Care Home: Elm House

Similar services:

• Coopers Mill Ltd
• Bramley Avenue (73)
• Paradise Lodge
• Grangewood
• Upaya Ananda
• Newton Court (1-2)
• Kings Lane (32)
• Pemdale

What the care home does well Elm House continues to provide an enthusiastic and committed package of care and support to residents with Autistic Spectrum Disorders. Residents spoken with were positive about the support they received. Observations made during the inspection also confirmed that the staff have a friendly and professional approach when assisting residents. What has improved since the last inspection? A variety of refurbishments and decoration has been carried out in the home to provide a comfortable and homely environment. The new manager is in the process of completing her application to become registered with the Care Quality Commission. What the care home could do better: It is recommended that the care plan files are audited with old information archived to give a clearer picture of current care and support needs Refurbishment and decoration is needed to the kitchen in side one as it is showing signs of deterioration. Staff must receive ongoing training updates to ensure safe working practices. The manager must ensure that regular fire safety tests are recorded and carried out to ensure the safety of residents and staff. Key inspection report Care homes for adults (18-65 years) Name: Address: Elm House Howitts Lane Eynesbury, St Neots Cambridgeshire PE19 2JA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Andy Green     Date: 0 9 1 0 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 22 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 22 Information about the care home Name of care home: Address: Elm House Howitts Lane Eynesbury, St Neots Cambridgeshire PE19 2JA 01480471166 01480471177 elmhouse@brookdalecare.co.uk na Brookdale Healthcare Limited care home 12 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Elm House is a registered home, provided by Brookdale Healthcare, for 12 people with Autistic Spectrum Disorders (ASD). Accommodation is provided in a large 3-storey house set in its own grounds. The home is divided into two six bed-roomed units each with their own kitchen, dining room and lounges. The bedrooms do not have ensuite facilities but there are 8 toilets 2 bathrooms and 3 showers available for service users. There is also a conservatory, which creates further lounge and office space. The home is within walking distance of St Neots town centre and there are shops and facilities close by. There are nearby bus and national train services. The fees range from £2187 to £2785 per week. 12 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 22 Brief description of the care home Copies of CSCI inspection reports are available to service users and their relatives upon request. Care Homes for Adults (18-65 years) Page 5 of 22 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: We, the Care Quality Commission , carried out an unannounced key inspection of Elm House on 9th October 2009. A variety of information was inspected including; service users assessments and care plans, staff training records, staff recruitment files, complaints records and management policies. We received an AQAA (Annual Quality Assurance Assessment) that had been completed by the manager. This a self audit document which provides the service with an opportunity to assess how they are meeting standards and regulations. We met with a number of residents and staff to gauge their opinion of the care and support provided in the home. Care Homes for Adults (18-65 years) Page 6 of 22 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 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 7 of 22 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 22 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. Prospective residents have access to a variety of information regarding the care and support that is provided. Thorough assessments are carried out to ensure that residents needs can be met. Evidence: All referrals are received via the referral Coordinator at the organisations central office. The multi-disciplinary team (MDT) then carry out an initial assessment of referrals to identify a suitable placement. A member of the MDT and a representative from the homes care team make a visit to the prospective resident to conduct an initial assessment. The prospective resident can then make a number of visits to the home. Relatives/carers can also be involved where appropriate. A record is made of each visit and a transition plan is put into place for the person during the assessment process. Copies of recent assessment documents were seen during the inspection. There have not been any significant changes to the assessment process since the last inspection. There were ten residents living in the home and referrals for the two current vacancies are being received. Care Homes for Adults (18-65 years) Page 9 of 22 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. Care plans are in place to ensure that there are clear guidelines regarding the care and support needs for each resident. Evidence: Three care plans were inspected and they were recorded in detail to ensure that care and support needs are met. A risk assessment process is also in place. The care plans are presented in a person centred style to incorporate personal, medical, social, activities and daily living needs. It was clear that the residents are involved in the care planning process as much as possible. Reviews are regularly recorded with input from the MDT. Residents are encouraged to be involved in reviews along with their relatives, where appropriate. However a number of residents find participation in reviews a difficulty and their wishes are respected if they do not wish to attend. The care files need to be audited to ensure that only relevant and up to date documents are in place with old information archived. This also includes pictorial aids and whether they remain relevant for individual residents. Some documents were not dated and the manager stated that she would ensure that this would be actioned Care Homes for Adults (18-65 years) Page 10 of 22 Evidence: immediately. It was clear from observations made during the inspection that the care team are actively involved with supporting residents throughout their day in a friendly, sensitive and professional manner. This was confirmed by residents spoken with during the day. Care Homes for Adults (18-65 years) Page 11 of 22 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. Residents are provided with assistance to access a variety of activities in the home and the wider community to meet their preferences and needs. Evidence: Residents continue to have access to a range of activities to meet their preferences and needs. Copies of individual activity programmes were seen in care plans. Examples included college courses, sports centre, bowling, cinema, swimming, football matches in St Ives, youth clubs, shopping trips to local towns