Care Home: Ellershaw House Limited

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What the care home does well Staff continue to encourage students to be independent and to make their own decisions. This enables students to have control over their lives. Staff are respectful to students and sensitive in meeting their needs. This helps in making sure students receive care in the way they prefer. The way in which information is gathered and kept about students means staff can provide support in a way that students need and prefer. It also means staff have in depth knowledge and understanding about each individual person and so encourage them to develop skills and experiences safely. Some students write in their own care plan, which gives them autonomy. Students made positive comments about their life at Ellershaw House such as: "I like living here". "The food is very good here, they always do things what you like. The staff always ask what you want" " Food is nice". " Riding. I like my room. Stable work. Like doing Rebound Therapy. I like my bathroom like to clean them on my own". "Riding, field management,nice food, keeping everything tidy, get alot of different activities to do". "Look after me properly, help me with my problems,staff help me, get free time to do what i like". "Look after me they care for me, I get on well with people who care for me". "Ellershaw is good, get on well with staff and students, Very good food". Surveys that were sent out and returned to Ellershaw House from relatives and health and social care professionals as part of their quality monitoring process were also positive. Some of the comments about the home were: "There is nothing in the organisational set up which seems to fall short of `excellent`. The care of student. The appearance,behaviourally and dress wise of students. Domestic arrangements, encouragement to improve students and staff". "An amazing and highly professional organisation". " Remote and rural setting providing students real opportunities in rural activities. Always warm and welcoming". "A well presented home providing excellent care for it`s students. Management and team members work in harmony together to create a happy environment, providing care/togetherness, learning/achievement,safety and security. Student`s are constantly encouraged to be independentand where appropriate, they are given responsibility in line with their ability/maturity". " I have found it very useful that a member of management attends my meetings and reviews. It means that anything requiring action can happen immediately with minimal fuss". "Always professionally managed and organised and students prepared for my visits. Alwyas a pleasure to work with staff and students at Ellershaw"."Ellershaw House provides an excellent service for some really difficult to place students with complex needs. It has a great atmosphere. I have limited knowledge of the training provided. Ellershaw is very well managed and the emphasis is 100% about students wellbeing." What has improved since the last inspection? There has been continuous ongoing redecoration in the home and outside of the home such as: Had the roof replaced on the main house.Had four windows replaced, two in the main sitting room and two in bedrooms above.Had a wall of the main sitting room dry lined and the room redecorated.Installed a new digital television in the kitchen. Replaced the existing minibus with a nearly new Mercedes Benz.Upgraded the computer to a server based system. Purchased a new ride and drive Cob. New Therapy horse. Enhanced our mobile communications by purchasing two new iPhones, enabling data and messaging anywhere in the world, particularly necessary for the centralised diary when booking student appointments in situ.New tractor, paddock topper, chain harrow and spike conversion for hay handling. New fences have been built around the horse paddocks. What the care home could do better: There was nothing identified at this inspection that the home needed to improve upon. Key inspection report Care homes for adults (18-65 years) Name: Address: Ellershaw House Limited Ellershaw House Bramley Grange Grewelthorpe Ripon N Yorkshire HG4 3DJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Irene Ward     Date: 2 8 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 30 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Ellershaw House Limited Ellershaw House Bramley Grange Grewelthorpe Ripon N Yorkshire HG4 3DJ 01765658381 01765658910 admin@ellershawhouse.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ellershaw House Ltd Name of registered manager (if applicable) Mrs Sandra Kreutzer-Brett Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 1.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: Learning disabilities: Code LD. 2. The number of service users who can be accommodated is: 12. Date of last inspection Brief description of the care home Ellershaw House is registered to provide residential social and personal care for 12 adults with learning disabilities in a therapeutic environment, which, along with other therapies offers riding, rebound therapy, music and drama. Ellershaw House has stables for about 11 horses and riding and the care of the horses is a fundamental part of the ethos of the home. As students progress and take other tutorials, they reduce Care Homes for Adults (18-65 years) Page 4 of 30 Over 65 0 12 Brief description of the care home the riding input to acknowledge other therapies more and more. The home offers a team of specialist tutors in many skills. The home is a large farmhouse set in open countryside in quite an isolated location. Transport is required to access all services and facilities. The registered providers are Mr. and Mrs. Kreutzer- Brett and the registered manager is Mrs Kreutzer- Brett. Information provided by the registered providers on 28th September 2009 indicated that the current weekly fee for the home ranges from 700.00 pounds to £3,000.00 pounds. Additional costs include hairdressing, massage, holidays and outings and activities. 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: three star excellent 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: The Care Quality Commission inspects homes at a frequency determined by how the service has been risk assessed.The inspection process has now become a cycle of activity rather than a series of one-off events.Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk This is what we used to write this report: We looked at information we have received about the home since it was registered. We asked for information to be sent to us before the inspection, this is called an annual quality assessment questionnaire (AQAA). We sent surveys to students who receive a service and to staff who work at the home. Care Homes for Adults (18-65 years) Page 6 of 30 One inspector visited the home unannounced. This visit lasted over six hours and included talking to the registered manager and staff on duty about their work and the training they have completed, and checking some of the records, policies and procedures the home has to keep. We looked at three students care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people who use the service. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The site visit took place on the 28th September 2009. The registered manager was available to assist throughout the visit and available for feedback at the end of the inspection process. Care Homes for Adults (18-65 years) Page 7 of 30 What the care home does well: Staff continue to encourage students to be independent and to make their own decisions. This enables students to have control over their lives. Staff are respectful to students and sensitive in meeting their needs. This helps in making sure students receive care in the way they prefer. The way in which information is gathered and kept about students means staff can provide support in a way that students need and prefer. It also means staff have in depth knowledge and understanding about each individual person and so encourage them to develop skills and experiences safely. Some students write in their own care plan, which gives them autonomy. Students made positive comments about their life at Ellershaw House such as: I like living here. The food is very good here, they always do things what you like. The staff always ask what you want Food is nice. Riding. I like my room. Stable work. Like doing Rebound Therapy. I like my bathroom like to clean them on my own. Riding, field management,nice food, keeping everything tidy, get alot of different activities to do. Look after me properly, help me with my problems,staff help me, get free time to do what i like. Look after me they care for me, I get on well with people who care for me. Ellershaw is good, get on well with staff and students, Very good food. Surveys that were sent out and returned to Ellershaw House from relatives and health and social care professionals as part of their quality monitoring process were also positive. Some of the comments about the home were: There is nothing in the organisational set up which seems to fall short of excellent. The care of student. The appearance,behaviourally and dress wise of students. Domestic arrangements, encouragement to improve students and staff. An amazing and highly professional organisation. Remote and rural setting providing students real opportunities in rural activities. Always warm and welcoming. A well presented home providing excellent care for its students. Management and team members work in harmony together to create a happy environment, providing care/togetherness, learning/achievement,safety and security. Students are constantly encouraged to be independentand where appropriate, they are given responsibility in line with their ability/maturity. I have found it very useful that a member of management attends my meetings and reviews. It means that anything requiring action can happen immediately with minimal fuss. Always professionally managed and organised and students prepared for my visits. Alwyas a pleasure to work with staff and students at Ellershaw. Care Homes for Adults (18-65 years) Page 8 of 30 Ellershaw House provides an excellent service for some really difficult to place students with complex needs. It has a great atmosphere. I have limited knowledge of the training provided. Ellershaw is very well managed and the emphasis is 100 about students wellbeing. 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 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 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. Students needs are properly assessed prior to admission, this makes sure that Ellershaw House is the right place for them to live. Evidence: There have been no new admissions into the home for sometime. There continues to be four potential vacancies as the registered manager is sensitive to the dynamics of the current group of students.There have been two enquiries about the home,however the manager said neither placement would have been appropriate. The manager confirmed that a new student would be given the opportunity to visit the home and stay for a meal or for the day whatever they felt comfortable with. The registered manager is aware however of the need for comprehensive pre admission assessments and explained that any such admission would be arranged via a planned introductory programme including visits to the home and a trial placement prior to this being made permanent. Students living at Ellershaw House are consulted and their views sought before another student moves into the home. Records of three students showed that the home carries out detailed pre-admission Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: assessments when referrals are made to the home. They visit people and get information from relatives and other professionals to help them decide if they will be able to meet peoples needs before a place is offered. This is particularly useful for those people who have complex needs. The AQAA (Annual Quality Assurance Assessment) completed by the home states that: Ellershaw House has a long and stable relationship with its students, 7 of whom have been with us for between ten and eighteen years. The most recent student joined us six years ago. In order to promote the wellbeing of our young people, the first thing we do is to call them students. We have discussed this with them and feel this makes them equal to other young people in training in the community and in Ellershaw House or in their work placements. It gives them a socially accepted title. None of our young people liked being called a service user and, after consultation we settled on student. