Care Home: Elmwood Nursing Home

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What the care home does well People are given clear information about the range of services offered and are encouraged to visit before making a decision about moving in. This helps to assure people that the home will be able to meet their needs. The home supports people in following their personal interests and making the most of their abilities. They offer a variety of social activities, which include group and individual work. The activities organiser is very enthusiastic about his role and is always looking at ways he can improve this aspect of the service. People living in the home told us they know how to raise any concerns they might have and the company has clear procedures for dealing with complaints and concerns. The home is well maintained and provides a very pleasant place for people to live. It is clean, comfortable, and suitably equipped to meet the needs of the people who live there. There is a good staff training programme that helps to make sure staff have the knowledge and skills they need to meet people`s individual needs. What has improved since the last inspection? There were no requirements following the last inspection. The manager has successfully completed the Registered Managers` Award which means people can be confident she has the knowledge and skills needed for her role. The home is constantly looking at ways to improve the service. Since our last visit a number of improvements have been made. These include providing a computer with Internet access for people living in the home and increasing the range of activities to include a cooking and gardening club. Improvements have been made to the environment for example; the hairdressing salon has been refurbished. What the care home could do better: There are no requirements following this inspection. The home has good systems for consulting with people who use the service and they take account of people`s views when planning further improvements. Plans for future improvements include looking at starting a computer club and doing more work to improve the outside areas. CARE HOMES FOR OLDER PEOPLE Elmwood Nursing Home 3 Wetherby Road Leeds Yorkshire LS8 2JU Lead Inspector Mary Bentley Key Unannounced Inspection 18th November 2008 09:45 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 Elmwood Nursing Home DS0000001339.V373203.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. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elmwood Nursing Home Address 3 Wetherby Road Leeds Yorkshire LS8 2JU 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) 0113 2323501/2 0113 2733137 www.bupa.co.uk BUPA Care Homes (GL) Ltd Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th March 2007 Brief Description of the Service: Elmwood Nursing home is situated in the suburb of Oakwood in north Leeds. It is in a quiet setting but is situated close to local amenities on the northern end of Roundhay Road. It is on bus routes to the city centre, other parts of Leeds and local towns. The home is also close to Roundhay Park. Elmwood is a purpose built home with accommodation provided over three floors. Personal care with nursing is provided for up to 36 people over the age of 65 years. There are 32 bedrooms, all with en-suite toilets. The communal lounges and dining room are on the ground floor. There are attractive gardens that are accessible and well used by people. Information about the service and facilities is available in the form of a statement of purpose and service user guide as well as a home brochure. In November 2008 the weekly fees ranged from £552.00 to £858.72. Additional charges are made for chiropody, hairdressing, aromatherapy, newspapers, and toiletries. Elmwood Nursing Home DS0000001339.V373203.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 2 stars. This means the people who use this service experience good quality outcomes. 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 inspection process included looking at the information we have received about the home since the last key inspection in March 2007. The purpose of this inspection was to look at how the needs of people living in the home are being met. We did this visit in one day between the hours of 9.45am and 4.45pm. During the visit we spoke to people living in the home, visitors, staff and management. We looked at various records including care records and looked at parts of the building. Before the visit we sent surveys to people living in the home, staff and health care professionals. In total 16 were returned. We asked the home to complete a self-assessment (AQAA); this was returned to us in good time and contained all the information we asked for. This report incorporates the information we have received from various sources including our visit to the home, the surveys, and the home’s self-assessment. What the service does well: People are given clear information about the range of services offered and are encouraged to visit before making a decision about moving in. This helps to assure people that the home will be able to meet their needs. The home supports people in following their personal interests and making the most of their abilities. They offer a variety of social activities, which include group and individual work. The activities organiser is very enthusiastic about his role and is always looking at ways he can improve this aspect of the service. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 6 People living in the home told us they know how to raise any concerns they might have and the company has clear procedures for dealing with complaints and concerns. The home is well maintained and provides a very pleasant place for people to live. It is clean, comfortable, and suitably equipped to meet the needs of the people who live there. There is a good staff training programme that helps to make sure staff have the knowledge and skills they need to meet people’s individual needs. What has improved since the last inspection? 