and visits to the local pubs/restaurants. Trips to theatres locally and in London have been organised. A number of residents have enjoyed holidays to Spain, Paris, Centre Parcs, a health spa hotel and music festivals. Day trips to local towns are also organised throughout the year. Staff are proactively involved with residents and provide assistance to meet individual needs. There are two lounges with a range of equipment for communal use including Care Homes for Adults (18-65 years) Page 12 of 22 Evidence: television, DVD and music sytems. Residents individual bedrooms are also personalised with a variety of computer, audio and television equipment to meet individual preferences. Residents are fully involved in menu planning and can choose a variety meals they would like during the week. Residents participate in the preparation of meals, with staff assistance, throughout the week. A number of residents were involved in the preparation of the evening meal. Care Homes for Adults (18-65 years) Page 13 of 22 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. Residents receive appropriate personal and healthcare support to meet their assessed needs. Evidence: Residents receive ongoing assistance with their personal and healthcare needs. Staff support residents to attend appointments with healthcare professionals where required. Care records evidenced healthcare appointments including GPs, dentists and opticians. The members of the MDT also provide regular input eg. psychology and speech & language therapy. The manager stated, however, some new appointments were awaited in the MDT. A nutritionist has been contacted to assess the dietary needs of residents and for the promotion of healthy eating. A number of residents also benefit from regular input from a beauty & massage therapist. Medication records were inspected and were accurate. Care Homes for Adults (18-65 years) Page 14 of 22 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. The home has an appropriate complaints and protection policy to ensure that residents views are listened to and that they are protected from harm. Evidence: The home has a satisfactory complaints and protection policy to ensure that all concerns that are raised are dealt with in a timely and professional manner. All complaints are recorded appropriately. It was also positive to see a number of complimentary letters from relatives of residents regarding the care and support provided in the home. The Care Quality Commission has not received any concerns or complaints. The home continues to ensure that residents are protected from abuse and staff have received training in safeguarding adults. It was noted, however, that a number of staff need updates in training. The manager stated that she would ensure that all staff receive annual safeguarding training via the local authority trainer. Care Homes for Adults (18-65 years) Page 15 of 22 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. The home provides a comfortable environment to meet the needs of residents. Evidence: The environment meets the needs of the residents as a group and individually. The home is bright, clean, and well furnished. There is an ongoing maintenance programme to ensure that decoration and repairs are carried out. Since the last inspection one of the bathrooms has been completely refurbished along with the bath/shower rooms. New sofas have been purchased for one of the lounges. A large flat screen television has been installed in one of the lounges. The kitchen, in side one of the home is in need of refurbishment as it is showing signs of wear and tear. The fridge freezer has damage to the door and needs to be replaced. The gardens are well kept and a resident from one of the local Brookdale homes is employed to maintain the lawn and to carry out weeding. Residents are encouraged to personalise their bedrooms. Two residents showed us their bedrooms which were personalised and clearly reflected their individual wishes and preferences. Care Homes for Adults (18-65 years) Page 16 of 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff receive induction and supervision but improvements are needed to ensure safe practice Evidence: The recruitment records for three members of staff were inspected and they contained appropriate documents including; a Criminal Records Bureau check, references, an application form and proof of identity. Evidence of regular monthly formal supervision sessions were also seen. There were sufficient numbers of staff on duty to meet the personal and social needs of residents. It was noted, however, that training needs to be updated to ensure the care staffs safe practice. Safeguarding adults and autism training need to be updated. Four staff were interviewed and they all confirmed that they received regular supervision. They however also confirmed that they required updates in a variety of training. The manager stated that she is auditing all training to ensure that updates are provided. Care Homes for Adults (18-65 years) Page 17 of 22 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally well managed but improvements are needed to some fire safety processes. Evidence: Since the last inspection there has been a change of manager. The manager is in the process of completing an application to register with the Care Quality Commission. She has completed the Registered Managers Award (RMA) and undertaken management training regarding teamwork, disciplinary and investigation. The Skills for Care management training is also awaited. Staff spoken with stated that they felt supported by the manager and management processes in the home. Health & Safety checks are carried out regarding water and fridge temperatures. There was evidence of fire testing being undertaken but it was noted that improvements are needed as gaps in recording were seen for the months of July and August 2009. The manager stated that she would ensure that consistent fire records are maintained. Care Homes for Adults (18-65 years) Page 18 of 22 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 19 of 22 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 24 23 Refurbishment and decoration must be undertaken to the kitchen in side one of the home. To provide a safe and well maintained area for residents and staff. 28/02/2010 2 35 18 The manager must ensure that staff receive ongoing training. To ensure safe practice and that residents are supported by competent staff. 31/01/2010 3 42 17 The manager must ensure that fire safety records are accurately maintained and up to date To ensure the safety of residents and staff. 30/11/2009 Care Homes for Adults (18-65 years) Page 20 of 22 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 10 It is recommended that the care plan files are audited with old information archived to give a clearer picture of current care and support needs Care Homes for Adults (18-65 years) Page 21 of 22 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 22 of 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!