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care provided is of a high standard and encourages students to make their own decisions about how they wanted to live their lives. Evidence: Students looked well cared for and staff were seen supporting them throughout the day and it was clear that they understood individuals needs. They supported students sensitively and supported them to make choices.There was a good atmosphere in the home with friendly banter between students and staff. Each person has a care plan detailing their individual needs and the actions that staff need to follow to meet these.Care plans focuses on the person and contained information about every aspect of the persons life including areas for developing new skills; they focus on achievement and improving opportunities for individuals. Care plans were very detailed and covered morning and evening routines and how students preferred their care to be provided. All areas of daily life such as students daily routines, activities were covered in the plans.In some students care plans daily Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: activities were in a pictorial format for them to understand.Care plans provided the reader with very good information, was easy to understand and gave a sense of the person. One student continues to write in the daily records of their care plan as to what sort of day they have had and what activities they have been involved in. Also present were a range of risk assessments with the purpose of supporting students to live as independently as possible with safeguards in place, these were reviewed regularly. Students living at the home said that they liked living at the home and comments made were: I like living here. The food is very good here, they always do things what you like. The staff always ask what you want. Students went onto discuss their recent holiday,as all of them had just come back from a cruise on the Mediterranean. Students continue to have regular meetings with support from staff. Here they can put forward views and suggestions and they are then helped to work towards achieving personal as well as group goals. Through discussion with the manager at the time of the visit and the contents of care plans it was clear that students are able to make choices wherever possible. Students are continually consulted on a regular basis about how the home runs and have the opportunities to voice their views. Care Homes for Adults (18-65 years) Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students living at Ellershaw House are always able to make choices about their lifestyle and are supported by staff to carry these out. Evidence: Students either have work placements or work in a voluntary capacity and said they enjoyed these opportunities. Students are encouraged to help with tending the horses kept by the home and are able to ride them if they want to and are taught skills in stable management. The home offers four tutorials a day. During the morning it was possible to observe a tutorial in horse riding. In observing this activity it was clear that students co-ordination and numeracy skills were improving and how students have been taught to develop their riding skills and for some students it was clear that their mobility had improved since the last inspection. The registered manager, staff and students have planned activities so that every student has a busy and interesting lifestyle geared to suit the individual and encouraging a presence in their local Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: community although the home is quite remote. Students said they are also allowed personal space when they want it. Six surveys have been returned from students living at Ellershaw House. These are the comments they made: Food is nice. Riding. I like my room. Stable work. Like doing Rebound Therapy. I like my bathroom like to clean them on my own. Riding, field management,nice food, keeping everything tidy, get alot of different activities to do. Look after me properly, help me with my problems,staff help me, get free time to do what i like. Look after me they care for me, I get on well with people who care for me. Ellershaw is good, get on well with staff and students, very good food. The AQQA (Annual Quality Assurance Assessment) completed by the home states that: We have a strong ethos of communication and negotiation, if somebody is unhappy with anything they are doing, be it a tutorial here or a work placement.They are encouraged to communicate both positives and negatives, through direct conversation or role-play. They can negotiate with anybody to change their environment, workplace, work people, tutor or tutorial. We provide, seek out and train our students in life skills, horse riding, stable management, horticulture, cooking, rebound therapy, swimming, keep fit, etiquette, role play, music and drama, assertiveness training, work and volunteer placements. Anything we can do in fact to empower them to self manage, give them autonomy and independence. Students are supported in maintaining appropriate jobs in the community. We support students to be part of the local community. Clothes are appropriate for work, leisure and social events and choices are supported to ensure style, fashion and age considerations are all met appropriately. Students continue to have opportunities to pursue other interests outside of the home such as going horse riding, shopping, theatre trips, pub outings, and youth club. Students also enjoy making things such as rugs, playing music, art, and peg loom weaving, playing badminton,football,cricket and trampoline. The manager said that the students have had holidays in Spain and at Center Parcs and have just returned from one weeks cruise on the Mediterranean. All the students spoken with said that they had very much enjoyed this recent holiday. A designated staff member cooks all the meals using high quality, fresh ingredients. Meals are planned daily and reflect the preferences of the students. Records of meals eaten show that meals are varied and nutritious