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. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 7 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 Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 8 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): 2, 3 & 5. Standard 6 does not apply People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are given information about the range of services offered, they are encouraged to visit, and their needs are assessed before they move in. EVIDENCE: Ten people who live in the home completed questionnaires for us. They all said they have contracts setting out the terms and conditions of their stay. The majority said they had been given enough information before moving in to help them decide if the home was the right place for them. One or two people said their families had chosen the home on their behalf, one person said “my son came to look around and found it very nice”. People’s needs are assessed before they move in and we saw evidence of this in the care records we looked at. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 9 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 & 11 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People’s personal and health care needs are met in a way that respects their privacy and dignity. EVIDENCE: People living in the home said they usually get the support and care they need and said they always get the right medical support. One person said the majority of staff give care and support cheerfully but said there are others who do not always seem interested and who do not smile much. Everyone living in the home has a care plan. We looked at three people’s care plans. The home has introduced a new format for recording care needs and the records contained detailed assessments of people’s needs. The care records have information about people’s personal, health, and social needs. The plans provide details of people’s individual strengths and weakness and Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 10 give clear instructions on what staff should do to support people in meeting these needs. There are risk assessments in place for example in relation to nutrition, falls, and the risk of developing pressure sores. When people are identified as being at risk appropriate plans are in place to show how the risk will be managed. The care plans were up to date. The manager told us that a selection of care plans are audited every month to make sure they are up to date. Care plans for new people are checked within the first 5 days of their stay to make sure the main areas of need have been identified. Visitors told us they are usually kept informed about changes in their relatives’ condition. We saw some evidence in the care plans that people or those close to them are involved in planning and reviewing care. This is an area that could be improved and we discussed this with the manager. The care plans have information on people’s wishes regarding end of life care. There are suitable systems in place to make sure that medicines are managed safely and people get their prescribed medicines. We saw that staff interacted with people in a way that showed respect for their privacy and dignity. When helping people we saw that staff took time to explain what they were doing, for example when helping someone to move with the aid of a hoist. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 11 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are offered the opportunity to take part in a varied range of social and leisure activities that take account of their preferences and abilities. EVIDENCE: Daily routines are flexible and people can choose how and where to spend their time. Some people prefer to stay in their rooms and if they wish they can have their meals in their rooms. The care records include information about people’s past lives and interests and this is used to help provide a programme of activities suited to their individual needs. As well as group activities time is allocated for one to one time with people. On the morning of our visit the activities organiser was not in the home but other staff, including the gardener, spent time chatting to people. In the afternoon when the activities organiser had returned a number of people joined in a game of Bingo in the dining room. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 12 The activities organiser is very enthusiastic about his role and talking to him it was apparent he has great empathy with people. He told us he is in the process of getting people registered for the Access bus so that it will be easier for them to go out, he is also looking at getting people Leeds Citizens Cards. These cards give people free or reduced rate admission charges to local places of interest. There are lots of photographs of people taking part in different activities. One of the most popular was a “virtual cruise”. As the virtual cruise docked in different destinations the dining room was decorated accordingly and people were offered food and drink of the destination. The home organises fund raising events and has an amenities fund, which is spent on social and leisure activities. A committee made up of representatives of people living in the home, their relatives, staff and management decide on how the fund will be spent. Money has recently been spent on bulbs for spring flowers such as daffodils and crocuses, and a group of relatives have planted the bulbs in the front garden. Visitors told us they are always welcome and we saw staff offering people refreshments. People who are able to go out alone safely or with family do so. The home has a varied menu. This is displayed in the dining room and there are menus on the tables. The home has introduced a “Lite Bite” menu, which is a list of snacks that are available when the kitchen is closed. People are offered a choice of food and we saw staff talking to people about the next day’s menu. We asked people if they liked the meals and the feedback was varied. Four of the 10 people who completed our questionnaires said they always liked the meals, 3 said usually, and 3 said sometimes. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 13 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There are suitable systems in place to make sure that complaints are taken seriously and acted on and to protect people from abuse. EVIDENCE: People living in the home told us they know how to make a complaint if they need to. Relatives told us that any concerns they raise are dealt with. The home keeps a record of all complaints and compliments. Senior management within the company monitors the way the home deals with complaints. The home told us they have had 3 complaints in the last 12 months and these have been dealt with. Earlier this year 2 concerns were referred to us, we sent these to the home and they dealt with them. The home has well established adult protection (safeguarding) procedures and staff have received training on the protection of vulnerable adults. When safeguarding concerns have been identified the home has dealt with them properly. There have not been any safeguarding issues since the last inspection. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 14 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 & 26 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is decorated and furnished to a high standard and provides a comfortable, safe and very pleasant place for people to live. EVIDENCE: The home was clean when we visited and people told us it is always clean. All areas of the home are decorated and furnished to a high standard and provide a pleasant and comfortable environment for people. There is a small lounge, which is used as a quiet room and can be used by people to receive visitors. The home has an outside seating area and pleasant gardens and people told us these areas are well used when the weather permits. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 15 In the rooms we looked at we saw that people have some of their personal belongings such as items of furniture, pictures and ornaments. The home no longer has shared rooms; the four rooms that were shared are now used as singles. The home has a hotel services manager who carries out weekly checks to make sure the communal areas and bedrooms are being maintained and cleaned to the required standard. There are suitable systems in place to reduce the risk of cross infection. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 16 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. There are usually enough staff available to make sure people’s needs are met and staff are supported in developing the skills and knowledge they need to care for people properly. People are protected because all the required checks are completed before new staff start work. EVIDENCE: People living in the home said there are usually enough staff available to give them the help they need when they need it. One person said the nursing staff, particularly those on during the day, make themselves available when needed. Another person said staff are sometimes very busy. People said staff generally listen to them and take notice of what they say. One person said some staff do this better than others, they said some staff have a tendency to go away and forget about what they have been asked for. We looked at two staff files and they showed that all the required checks are completed before new staff start work in the home. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 17 Staff who completed our questionnaires told us they received a good induction when they started work. They said they receive training to help them understand the individual needs of people living in the home and to keep them up to date with new ways of working. Information provided by the home showed that 88 of care staff have achieved an NVQ (National Vocational Qualification at level 2 or above. The training records show clearly what training staff have completed and when training needs to be updated. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 18 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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is appropriately managed. People are able to share their views and contribute to the development and improvement of the service. EVIDENCE: The manager has completed the Registered Managers’ Award and is in the process of applying for registration. She is an experienced nurse and has worked with the company for many years. She has been the manager at Elmwood since December 2006. She has an open approach and communicates well with people. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 19 The company has well established systems for monitoring the quality of the service. For example, monthly audits are carried out of the care plans, medications and of kitchen practices. The home sends information to the head office every month regarding, for example, accidents, and complaints. A senior manager visits the home at least once a month and looks at various aspects of the service. Satisfaction surveys are also sent out every year and meetings for people using the service are held every 3 months. The home does not get involved in managed people’s finances. They do hold small amounts of personal money for some people. All transactions are recorded and receipts are kept for any money spent of people’s behalf. Someone from the company’s head office audits this at least once a year. The self-assessment form completed by the home indicated that all the required maintenance and servicing of equipment is up to date, the records we looked at confirmed this. Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 20 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 X 3 3 X 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Elmwood Nursing Home DS0000001339.V373203.R01.S.doc Version 5.2 Page 23 - 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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