Care Home: Elm Royd Nursing Home

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What the care home does well We spoke to six people who were using the intermediate care service. They all told us that staff were kind and patient and that nothing was too much trouble. They also said that they were regaining their confidence and independence and were all hoping to return home. Staff know about the safeguarding procedures, this means that they know about the different types of abuse and what they need to do to make sure people are kept safe. What the care home could do better: Staff must make sure that they use the assessment information to formulate a risk management plan for people who are moving into the home. This will make sure that risks to individuals are reduced or eliminated. The manager needs to continue with her plans to increase the level of activities that are available in the home. This will make sure that people are kept occupied and stimulated. The manager needs to continue with her review of the menus and mealtimes, in consultation with people living in the home. This will make sure that people are getting the meals that they want and that meal times are an enjoyable social occasion. The staff who work in the intermediate care unit must receive specific training about how to support people in regaining their independence and daily living skills. This will make sure that people using the service are supported consistently. All of the staff recruitment files must be audited to make sure they all contain the necessary checks and information. This will make sure that all of the recruitment files are up to date. The home must make sure that they keep us informed of certain things that happen in the home. This will make sure that people using the service are supported consistently. Random inspection report Care homes for older people Name: Address: Elm Royd Nursing Home Brighouse Wood Lane Brighouse West Yorkshire HD6 2AL two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Paula McCloy Date: 1 5 0 4 2 0 1 0 Information about the care home Name of care home: Address: Elm Royd Nursing Home Brighouse Wood Lane Brighouse West Yorkshire HD6 2AL 01484714549 01484711400 elmroydoffice@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Philip Bennett (Elmroyd) Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 50 Number of places (if applicable): Under 65 Over 65 0 35 dementia old age, not falling within any other category Conditions of registration: 15 0 The maximum number of service users who can be accommodated is: 50 The registered person may provide the following category of service only: Care home with Nursing - Code N, to service users of the following gender: Either, whose primary care needs on admisson to the home are within the following categories; Old age, not falling within any other category - Code OP and Dementia - Code DE Date of last inspection Care Homes for Older People Page 2 of 10 Brief description of the care home Elm Royd Nursing Home offers nursing care, personal care and accommodation for up to 50 older people. This includes 15 places registered for people with dementia. The home is located in a residential area of Brighouse just a short distance from the town centre and near to the bus routes between Brighouse, Elland and Halifax. Care Homes for Older People Page 3 of 10 What we found: We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. One inspector visited the home unannounced. During the visit we talked to people living in the home, the staff and the manager about their experiences of living and working at Elm Royd Nursing Home. This is what we found: We looked at the assessment information that the home had received for one person prior to them being admitted to the intermediate care unit. This told us that the person already had pressure sores, was at high risk of falling and that they often wake at night because they need the toilet. Staff had not completed any written risk assessments to show how they were going to reduce the identified risks. However, we did see that they had made sure that a specialist mattress and pressure relieving cushion were in place to make sure this person was nursed appropriately regarding their existing pressure sores. Staff failed to address the risk attached to this person waking at night and needing the toilet. This person fell in the en suite toilet on the first night. Subsequently a commode was put by the bed and staff told them to use their buzzer. There have been no further falls. If staff had completed the risk assessments properly we feel it is likely the fall could have been prevented. Staff must make sure that they use the assessment information to look at a risk management plan for individuals and to inform a basic care plan, as far as possible, before people are admitted. We spoke to six people who were using the intermediate care service. They all told us that staff were kind and patient and that nothing was too much trouble. They also said that they were regaining their confidence and independence and were all hoping to return home. All six people we spoke to told us that there was little on offer in the way of activities, apart from an exercise class. We talked to the manager about this who agreed that there is generally a lack of stimulation for people and she has plans in place to address this. Peoples views about the meals in the surveys were mixed. The people we talked to said the meals were a bit hit and miss sometimes they like them and sometimes they dont. Again the manager is aware of the issue with meals and is currently getting advice on the current menus and is looking at ways of improving meals for people living in the home. We observed the second sitting of the lunchtime meal. People from the intermediate care unit go to the main dining room downstairs, unless they prefer to have their meals in their room. As they arrived staff were trying to set the tables with cutlery, but there was not enough, so they had to wait for some to be washed up. One person told me that