Care Home: Elm Tree House

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What the care home does well Prospective residents and their relatives are given clear information about the home and the services provided to help them make decisions about whether or not they felt the home was suitable for them. The manager ensures that a full assessment of need is carried out prior to any person being offered accommodation at Elm Tree House. This ensures that the home has the staff and facilities to provide the appropriate amount of care and support necessary to meet assessed need.On admittance every person is provided with a care plan which identifies details about their health, personal and social care needs and of how these needs would be met. Records show that staff are well trained and supported to carry out quality care and comments from people living in the home included; "The staff are kind and caring and know how to look after us" "The staff are a grand bunch. They look after me, make sure I get my medication at the right time and assist me to do the best I can to enjoy my days" "I love being here, the staff talk to me and the atmosphere is good. We have fun". Minutes of meetings and other documentation revealed that the people living in the home were involved in decisions about the day to day routines; people were consulted abut their level of satisfaction of the services provided and asked if they wanted any changes to be made. Discussion with people living in the home confirmed that the food is good, plentiful and well cooked. Comments included: "This meal is wonderful but so are all the others" "The food here is excellent. We get asked what we want and can have as much as we like, I love puddings and we get them every day" " I have never had a bad meal here yet and I have lived here for a long time. The food is always well cooked and presented and a pleasure to eat". The premises are subject to an ongoing refurbishment programme and the atmosphere is warm and welcoming with excellent interactions between staff, people living in the home and their friends and families. What has improved since the last inspection? Recruitment and section procedures have been updated to ensure that necessary checks and references have been completed prior to staff being appointed to work in the home. Care plans have been reviewed and include more detail about life history and diverse needs. Staff training has increased to include some in-house training now being available. Staffing levels have improved and additional senior roles have been introduced to ensure appropriate levels of leadership and support are available at all times. What the care home could do better: The inspection was most positive and comments from staff, people who live in the home and their family and friends confirmed that the home was very well run and provided top class services. Whilst all documentation seen was clear and relevant it was noted that staff do not write a daily activities log for the people who live in the home. Tick boxes are used to show various daily living tasks and on average twice weekly full records are maintained. However it is recommended that staff complete a written daily log of activities to ensure they reflect individual input and responses to all aspects of daily life. CARE HOMES FOR OLDER PEOPLE Elm Tree House 32 Crow Lane West Newton-le-Willows Merseyside WA12 9YG Lead Inspector Mrs Lynn Paterson Key Unannounced Inspection 09:30 27th October 2008 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elm Tree House Address 32 Crow Lane West Newton-le-Willows Merseyside WA12 9YG Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01925 291492 01925 228727 elmtreeresthome@aol.com Living Developments Ltd Mrs Beverley Steele Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The service should employ a suitably qualified and experienced manager who is registered with the CSCI Service users to include up to 20 OP The Service may accommodate up to a maximum of 5 (PD) over 55 years of age 27th November 2007 Date of last inspection Brief Description of the Service: Elm Tree House is a large Victorian Detached property, which has been extended and adapted to provide residential care for a maximum of 20 older persons. The home is situated on a main road location in Newton Le Willows and is close to shops and other local amenities. Accommodation is provided on the ground and first floor and a passenger lift and stair lift are in place for ease of access. The garden areas include a side patio and fishpond with open car parking facility to the front. Fees are currently between £380.00 and £451.00 per week. Further details of fees can be obtained from the home manager. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The inspection was unannounced and was conducted over a one -day period. All day and recreation areas were seen, some of the resident’s bedrooms were viewed and observations made of staff and residents interactions. Care files and other records kept in the home such as health and safety records and staff files were also examined. Discussions were held with the people living in the home and their visitors and the people who worked there. The visit formed just one part of the inspection. Other information about the home was also looked at. Prior to the visit the manager was asked to complete an Annual Quality Assurance Assessment (AQAA) which is a detailed document that gives lots of information and updates about the home and questionnaires were also sent to people who live in the home, their families and to staff members of Elm Tree House in order to find out their views of the home and services provided. Other information received since the last inspection was also reviewed. All this information was then used to format this report. What the service does well: Prospective residents and their relatives are given clear information about the home and the services provided to help them make decisions about whether or not they felt the home was suitable for them. The manager ensures that a full assessment of need is carried out prior to any person being offered accommodation at Elm Tree House. This ensures that the home has the staff and facilities to provide the appropriate amount of care and support necessary to meet assessed need. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 6 On admittance every person is provided with a care plan which identifies details about their health, personal and social care needs and of how these needs would be met. Records show that staff are well trained and supported to carry out quality care and comments from people living in the home included; “The staff are kind and caring and know how to look after us” “The staff are a grand bunch. They look after me, make sure I get my medication at the right time and assist me to do the best I can to enjoy my days” “I love being here, the staff talk to me and the atmosphere is good. We have fun”. Minutes of meetings and other documentation revealed that the people living in the home were involved in decisions about the day to day routines; people were consulted abut their level of satisfaction of the services provided and asked if they wanted any changes to be made. Discussion with people living in the home confirmed that the food is good, plentiful and well cooked. Comments included: “This meal is wonderful but so are all the others” “The food here is excellent. We get asked what we want and can have as much as we like, I love puddings and we get them every day” “ I have never had a bad meal here yet and I have lived here for a long time. The food is always well cooked and presented and a pleasure to eat”. The premises are subject to an ongoing refurbishment programme and the atmosphere is warm and welcoming with excellent interactions between staff, people living in the home and their friends and families. What has improved since the last inspection? Recruitment and section procedures have been updated to ensure that necessary checks and references have been completed prior to staff being appointed to work in the home. Care plans have been reviewed and include more detail about life history and diverse needs. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 7 Staff training has increased to include some in-house training now being available. Staffing levels have improved and additional senior roles have been introduced to ensure appropriate levels of leadership and support are available at all times. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1.2,3.4.6. Quality in this outcome area is excellent. The home provides clear information about the service provision to enable them to decide upon its suitability. Staff carry out detailed assessments on people before offering them a room in the home to determine if they can offer services appropriate to need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information about the services the home provided had been reviewed and updated so that people could make informed decisions about whether the home would suit their needs. The manager said that this information is available in differing formats to include large print and audio, which can be provided on request. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 10 Information gained from discussions and questionnaires indicated that people who live in the home are provided with documentation about their terms and conditions and they knew what the home offered, and what their contract said, if they ever wanted to leave or if the home said they could no longer provide care appropriate to need. Signed copies of this agreement are also held in the persons care file. Care files viewed clearly detailed that information had been collected about the prospective resident prior their admittance to the home. The manager said that this information was then analysed and a decision made as to whether the home had the staff and facilities to meet the assessed need. Documentation viewed revealed that the manager had refused several requests for accommodation in the home due to her assessment with the outcome that the needs of the individual could not be met within Elm Tree House. Staff said prospective residents are encouraged to visit the home and meet staff and the people living at the home to enable them to reach a decision about their future care. Staff records and training files show the staff of Elm Tree House have the skills, knowledge and experience to meet all individual needs of the people living there. People living in the home said they had either visited the home or been invited to visit prior to going to live there. They said that they had been given lots of details about the home and the services provided before they made the decision to move in and had also had much discussion with the manager about how much care and support they would need. People said that they had been given plenty of information and felt they had been able to make what could have been a difficult choice for their future, very easy. Intermediate care is not provided at this time. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7.8.9.10. Quality in this outcome area is excellent. Care plans are thorough and identify the levels of care and support needed by each person living in the home and how this will be provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five care plans were examined in detail. Information contained in the plans showed they had been developed from information obtained prior to admission and included details about how peoples health, personal and social needs would be met. Care plans held signatures of all who had been involved in drawing them up and detailed reviews of care taking place to ensure that any changing needs were identified and addressed. Changing needs noted included decreased mobility, changes of diets and medication. Discussion with people living in the home revealed that they are fully involved in their care plans and reviews and they say they are asked everyday if they Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 12 need anything changed in respect of their care and support. Comments included: “The staff talk to us each day and ask us if we need anything changing or if everything is alright” “ The staff speak with us all the time and check if we need anything different. They look after us so well” “They seem to know when things are changing for us, they always have their eye on us to see we are OK” “We have official care reviews when we and our families meet with staff to discuss things but we have unofficial care reviews everyday.” Families and other representatives of people living in the home said they were always kept up to date and consulted with any about any changes that may have occurred in their friends/relatives condition. Care file showed that risk assessments had been carried out for all the people living in the home to reduce or remove any risk that had been recorded in the plan. It was noted that a range of specialised aids and adaptations were in place to maintain the comfort of the people living in the home and to maintain their independence wherever possible. Records showed that staff training is good and enables them to monitor and review any changes in people’s conditions. Staff said this is further enhanced by the home having a key worker system in which each staff member holds extra responsibility for one or two residents to include monitoring and reviewing their wellbeing. It was noted that people living in the home have ease of access to external health care professionals to include district nurses, dentists and chiropody services. It was noted that some activities of daily life are recorded by use of a tick box system, with a full written record being made on average twice weekly. Whilst this identifies what services and activities have occurred it does not fully record how the person has responded. It is therefore recommended that a daily written log be in place to ensure an individualised record is available of the input of each person living in the home in respect of the activities of daily life. The medication policies and procedures were clear and provided safe guidance that reflects good practice. Medication records viewed were clear and consistent, medication storage was well managed and staff identified they had benefited from medication training updates to ensure they fully understood the policies and practices in respect of the safe management of medication. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 13 There were no people looking after their own mediation although the manager advised that lockable storage was provided in residents rooms if any person wished and was risk assessed as able to self medicate. The manager advised that she carried out a minimum of weekly medication audits to ensure medicines were managed safely. Observations of staff interactions with the people living in the home and their visitors revealed the atmosphere was one of mutual rapport and respect. Visitors to the home said they never felt as if they were intruding and were always made welcome. They said that if they wished for privacy they were able to go to a quiet room or the person’s bedroom. The family and friends of the people living in the home said they felt the home fully respected everyone who either lived or visited the home and acknowledged and understood all diversity. People living in the home said they could spend time in their rooms and have visitors there if they wished. They said that staff never made they feel uncomfortable and if they needed anything done that was of a personal nature staff always made sure it was done in private and dignity was preserved. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14.15. Quality in this outcome area is excellent People living in the home are encouraged to take part in activities to suit their diverse interests. A healthy, tasty diet is provided to meet all individual preferences and requirements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The activities in the home are arranged in a way that recognises and reflects every person’s interests and capabilities to ensure that all the people who live in the home can, if they wish, participate in the activities programme. People spoken with said they loved the things that went on in the home, as they were able to have fun and enjoy their days. Comments included: “I like to watch the others doing activities as I don’t do much myself but have a good time watching” Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 15 “I play bingo, quizzes and things. Sing songs are good and we have good entertainment” “We just have a good time, I sing for the staff and they love me. I have good friends here and we go out and we have parties and entertainers come and sing and play instruments and we have a little drink if we want, its great” Minutes of residents meetings showed that all the people living in the home are invited to discuss the activities and the way the home is managed and to discuss suggestions, choices and preferences concerning the daily running of the home. These meetings are further enhanced by the registered owner of the home visiting the residents on a very regular basis to find out their wishes about daily life at the home. He then holds discussions with the staff of Elm Tree House to ensure the resident’s voices are heard and any changes to routines can be put in place to comply with people’s wishes. Discussion with staff and people living in the home confirmed that people are given choices in all aspects of their daily life to include choosing the clothes they wear, meals, drinks, activities, bathing issues, medication and receiving visitors. People living in the home said they were always given choices and fully allowed to live the life they chose. Care plans show they are person centred and include social history details to include past employment, family tree, hobbies and interests and any other information that is significant to the individual. Staff revealed that these details enable them to enjoy meaningful conversations with the people living in the home and ensure any emotive issues are dealt with sensitively. The menu offered a choice at each meal and was displayed on the notice board in the dining room. Records showed that choices are offered and any alternatives to the menu were provided on request. Observations of people eating lunch revealed that all the food provided was eaten and no food was left on plates, as everyone appeared to fully enjoy the meal. People said the food was always excellent, plentiful and extra portions a offered at every meal. Comments include: “Food is smashing, I love the food here”,” The choice is so good sometimes I don’t know what to ask for”, ”This meal today is so tasty but they are tasty everyday”. “The cook is wonderful, her meals are so good and the food is always so well cooked I hope she never leaves”. ”Food is available here twenty four hours a day if we want it” The dining areas presented as bright and pleasant and tables were set with good quality cloths and napkins. Staff were on hand to give discreet to people who needed support with their meals. The atmosphere was one of calm and Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 16 comfort with good conversation and gentle humour being used between residents and staff. It was noted that it was the birthday of one staff member and residents had provided a birthday card and some sang to her and gave her their congratulations. Observations and discussions confirmed that Elm Tree House enables the people living in the home to feel totally at home and experience a quality lifestyle of their choice. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16.18. Quality in this outcome area is good. People know how to complain and staff are trained to understand all aspects of adult protection which reduces the possible risk of harm to the people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is fully accessible to people living in the home and their representatives and discussion and information received from surveys confirmed that people understand the procedures and known what to do if they have a complaint. People spoken with said that they felt that any complaints would be dealt with quickly and fairly and added that the staff and home owner asked them all the time if everything was alright and if they had any complaints. No people spoken with said they had ever had need to make a complaint. However the manager said that one complaint had been received in the past twelve months and records showed that this had been responded to according to procedure. The policies and procedures in respect of safeguarding adults were clear and detailed specific guidance for staff to include actions they should take if they suspected abuse had occurred. Staff records revealed that all staff had received training in adult protection and staff spoken with identified that they Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 18 were able to recognise abuse and respond appropriately to protect residents from harm. There had been one safeguarding referral in the past twelve months and records show that this had been openly discussed with the appropriate agencies. The home has a Whistle Blowing policy in place, which staff said they fully understood. Risk assessments were in place for all people living in the home to ensure that all equipment or restraint methods that may be used were fully discussed with the residents and their representatives and monitored and reviewed to make sure they were used appropriately. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19.25.26.Quality in this outcome area is excellent. The home is safe, clean, and comfortable and well maintained which makes it a pleasant place for people to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial tour of the premises identified that the home was well maintained both internally and externally and met the resident’s needs in a safe, comfortable and homely way. The manager and home -owner revealed that they have a development plan in place that supported refurbishment work taking place as an ongoing process. Records show that all essential service and equipment checks had taken place within the past three months and there had been no concerns expressed Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 20 around safety. Alarm call systems were fitted in each bedroom and testing of this system confirmed it was in full working order. Communal areas were comfortable, warm and inviting. Fabrics and furnishings were of good quality and the premises clean and free from unpleasant smells. The garden areas appeared to be well managed and people living in the home said they liked looking out at the gardens and also looking at the fish in the large fishpond at the side of the garden. The rooms of people living in the home were clean and smelled fresh and were furnished to a good standard. People said they had been welcomed to bring in some of their own possessions to make their rooms feel more personalised and homely. Comments from people living in the home and their relatives included: “I love my room it is comfy and cosy and its great” “I like being in my room, it’s got everything I need and if I want the staff to help me I just press this buzzer” “We like coming here, its such a nice home. It always smells nice, we know she is safe and happy here”. General comments from discussions and returned questionnaires revealed that people living in the home and their representatives feel that home provides first class, safe and comfortable accommodation and that ongoing work is constantly carried out to continue to meet these high standards. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27.28.29.30. Quality in this outcome area is excellent. Trained and competent staff are provide in numbers and skill mix to ensure the people living in the home are safe and well cared for. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff records viewed showed that a safe recruitment and selection process was in place to ensure that people appointed were able to provide references and police checks prior to them being offered employment at the home. Records showed that staff had received appropriate training and support to help them to understand the needs of the people living in the home. Almost three quarters of the staff have achieved a recognised qualification in care and staff said they are encouraged and supported to develop their skills and knowledge as an ongoing process. Records showed that staff meetings are held regularly and staff said they were able to voice their opinions, give suggestions for service improvement and get a general update about any changes in legislation or the running of the home. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 22 Staff rotas were clear and identified that staff were provided in sufficient numbers and skill mix to meet the assessed need of the people living in the home. Staff said they worked hard but were able to manage to provide care and support as required. People living in the home and their family and friends said that staff are “wonderful”, “helpful” and “kind”. Other comments included: “Staff treat us all so well its like family when we visit here. The atmosphere is always good no matter how busy they are. They are cheerful and supportive of us all” “The staff are always available to us, nothing is too much trouble. I don’t know how they manage but they do” “They always keep us informed, they look after mum very well and it’s a pleasure to visit”. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31.33.35.38. Quality in this outcome area is excellent People benefit from a well managed home which is run the very best interests of the people living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has vast experience in the care of older people and she has achieved her registered managers award. Staff, residents and other people associated with the home commented that she was a very good manager, was very supportive, a good listener and was always ready to assist- whatever the situation. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 24 The home has excellent systems in place to monitor the quality of the home and to ascertain if people felt they were getting a service of their choice. It is also monitored by external agencies to include St. Helens local authority contracts department and environmental health. Feedback was generally most positive. The manager and people living in the home said that the registered provider visited the home on very regular basis and spends much time chatting with the residents and seeking their views about the service provided and asking for their ideas about if they felt any changes or improvements were needed. People living in the home said they respected him and knew that he always had their best interest at heart. The manager said she has frequent meetings with the registered provider and feels able to freely discuss any issues or areas of concern in the knowledge that if there are any problems solutions will be quickly found. The Annual quality self -assessment document (AQAA) was completed and showed that the home continues to provide good quality services to meet the changing needs of the people living in the home. This includes providing services for people who experience dementia. Although the AQAA was completed and returned as directed it did not do the home justice and much more information about quality systems and services was gained during the visit. Financial records for three residents were checked and showed that systems in place for safeguarding people’s monies were well managed and included the use of double staff signatures and frequent audits being carried out on each account. Staff said they had regular one to one supervision and support sessions, which were good as they identified positive and negative issues. They said the sessions also enabled staff to discuss their continuous personal development to include being able to undertake specialised training of their choice. The AQAA and other documentation showed that all essential services were regularly maintained and safe and health and safety training is provided for all staff to ensure that they and people who live in the home are safe and their welfare protected. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 4 3 4 4 X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X 4 4 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 4 Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations It is recommended that staff enhance their current recording systems and complete a written daily log of activities to ensure they reflect individual input and responses to all aspects of daily life. Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Merseyside Area Office 2nd Floor South Wing Burlington House Crosby Road North Waterloo, Liverpool L22 OLG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Elm Tree House DS0000061681.V367486.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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