Care Home: Elizabeth Road Nursing Home

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What the care home does well The home has a good staff team who work well together to ensure that the lifestyles of the people living in the home are maximized. Residents were observed enjoying excellent interaction with staff and staff advised that they are trained and supported to provide person centered care based on the wishes ,choices and capabilities of each resident. Staff said the manager "manages well" and they feel supported by her management style. Comments included: " The manager provides us with motivation to carry a very high standard of care" "the manager is supportive and we know we can always spoken with her at any time for advice" Staff training records show that training is an ongoing process of the home. Assessments and care plans are clear and identify the levels of care and support necessary and how that will be carried out. What has improved since the last inspection? The manager has reviewed the policies and procedures and has amended them where necessary. Staff training is an ongoing process and staff advised that the manager encourages them to develop their skills and attend not only mandatory training but also training in specific areas of their choice. What the care home could do better: The medication records did not accurately reflect the amount of medication stored in the home. All medication records must be accurate to ensure the safety and wellbeing of the people living in the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Elizabeth Road Nursing Home 45 Elizabeth Road Huyton Liverpool Merseyside L36 0TG     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: Lynn Paterson     Date: 2 4 1 1 2 0 0 8 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 27 Information about the care home Name of care home: Address: Elizabeth Road Nursing Home 45 Elizabeth Road Huyton Liverpool Merseyside L36 0TG 01514430732 01514430732 elizabethroad@c-i-c.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Community Integrated Care care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Service users to include up to 5 LD Date of last inspection Brief description of the care home Elizabeth Road is a bungalow providing accommodation & nursing care for up to 5 adults with a learning disability. The service is provided by Community Integrated Care (CIC), a voluntary organisation and is managed by Ms Geraldine Atkinson, a qualified nurse. The home is located in a residential estate, in Huyton. As a bungalow, all accommodation is located on one level. There is a private garden to the rear of the bungalow. Shops are a short distance by transport, along with leisure and community facilities. Buses and other transport serve the area and Liverpool/Merseyside is accessible. On street parking is available for visitors. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 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: Quality rating for this service is two star. This means the people who use the service experience good quality outcomes. An unannounced visit was made to the home on 24th November 2008 as part of the inspection process. During the visit care files, daily records and polices and procedures were looked at. Discussion were held with the manager and staff and observations made of tier interactions with the people living in the home. Before the inspection took place the home manager was asked to complete an annual quality assurance assessment (AQAA) to provide up to date information abut the service.Questionnaires were also provided for staff and people using the service and /or their representatives to find out their views about the way the home was run. Care Homes for Adults (18-65 years) Page 5 of 27 All information gained from the above methods were used to formulate this report. 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. 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 7 of 27 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 8 of 27 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. The assessment and admission procedures used by the home ensure that people have the information to choose a home that will meet their needs. Evidence: Record show that one person has been admitted to the home since the last inspection. Care files showed that the process of assessing and admitting this person had been through and had been carried out as per the companies policies and procedures. Records detailed that an assessment visit had been made to assess needs prior to a placement being offered and all relevant documentation had been provided to the prospective resident and his/her family to enable them to make a decision if this would be a suitable place for him/her to live. All documentation about the service were provided in easy read format to include pictures and large print. The assessment documentation held on file showed that all people who were involved with he care and support of the individual were involved in completing the assessment to include input from social workers, nursing staff and family and friends. Staff said that the other People living in the home were also asked for their input as to how they Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: felt about the individual sharing their home. Staff said that part of the assessment practice is to invite people to the home prior to them making a decision about their future, however records show that the most recent placement did not include this action due to home/hospital circumstances. Care Homes for Adults (18-65 years) Page 10 of 27 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. Staff drawn up person centered plans with the people living in the home so that they have full information to enable people to live independent and full lives. Evidence: Care plans were in place for the five people living in the home and identified that all the information gained prior to their admission to the home had been transferred to the care plan. Documentation shows that this information was added to as an ongoing process ,on some occasions on a daily basis if required to build up a picture of the person and how best they could maximize their lives. The care plans were fully person centered centered which means that all information about he person is detailed on file to include advice for staff