they had eaten their cornflakes at breakfast time with a teaspoon as they had run out of desert spoons. There wasnt a full set of condiments on each table and people had to ask staff for the salt. People were offered a choice of orange or red squash. One person said they didnt know what flavor the red squash it didnt taste of anything. People were then given their selected choice of lunch, hot drinks were served and then the pudding. The process was very quick and not a particularly social occasion. We discussed this with the Care Homes for Older People Page 4 of 10 manager who again is aware of this and has various ideas about how mealtimes can be improved. There have been some safeguarding issues at the home, which have been reported and dealt with properly. We spoke to six members of staff who all told us that they had received training about safeguarding and the reporting procedures. This means that staff know about the different types of abuse and what they need to do to make sure people are kept safe. The home is clean, comfortable, tidy and well maintained. There is a programme of staff training in place and staff told us that their training is kept up to date. The staff that work on the intermediate care unit have not received any specific training about re enablement. It is important that they have this training as people using the intermediate care unit are all working towards improving their independence skills and confidence so that they can return home. This means working in a different way with people. One person told us that they cant put their hearing aid in. They said that staff will do it for them but that wont help when they go home. On the intermediate care unit people using the service get support from staff at Elm Royd and also the rapid response team, who are a team of physiotherapists, occupational therapists and support staff. The rapid response staff all have a key role in helping people to regain their skills and experience. For example during our visit some rapid response staff were present and were walking people to help them improve their mobility. When we talked to Elm Royd staff working on the unit they seemed to think that the rapid response team do one job and they do another, rather than them all working together. For example we asked if they continue with walking practice, for example, they said with some people but not others. This is another reason that staff need specific training so they feel confident in a supporting role. The current manager is in the process of recruiting more staff including nurses. No staff will be taken on until all of the necessary checks have been completed to make sure they are suitable and safe to work with older people. New staff will also receive induction training before they start working in the home. We looked at one recruitment file for a nurse who started working at the home before the current manager started. The checking process was not thorough and this person had worked in the home before their criminal records check had been received. This means that they had worked, unsupervised, before confirmation had been received to say they were suitable. This person no longer works at the home, but all of the staff files must be audited to make sure all of the necessary information has been obtained. The current manager has been in post for 6 months. Staff told us that she is approachable and is making changes to benefit people living in the home. When we looked at various records we found that the home have not been telling us about certain things that they should be. For example people living in the home going to A & E following an accident, an outbreak of an infectious disease and the passenger lift being out of action for several days. It is important that they tell us about certain events so that we can make sure they are taking the right action. Care Homes for Older People Page 5 of 10 The accident reporting procedures at the home are good and every accident is followed up. For example if someone has fallen the following day staff will check to see if there is any bruising. The manager also analyses the accident reports every month to see if there is any pattern emerging for example time of day, location etc. This means that she is always looking at ways to reduce the risks. What the care home does well: 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 3 13 Staff must make sure that they use the assessment information to formulate a risk management plan for people who are moving into the home. This will make sure that risks to individuals are reduced or eliminated. 21/05/2010 2 29 19 All of the staff recruitment files must be audited to make sure they all contain the necessary checks and information. This will make sure that all of the recruitment files are up to date. 30/06/2010 3 30 18 The staff who work in the 30/06/2010 intermediate care unit must receive specific training about how to support people in regaining their independence and daily living skills. This will make sure that people using the service are Care Homes for Older People Page 8 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 supported consistently. 4 38 37 The home must make sure 14/05/2010 that they keep us informed of certain things that happen in the home that are specified in regulation 37 of the Care Homes Regulations 2001. This will make sure that we can check that they are taking the right action and managing the home properly 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 12 The manager needs to continue with her plans to increase the level of activities that are available in the home. This will make sure that people are kept occupied and stimulated. The manager needs to continue with her review of the menus and mealtimes, in consultation with people living in the home. This will make sure that people are getting the meals that they want and that meal times are an enjoyable social occasion. 2 15 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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