Care Home: Elkington House

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What the care home does well Each person had a care plan which described what they like, dislike and how staff are to support and care for them. Residents are involved in making decisions about how they live their lives and how the home is run. They make decisions about the things that are important to them such as menus, meals, activities and general concerns/issues. Each resident has a health action plan and information about their health care needs is recorded. Staff ensure that people living in the home receive the medicines they need, attend routine appointments for health checks and that they see the doctor if they are unwell. Residents general health and well being is monitored and they are encouraged to eat healthily and to participate in exercise as part of a healthy lifestyle. People living in the home can go out to local pubs, restaurants and places of interests. They have regular visits to and from family,friends and spend time with other people who are important to them. Staff are trained to understand and support residents and to recognise and report any bad practice and so help to safeguard people who may be vulnerable. Any complaints or concerns are investigated and residents feel happy to discuss any issues with staff or the manager. Staff are recruited through a thorough process and all of the relevant checks are carried out to help ensure that only those who are suited are employed in the home. The home is clean, safe and comfortable. The home is well managed and residents are asked to comment on and suggest changes to help make things better where there are any areas for improvement. What has improved since the last inspection? All the recommendations and requirements from the last inspection have been met. Care plans and the way staff record information about residents has continued to improve and residents are more involved in this. What the care home could do better: The manager needs to go ahead with training for all staff in basic and specific resident related training and to ensure that all staff receive regular supervisions, yearly appraisals and staff meetings. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elkington House 9 Imperial Avenue Westcliff On Sea Essex SS0 8NE     The quality rating for this care home is:   three star excellent 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: Sarah Hannington     Date: 0 3 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Elkington House 9 Imperial Avenue Westcliff On Sea Essex SS0 8NE 01702348200 01702348200 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) : Southend Blind Welfare Organisation care home 25 Number of places (if applicable): Under 65 Over 65 25 25 dementia sensory impairment Additional conditions: Date of last inspection Brief description of the care home 0 0 Elkington House provides accommodation for twenty-five older people who have a sensory impairment with/without dementia. The home is situated within easy reach of the seafront and a local shop area at Westcliff on sea. The town centre and shopping centre of Southend on sea is a bus or train ride away. The home is close to rail and bus links. There is parking to the front of the property. The accommodation is on two floors and there are 2 passenger lifts to enable access to both floors. There are single and shared bedrooms, some of which have en suite facilities. There are lounges and a dining area and a large rear garden with a patio area with garden seating and ramp and step access to the garden. The current scale of charges as at June 2007 ranges from #445 for a double room to #467 per week for a single room. Hairdressing, chiropody, dentist, optician, personal toiletries, newspapers and magazines, clothing are charged at cost. Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a routine unannounced inspection, which included a visit made to the home on 3rd July 2009. The last inspection was carried out on 15th June 2007. As part of the inspection process we reviewed information we had received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. We also looked at the information the manager provided us with in the homes Annual Quality Assurance Assessment. This document is a self-assessment, which the registered provider or owner is required by law to complete and tell us what they do well, how they evidence this and the improvements made within the previous twelve months. Care Homes for Older People Page 5 of 25 We sent surveys each to the home to distribute to residents and staff and to complete and tell us what they think about the home. At the time of writing this report we had received ten surveys back from six residents living in the home and four staff members. During the inspection we spoke with twelve residents and five members of staff. The views and comments expressed by these people are reflected in this report. When we visited the home we looked at residents care plans and information available to staff to help them support residents. We looked at how staff were recruited to work in the home and how they were trained to support residents. We looked at how the home was managed and how residents were involved in this. We also observed how staff interacted with residents when supporting them with activities such as meals and providing recreation and stimulation. A brief tour of the premises was carried out and communal areas including lounge and bathrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgments about outcomes for people who use social care services in a consistent and fair way. 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.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 7 of 25 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 8 of 25 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. A clear and comprehensive assessment process assures people that their needs could be met prior to moving in their home. Evidence: The manager told us that people who were looking for a care home would be invited to spend time in the home to get to know residents and staff before they made a decision as to whether the home was suitable for them. They told us that there was information about the home and the services offered. Six of the people living in the home completed surveys to tell us what they thought about the home. They all told us that they had been asked if they wanted to move into Elkington House and they had been given enough information about the home to help them make their decision. When we visited we looked at the information available, which described the home. This information was detailed and described the home and provided information about Care Homes for Older People Page 9 of 25 Evidence: staff who work there and their skills and qualifications, and