and provide students with a healthy Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: diet including those requiring specialist diets. Students and staff eat all their meals together and lunchtime was very relaxed and informal. Liquid refreshments and snacks were also offered on a regular basis throughout the day. The AQQA (Annual Quality Assurance Assessment) completed by the home states that: Our students are offered a healthy and well balanced diet. We have menu plans, students requests are always accommodated over the week. We have set meal times throughout the day. All our students take it in turns throughout the week to get involved in cooking lessons.They are supported to prepare and cook the meal, under supervision. The atmosphere at meal times is very relaxed and unrushed, this is a time for the whole group to get together and chat about the day or anything else impacting on there lives both positive and negative. When spoken to all the students said that the food at Ellershaw House was very good one person commented, The food is very good here, they always do things what you like. The staff always ask what you want. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students personal and health care is provided appropriately and sensitively according to individual needs. Evidence: Each person living at the home is registered with a General Practitioner. Students receive support from staff in attending dental and other health care service appointments. Everyone has a care plan, which details how they will be supported with their health and care needs with additional step-by-step instruction as to how they wished to be supported. Daily record entries continue to reflect the care that was being provided.Students are supported to manage their own medication if they are able to do so. Harrogate District Hospital is used for Accident and Emergency service and most out patients appointments.Occasionally Ripon Community Hospital and the Friarage Hospital in Northallerton are also used. The home operates a monitored dosage system.There is a policy in place for the storage and administration of medication for all staff working in the home to follow. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: The Medication Administration Records show that everyone receives their medication as prescribed.Records were up to date and well maintained. Medication seen in the home was securely stored in a locked cabinet. No controlled drugs are currently held. All staff that administers medication in the home have been provided with medication training.The manager said that two staff from the home were booked to attend the following week,training in the Safe Administration of Medication in Care Homes, which was being held in Harrogate by the Primary Care Trust. 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 who use the service have access to an effective complaints procedure and are protected from harm. Evidence: A comprehensive complaints procedure is followed and is made available to people and any other interested parties. The complaints procedure is summerised within the service user guide. No complaints have been received by the Care Quality Commission.Students when asked were clear as to whom they would speak to if they had any concerns or worries. They all said they would speak to either the manager or staff or would contact the inspector from the CQC (Care Quality Commission). One complaint had been received by the home,which was appropriately investigated by the home with a satisfactory outcome for the person who made the complaint. There is a policy and procedure with regard to safeguarding adults and the procedure to take if there is a suspicion of abuse and staff demonstrated a good awareness of this.Staff receive training in adult protection and safeguarding issues during induction training and further training when required.There have been no allegations regarding safeguarding made to the home or to the Care Quality Commission. There is a policy of minimum restraint in operation within the home and the registered manager explained that staff are expected to employ de-escalation skills wherever possible and only employ minimum restraint where no alternative is possible. This Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: approach is confirmed by the restraint training that all staff have which is regularly updated. Appropriate recruitment procedures are followed, with references and Criminal Records Bureau (CRB) checks made to reduce the risk of unsuitable people working in the home. Peoples finances were discussed and checked with senior staff on duty. Monies checked all balanced and receipts are obtained for all purchases made. 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. Students live in a clean, comfortable and safe home. Evidence: The home provides spacious and good accommodation for students. This includes two lounges. One of which is quite large and is on the first floor and a large dining kitchen and a utility room that are all on the ground floor. The home has three bathrooms, one shower room and three separate toilets situated throughout the home. Students all have single bedrooms. There are six bedrooms on the ground floor and six bedrooms on the first floor. The home is situated in fourteen acres of land, which includes gardens with pond, vegetable plot with polytunnel, chicken run and sheep paddock plus several paddocks for horses. There is also an indoor school and stables where students learn to ride and look after horses. Students bedrooms seen had been personalised with posters and their various possessions such as two students kept goldfish, and items they had collected and made. Rooms have been decorated and furnished appropriate for their age. All areas including the lounges, dining kitchen and utility room were all clean, free from any odours and maintained to a good standard. A range of maintenance checks is completed on a regular basis to make sure that the Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: house is safe and secure. The AQQA (Annual Quality Assurance Assessment) completed by the home states that improvements have been made in the following areas since the last inspection: All of last years targets have been achieved. This year we have:Had the roof replaced on main house.Had four windows replaced, two in the main sitting room and two in bedrooms above.Had a wall of the main sitting room dry lined and the room redecorated.Installed a new digital television in the kitchen.Replaced the existing minibus with a nearly new Mercedes Benz.Upgraded the computer to a server based system.Purchased a new ride and drive Cob. New Therapy horse.Enhanced our mobile communications by purchasing two new iPhones, enabling data and messaging anywhere in the world, particularly necessary for the centralised diary when booking student appointments in situ.New tractor, paddock topper, chain harrow and spike conversion for hay handling. New fences have been fitted around the horse paddocks. 