal Records Bureau (CRB) disclosure repeated and was to check the CRB guidance on how often these should be done. All staff had CRB checks completed. Staff had received training in dealing with aggressive behaviour so knew how to respond to people that were angry and distressed. People that use services said the home was a nice place to live and everyone got on well together. No safeguarding referrals were made to the local council in the last twelve months. The safeguarding procedure is how the local council and other agencies involved respond to and manage allegations of neglect or abuse against vulnerable adults. People that use services managed their own monies where possible. Some people that use services needed support to manage their own monies. We checked the records of how monies were handled between people that use services and staff. The home had clear records to account for any monies held on behalf of people that use services. Records showed when monies were paid in and and taken out and where monies had been received from. People that used services signed for any monies received and taken out and this was witnessed by staff so the accounting of monies was safe. Care Homes for Adults (18-65 years) Page 21 of 30 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 that use services live in a safe comfortable and well maintained home, which is equipped to meet their needs. Evidence: We looked around the building and found it to be comfortable and homelike. The ground floor is one large lounge/dining room. There is access to the kitchen from the lounge and toilets and bathing facilities are also located on the ground floor. The bedrooms of people that use services are located on both the ground and first floor. On the first floor is a quiet room which is also used as a sleep in bedroom by staff. We saw some of the bedrooms of people that use services and these looked comfortable and contained their own furniture and possessions so were personalised to their own choice. The building was well maintained with an ongoing programme of redecoration. There is a handyman employed who works at the home each week. Since the last visit an external boundary wall had bee repaired as required. People that use services no longer smoke in the building so the environment is more healthy and comfortable for them. The manager agreed to decorate a ground floor toilet with bathroom that had no privacy curtain on the window and where the decor looked bland so people that use services had a more comfortable private bathing facility. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: There were sufficient domestic staff employed and health, hygiene and safety practises in place to keep the home clean so people that use services lived in a clean and safe home. Before the visit people that use services returned surveys and said their home was always fresh and clean. Care Homes for Adults (18-65 years) Page 23 of 30 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 recruitment and training programme provides a competent staff team so people that use services are protected and in safe hands at all times. Evidence: Throughout the visit we saw warm and friendly relationships between people that use services. Staff related to people that use services in a warm professional way so treated them with dignity and respect. Staff had been provided with training on equality and diversity, mental health awareness, managing challenging behaviour, safeguarding adults, medication management, food hgiene, fire safety, infection control and first aid so people that use services were supported by a competent staff team. Staff had not had training in how to support and respond to the negative effects of the mental health of people that use services which effected their ability to be motivated to do things socially or care for themselves so could not always support and motivate them. The manager agreed to talk to the professionals involved in the care of people that use services to see if staff could have access to the training the mental health services provided to its own staff, so staff at Elgin Lodge so staff could support people Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: that use services to deal with the negative effects of their mental health needs. Surveys returned by staff working at the home said they were given up to date nformation about the people they support, received a good induction and received training relevant to their role. Surveys returned by staff said sufficient staff were available to meet the needs of people that use the service and they know what to do if people that use services raise concerns so could respond to any concerns raised and take appropriate action. The home had experienced staff who have worked at the home for many years. All staff were recruited following a thorough recruitment process including references being checked and CRB disclosure being completed. There had been no staff recruited since the last visit so we could not look at the homes recruitment and selection procedures. Staff turnover was low so people that use services received consistent care and support. There were nine care staff employed. Four of these held both NVQ level 2 and 3 and three qualifications a recognised qualification in social care and other staff held an NVQ level 2 so people that use services were supported by a skilled staff team. Not all staff wished to complete an NVQ level 2 qualification. Staff receive supervision but not at the recommended six supervisions per year. Staff spoken with said they always had time to speak to the manager about how they did their jobs, training and supporting people that use services so had opportunities to discuss their performance. Staff said the manager had an open door policy and being a small staff team communication always worked well. Staff meetings were held at least every two months and discussed how staff supported people that use services, review of activities, staff involvement in activities and infection control so staff had opportunities to discuss the management of the home. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 is well managed, organised and run in the best interests of people that use services so their welfare and safety is promoted and protected. Evidence: The manager had been managing the home for thirteen years. The home was well managed in the best interest of people that use services. The manager and staff were constantly seen to include people in daily decisions about how the home was managed so they were included in how the home was run. During the visit the manager demonstrated her experience and skill of managing the home and was knowledgeable about the people that lived at Elgin Lodge. People that use services have the opportunity to have meetings about how the home is managed and when meetings take place is decided by them so they are able to take part in meetings if they wish. Monthly meetings to discuss the activities in and outside of the home generally took place for people that use services so they had opportunities to discuss their leisure interests. Minutes of the meetings were taken and provided for Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: people that use services. Each month someone who represents the owner visits the home to check the home is being managed, to talk to people that use services and staff and to look at important records so the owner is confident the home is managed responsibly. The home has many policies and procedures and these were revised in 2008. Policies and procedures were in place to make sure that safe working practises were used in the home so people that use services lived in a safe environment. Each month the manager checks the health and safety of the buildings and fire equipment was checked on a regular basis. The manager maintains checks on the quality of the care provided and maintenance of the building. An external organisation did an audit of the home in 2008 as part on a quality assurance system. The manager was described as transparent in her approach to managing the home and good at communicating with people. The manager was responsible for policies and procedures being followed. The manager said the owner provided the necessary finances and resources for the manager to operate the home to a good standard. People that use services said the manager was good at listening to things that concerned them as were all the staff. A person that used services said the home was like a hotel and another said This has been the happiest place I have ever lived in. I could see myself living here for years or growing old here. The staff are really supportive. I was unwell a few years ago and they helped me through it. Care Homes for Adults (18-65 years) Page 27 of 30 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 Adults (18-65 years) Page 28 of 30 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 6 The care plans of people that live at Elgin Lodge should include information on their personal and lifestyle routines and details for staff on how agreements and choices are decided so staff are aware of how to support and encourage their indpendence and take control of their lives. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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