the support a person could expect if they move into the home. There was also information about how a person could complain if they were unhappy and how they could make suggestions or comments about the home. However the statement of purpose and service user guide should be updated annually and needs to include th current details of CQC. Care Homes for Older People Page 10 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples assessed needs are followed through in good care plans that give staff the necessary information to provide good care outcomes. Evidence: The manager told us in the Annual Quality Assurance Assessment that each resident had a full assessment undertaken of their health and personal care needs and a care plan which describes how staff are to support the person. They also told us that staff received training people specific to the needs of residents including training in supporting people who have dementia, visual impairments, continence and diabetes. Staff who completed surveys confirmed that they received training and information to help them understand residents needs and to support them properly. When we visited the home we looked at the care plans for eight residents. Each person had an individual care plan. Within this it described the person and the things they like and dislike. There was information recorded about how the person wished to be supported to maintain personal care and hygiene. We looked at how staff supported residents with their health care needs. Each person had a health action plan, which described Care Homes for Older People Page 11 of 25 Evidence: their needs and how staff were to assist and support them. We saw that staff supported residents to attend doctors appointments, receive medicines and to monitor their general health and welfare. Staff supported residents to choose and eat a healthy and well balanced diet and to monitor weight on a regular basis. Care plans were reviewed and amended where there were changes to the support that the individual needed. We looked at reviews which had been carried out by the people who pay for people to live in the home (Social services, the health authority and relatives). We saw that some peoples care had been reviewed by their social workers and that both were satisfied with how the way that residents were supported and cared for. One relative told us that, Every effort was made to make my relative become more independent again. Staff working in the home received training and information so that they handled and administered medicines to residents in a safe way. Where residents were capable of safely handling medicines they were fully supported to do this. Care Homes for Older People Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that they will have the opportunities for personal development and are able to lead a lifestyle that they choose. Evidence: The manager told us that they continued to offer residents opportunities to express their social, emotional and lifestyle choice. The six residents who completed surveys and told us that they could make decisions of what they wished to during the day, evenings and at weekends. On the day of the inspection twelve residents told us that they went to bed and got up when they chose, and that if they wanted a lay in or a cup of tea in bed they could do so. We looked at how residents are supported to access activities and maintain relationships with people who were important to them. Residents told us that they told us that they had some planned activities during the week such as, reminiscence, quizzes, exercises, talking books, audio newspapers and newsletters from the southend blind welfare organisation and that on weekdays and weekends they had free time to spend time with family and people important to them and that visitors were Care Homes for Older People Page 13 of 25 Evidence: welcome at any time. The home employs a full time cook during the week and at weekends. Their information showed us that they held the relevant qualifications need for this role. Kitchen equipment and regular checks were all in order. There was a four week menu in place that showed us that the likes of residents that were recorded in their information were reflected in the meals provided and that they had a varied and good quality of diet. The lunch time meal seen was of good quality and home cooked and presented nicely. Liquidized meals for people were prepared nicely and separated into meat and vegetables etc, so that smell, texture and quality were retained. All of the twelve residents spoken with told us that the meal were of their liking, good quality and had plenty of choice. One relative told us that, The planning and quality of food contributed a lot to my relative getting better. Comments received back from residents surveys included, The staff are very helpful, I live in a very happy and pleasant home, The manager and her staff look after me so well and take care of all of our needs, We are treated with respect and kindness that we wished and hoped to receive when having to live within a care home. Care Homes for Older People Page 14 of 25 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. There are systems in place to ensure that peoples views are listened to acted upon and support residents to be protected from abuse. Evidence: Each of the twelve people living in the home told us that they knew who to speak with if they were unhappy or needed to make a complaint. Some residents identified staff who they would report to. Four members of staff completed surveys and they told us that they were aware of the homes policy for dealing with complaints and safeguarding people from harm. When we visited the home we looked at the policies and procedures. We saw that there was detailed information available for residents to assist them in understanding how to complain if they were unhappy. There was also detailed information made available to staff once they commenced work at the home, which described their roles and responsibilities in reporting bad practice. This included a whistle blowing policy. This helped to assure staff that they would be protected from harassment should they need to raise concerns. We looked at how staff were recruited to work in the home and saw that all of the checks such as employment references, Criminal Records Bureau disclosures and PoVA First checks were obtained before a person started work at the home. This helped to ensure that only people who were suitable were employed. We saw that all staff had Care Homes for Older People Page 15 of 25 Evidence: undertaken training in recognising and reporting abuse or bad practices. There had been no complaints or concerns raised about the home since the last inspection. During the inspection we spoke with twelve residents and the six