on how to effectively communicate with residents, how best to manage any challenging behaviors and how to maintain their Two care plans picked at random were examined in detail and showed that staff record everything they can about the person living in the home to include what they like and dislike, what their interests are, how they want to live their lives and what support they require to make Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: sure they are safe but have full choice and control ab out their daily living. Staff said that although only one of the five people living in the home can enjoy verbal communication, staff have developed an excellent understanding of non verbal communications to include facial expressions, body language,gestures,pictures and general mood. Staff were observed effectively communicating with the residents in many different ways and enabling them to have full choice and control of their daily lives. Care Homes for Adults (18-65 years) Page 12 of 27 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. Staff support residents to live healthy and active lifestyles. Evidence: Activities are arranged as per the mood of the day and the home do not have a Pre arranged program of activities. Staff said that they have an activities plan that identifies the range of activities available and people living in the home can choose what they want to do each day according to their mood and capabilities.Records revalued that the activities which take place include art work, games such as monopoly, reading, staff reading newspapers to residents,bowling, going out for meals to restaurants and pubs and visits to the cinema. Other records show that the People living in the home receive visits from family and friends and neighbor -hood wardens call in to see them as does the local Chaplin. Care files examined indicated that staff give full choices about how they live their lives to include addressing their sexuality Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: although it was noted that personal decision making took into account peoples mental capacity as to their ability to make safe decisions about their daily life. The weekly menu is prepared accordingly to residents wishes and the food is purchased by staff who demonstrated they fully understood all the residents dietary needs and food preferences. Records show that none of the people living in the home are currently involved in education,training or employment but documentation seen shows staff encourage and support people to maximize their potential and live a lifestyle of their choice. Staff said that whilst the residents are not able to have house keys they are supported to come and go from the home as they wish and staff are always readily to support them if they wish to go to the shops or other outings of their choice. Care Homes for Adults (18-65 years) Page 14 of 27 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. Staff monitor and review peoples health and social care to ensure they receive care appropriate to need. However the recording of medication is not well managed and as a consequence residents wellbeing could be put at risk. Evidence: The daily records for each person living in the home were clear and fully identified the level of support staff provided in all aspects of daily life. The records included what each person had done during each day what food they had eaten, who had visited and the persons general health and wellbeing. Care plans for all residents included details of interactions of what makes the person happy/ sad/ angry and held good risk assessments of how to maintain their safety and wellbeing. Staff were observed interacting with the people living in the home and they showed they were aware of the rights of each person in respect of them retaining their privacy and dignity. Staff were seen to knock on each persons door and asking if they could enter, assisting people to zip or button clothing if the need arose to ensure their dignity was Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: retained ensuring doors were closed as appropriate and generally being respectful to each person whilst attending to their individual needs. The home use a key worker system in which a staff member has responsibility for one resident and is able to develop a close relationship based on mutual trust and rapport.This enables staff to assist people to access a social network of their choice and also to ensure that all heath needs are identified and met. Medications are administered by qualified nursing staff and audits carried out by senior managers each month and records that the manager has developed a close working relationship with the local GP and pharmacy . However a medication record check identified that a count of rectal diazapan was incorrect with one extra container being recorded as being in place. The manager identified who was responsible for this error and made contact to ascertain how this had happened. It was identified as being a human error of miscounting , however it was clear that this was unacceptable and the manager immediately recorded this and advised her manager of the incident. Care Homes for Adults (18-65 years) Page 16 of 27 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 living in the home and their Representatives are provided with full details on how to make a complaint and staff are trained and knowledgeable on the policies and procedures in place to protect residents from abuse. Evidence: Records showed that the home had not received any complaints, concerns or allegations since the last inspection. Staff advised that they had a complaints policy on display in the home and they said that the service user guide also held clear easy read information about the complaints system and how to use it if required. Staff said they had a whistle blowing policy in place which they understood and records revealed that this policy had been activated be a staff member and appropriate action had been taken by the manager to ensure residents were protected from harm. The manager identified that the home had a company protection of vulnerable adults policy and guidance and it was noted that the home also have a Knowsley Local Authority Vulnerable Adults pack available. All staff spoken with identified they had received training in the protection of vulnerable adults