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. Sufficient staffing levels, proper recruitment procedures and good staff training means that peoples needs are being met and their interests are safeguarded. Evidence: Staffing levels were sufficient for meeting the needs of people. The duty rota showed that there are usually six or seven members of staff on duty both in a morning and afternoon. This includes the registered managers hours. The manager said that staffing hours were increased and were dependent on what activities people who live at the home were doing.This makes sure that peoples social activities are not compromised. At night there is two staff sleeping in on the premises. The staff records of three staff were looked at one of which was recently appointed.These showed that all the necessary pre employment checks had been carried out prior to the new worker starting in post.All records showed completed application forms, two written references, CRB (Criminal Record Bureau) checks had been obtained. The home provides all the mandatory training that is required.A range of other training has been completed by staff such as food hygiene,POVA (Protection of Vulnerable Adults),moving and handling,emergency aid,NAPPI and medication are just some of the training staff have attended.Other training staff have attended have Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: been diabetes update,team building, rebound therapy,sensory awareness,general psychiatry and autistic spectrum disorder are just some of the courses staff have attended. One staff holds National Vocational Training Level 2 and two staff hold Level 3.One staff is in the process of completing NVQ Level 4. Staff meetings are held regularly and minutes of meetings were seen at the site visit.People who live at the home who were spoken to on the day spoke positively about staff. Three surveys were returned from staff who work at Ellershaw House and these are the comments they made when asked, What does the home do well. We meet all individual needs. All staff needs in training. Ellershaw is fun and exciting place to work. I think that Ellershaw House Ltd. done their job very well. Gives alot of opportunities to the students who live here and provides a unique environment to live in. The students get enough space to manage their own lives but have the support from staff when needed. We provide a wide range of opportunities outside of Ellershaw as well, such as work opportunities and days out. They are concerned for everyone, for all staff and all students as well. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Students benefit from a well managed home in which their needs and wishes are put first. Evidence: The registered manager has owned and managed Ellershaw House since it was first built. The manager holds the (NVQ) National Vocational Qualification Level 4 Registered Manager Award in Care.The home has a good and effective management team in place.The ethos of the home is open and positive.People who use the service and staff all commented highly about the home. Regular house and staff meetings are held and minutes are taken. Comprehensive Quality Assurance systems are in place at the home as students and other intersted parties views are continuously sought.The home has recently carried out their own survey.Comments received from relatives and health and social care professionals were positive, some of the comments made were: There is nothing in the organisational set up which seems to fall short of excellent. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The care of student. The appearance,behaviorally and dress wise of students. Domestic arrangements, encouragement to improve students and staff. An amazing and highly professional organisation. Remote and rural setting providing students real opportunities in rural activities. Always warm and welcoming. A well presented home providing excellent care for its students. Management and team members work in harmony together to create a happy environment, providing care/togetherness, learning/achievement,safety and security. Students are constantly encouraged to be independent and where appropriate, they are given responsibility in line with their ability/maturity. I have found it very useful that a member of management attends my meetings and reviews. It means that anything requiring action can happen immediately with minimal fuss. Always professionally managed and organised and students prepared for my visits. Always a pleasure to work with staff and students at Ellershaw. Ellershaw House provides an excellent service for some really difficult to place students with complex needs. It has a great atmosphere. I have limited knowledge of the training provided. Ellershaw is very well managed and the emphasis is 100 about students wellbeing. All accidents are recorded as required and an accident book is maintained in line with the requirements of Data Protection. Three peoples finances were checked at this site visit. Monies checked at the time of the visit all balanced and receipts are obtained for all purchases made. Information provided from the (AQAA) Annual Quality Assurance Assessment and the examination of selected health and safety documents show that regular checks to electricity and gas and fire safety equipment are regularly undertaken. 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 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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