surveys returned told us that staff treat them well. We saw that staff treated residents with respect and that residents were very comfortable and open in the company of staff. Care Homes for Older People Page 16 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and safe environment. Evidence: The manager told us that residents had all of the equipment that they needed and that bedrooms reflected each persons individual personality through their choice of furniture, decor and personal belongings. They told us that there had been improvements to the environment with the redecoration and refurbishment of some areas of the house. Each of the six residents who completed surveys told us that the home is always fresh and clean. When we visited the home we were invited by some residents to view their bedrooms. We saw that these rooms were bright, clean and reflected each persons individual taste. Rooms were nicely decorated and decorated in colours, which residents told us they had chosen. Residents we spoke with told us that they were happy with their home. The manager told us that in each bedroom were a nurse call point which was in easy reach for each person to use, these were also provided in all toilets, bathrooms, lounges and the dining room. She told us that all doors within the home are wide enough to accommodate wheelchair users and has two large lifts plus a wide staircase. This was seen by us when a tour of the building was undertaken. Care Homes for Older People Page 17 of 25 Evidence: We saw that there were procedures in place and that staff had training to promote good hand washing practices and to reduce the risk of infection. We saw that the home was well maintained, that checks were carried out regularly to ensure that equipment was in good working order. Relatives and residents told us that, My relatives room is always clean and is designed for their specific needs, My relatives room is always clean and is comfortable, Another commented that the Hygiene standards at Elkington are very high. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are offered positive relationships by caring staff and are protected by staff recruitment. Evidence: Residents who completed surveys said that staff listen to them and act on what they say. When we visited the home we saw by observation that, staff interact well with residents, were motivated, competent and listened to people. The manager told us that all staff had been at the home for some years. She told us that all staff had a detailed job description in relation to their jobs, that they had an induction to the home when they started work and that they received both mandatory and specialist training to best support residents. Staff who completed surveys told us that checks such as Criminal Records Bureau disclosures had been obtained before they commenced their employment. Staff also told us that they received training, which was relevant to their roles, helped them understand the needs of residents and kept them up to date with new way of working, although some staff have completed training others are yet to carry this out although the manager has booked courses for the near future. When we visited the home we looked at staffing levels (which are good) and how staff were recruited, trained and supported to meet the needs of residents. We looked at the recruitment files for eight members of staff. We saw that Care Homes for Older People Page 19 of 25 Evidence: before they commenced work that satisfactory employment references, Criminal Records Bureau disclosures and PoVA First checks had been obtained and a full ten year employment history was checked for both people. Staff who completed surveys told us, that their induction covered everything that they needed to know about the job. In addition we saw that staff had detailed job descriptions and information about their roles and the conduct expected of them. We saw that staff were supported well by the management team, however yearly appraisals, supervisions and staff meeting need to be regular and recorded and minutes of these held within the premises. There was an ongoing programme for staff training and development. Staff undertook training in a wide range of topics including communication, assessing risks, managing visual impairments, diabetes and safe handling of medicines. Staff were also trained to recognise and report abuse or poor practices and they had specific training in understanding the needs of people who have visual impairments. Surveys returned by relatives and residents told us that, Staff training and direction is always based on peoples needs within the home, Staff show interest in individuals needs, The manager and staff have given more than their best to make my relative as comfortable as possible and The care shown is excellent. Care Homes for Older People Page 20 of 25 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 strategies of the home were stable which ensures the health, safety and welfare of all residents. Evidence: The registered manager has been in post for many years, has achieved much and holds a wealth of experience and knowledge of the current resident group and this goes toward securing the health, safety and welfare of all people. It also provides consistency of care and supports staff to maintain the quality of care given to people. She is NVQ 4 qualified and holds the Registered Manager Award. We looked at the arrangements for ensuring that the home was maintained safely. We saw that regular checks were carried out on equipment such as hot water and heating systems, fire alarms and fire fighting equipment, gas and electrical installations and equipment. All equipment was well maintained and repaired as required. We looked at how the views of residents, their families and other people who were Care Homes for Older People Page 21 of 25 Evidence: important to them were obtained and acted upon. Relatives meetings were not routinely held but relatives visited the home usually once a week and staff were available to speak with them. Questionnaires were sent to residents and other people each year to ask them for their views about the home and the findings from these were analysed as part of the overall system for monitoring and improving the quality of the service. Care Homes for Older People Page 22 of 25 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 23 of 25 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 1 1 4 Statement of purpose and service user guide has the information they need to make an informed choice. This is because the two documents mentioned do not have the latest CQC details and are not up-todate. 31/08/2009 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 Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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