and fully understood the processes needed to ensure the safety and wellbeing of all the people living in the home. Staff recruitment records identified that the company have a structured recruitment policy in place to ensure wherever possible the protection the residents of Elizabeth Road Care Home. Care Homes for Adults (18-65 years) Page 17 of 27 Care Homes for Adults (18-65 years) Page 18 of 27 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 living in the home do so in comfort and staff ensure the environment of the home is pleasant and hazard free. Evidence: The home presents as a well maintained five bedroomed bungalow situated in a residential area of Huyton.The home is situated close to all local amenities to include shops, entertainment centers and public transport. All five bedrooms were viewed and they were personalized to suit each individual resident. Rooms seen were comfortable and cozy and were decorated as per the individuals choice. for example one room seen was obviously that of a football fan with flags and colors of the team and other memorabilia on show. The communal space includes a lounge , dining room, kitchen which were well maintained and homely. The home has two spacious bathrooms which have specialized equipment to enable residents to bathe and shower safely. The garden areas presented as tidy and well managed. The frontage of the home provides a driveway which is suitable to accommodate up the three vehicles and their is also care parking space on the roadway. The home was clean ,tidy and free from any unpleasant smells and staff advised that a housekeeper held the responsibility for the day to day cleaning. Care and support staff Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: were observed carrying out basic hygiene tasks when necessary to ensure the home retained its appearance. Cleaning products were stored in locked areas and staff identified in discussion that they had been trained and understood all aspects of infection control. Care Homes for Adults (18-65 years) Page 20 of 27 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. Recruitment and training of staff is thorough to ensure the safe care and protection of the people living in the home. Evidence: Staff files examined showed that the company use a though recruitment and selection process to include requesting references, police checks and work records prior to any offer of employment being made. Staff spoken with displayed excellent knowledge and understanding of their role and also of the effects and necessary treatment of the illness and/or disability experienced by the people living in the home. All staff files viewed held job descriptions, contracts , training records and supervision notes and discussions with staff revealed that they felt supported by the manger and their work colleagues and enjoyed working in the home. They said they felt valued as people and were able to develop their skills as an ongoing process. Staff identified in discussion their understanding of the residents needs and said that the staff team comprised of diverse range of people to include age, heritage and gender and this enabled staff to have the skill mix to meet each residents individual needs. Comments form staff included : I am provided with a vast amount of training some that is mandatory but other Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: courses that are of my choice.This assists me to understand the different types of illness the People living here experience and helps me to help them The home has a good staff team who work tirelessly together in the best interests of the people living here. Care Homes for Adults (18-65 years) Page 22 of 27 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 management of the home is good and clearly benefits all who live and work there Evidence: The registered manager of the home ,Geraldine Atkinson, is a qualified registered nurse (RGN) and also has a level 4 National Vocation Qualification (NVQ) in care. M/s Atkinson staff records show that she updates her training as an ongoing process to ensure she retains her skills. Staff spoken with revealed that they feel valued and supported by their manager who they say is fair, firm, supportive, knowledgeable, understanding, caring, and a very good manager Examination of the AQAA and discussions with the manager revealed that the home has clearly identified policies and procedures for the running of the home to include systems to ensure that monitoring and reviewing of the service is an ongoing process. Records show that staff supervision, care planning updates and general administrative tasks are carried out as per the homes policies.T The home forms part of a company called Community Integrated Care (CIC) and information gained from their documentation shows they are an equal opportunities employer who have a full range of polices, procedures and Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: codes of practice to ensure that staff understand the philosophy of the company and what they expect from their staff. Staff said that were provided with staff handbooks about their rights and how they should conduct themselves with residents and said that they received ongoing training in all aspects of health and safety to ensure the wellbeing and safety of all who live and work in the home. Information form the AQAA showed that all essential services and equipment have regular checks and are maintained to provide a safe environment. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 20 13(2) All medication kept at the 14/12/2007 home must be recorded correctly to ensure the health and safety of residents. Care Homes for Adults (18-65 years) Page 25 of 27 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 1 20 13 Medication records must be an accurate. Medication records must be accurate at all times to ensure they are a true reflection of the medication stored or administered to people living in the home 03/01/2009 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 Care Homes for Adults (18-65 years) Page 26 of 27 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. Copyright © (2008) 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. Care Homes for Adults (18-65 years) Page 27 of 27 - 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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