Care Home: Elmwood Nursing Home

Similar services:

• Clovelly House Residential Home Ltd
• Cherry Orchard Nursing Home
• Coppermill Care Centre
• Fountains Care Centre (The)
• Eleanor Palmer Trust Home
• Elmstead House
• Bridgeside Lodge Care Centre
• Dalemead

What the care home does well The home provides comfortable accommodation for up to 60 people with dementia. There is plenty of room for people to wander around safely and sufficient staff on duty to meet their needs. Although many of them are unable to contribute to the inspection process they all look happy and well cared for. People who returned our surveys told us that the staff are kind and friendly and always happy to help them. A commitment to staff training ensures that they have the skills necessary to meet the needs of the residents that they support. A range of activities is in place to offer interest and stimulation. What has improved since the last inspection? All of the requirements that were issued at the last inspection have been complied with. Staff training programmes are continuing to be developed and the home is also working towards Gold Standard Framework accreditation. This will help them to provide a good standard of care and support for those people who are nearing the end of their lives and their families. What the care home could do better: The AQAA submitted by the home shows that they are aware of areas that could be improved. They will be continuing to increase training for staff and try to provide more activities and outings for residents. The redecoration and refurbishment plan will be ongoing to ensure that the home provides a pleasant and safe environment for the people who live there. Key inspection report Care homes for older people Name: Address: Elmwood Nursing Home Elmwood Nursing & Residential Home 32 Elmwood Road West Croydon Surrey CR0 2SG     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: Alison Ford     Date: 0 6 0 4 2 0 1 0 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 Older People Page 2 of 26 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 Older People 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Elmwood Nursing Home Elmwood Nursing & Residential Home 32 Elmwood Road West Croydon Surrey CR0 2SG 02086894040 02086894141 elmwood@highfield-care.com www.schealthcare.co.uk Southern Cross Care Homes No 3 Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 60 The registered person may provide the following category of service only: Care home with nursing (CRH - N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia Code DE Date of last inspection Brief description of the care home Elmwood Care Centre is a purpose built care home providing both personal and nursing care. The home is situated in West Croydon and is near to shopping centres and transport. The service users accommodation is situated on the ground, middle and top floors. There is a lower ground floor accommodating the kitchen, laundry, plant machinery and offices. There are 46 single bedrooms and 7 double rooms. The Care Homes for Older People Page 4 of 26 Over 65 0 60 0 6 0 5 2 0 0 9 Brief description of the care home majority of bedrooms have ensuite toilets and the manager states all bedrooms meet the new National Minimum Standards for space. There are lounges and dining rooms on each floor and each floor has its own facilities including bathrooms, showers, kitchenette and office. There is a lift serving all floors. We are told that fees currently range from £577:86 - £900 depending on the needs of the resident. Some extra charges may be payable for services such as hairdressing or private chiropody and these would be discussed prior to admission. Different rates apply for residents who are privately funded as opposed to those who are paid for by the local authority. Care Homes for Older People Page 5 of 26 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This report follows an announced inspection visit to the service. However we have also taken into consideration other information that we have received since our last inspection which was in 2007. This has included comments that we have received from people who live or work in the home, information that we have about how the service manages any complaints and also what they have told us about things that have happened there, notifications. In addition the home sent us their Annual Quality Assurance Assessment (AQAA) when we asked for it. This is a self assessment which tells us how well they believe that they are meeting their aims and objectives and about their plans for the future. When we visited we were able to walk around the home and talk to the manager and the staff on duty. We did chat with some of the residents although all of them have some degree of dementia and their ability to contribute to the inspection process is Care Homes for Older People Page 6 of 26 limited. Care Homes for Older People Page 7 of 26 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 Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. No one is admitted into the home without having had an assessment of their needs, in order to ensure that they can be met. Evidence: The management team are aware of the need to help people through the admission process and all prospective residents would be assessed by either the manager or a senior nurse to ensure that their needs can be met. They, if they are well enough, and their families would be encouraged to visit the home prior to admission to help them in their choice and the manager or her deputy would spend time discussing the services and support that can be offered. Those people who are funded by the local authority would also have an assessment of needs, provided by their care manager. Written information is available, in the form of a Service User Guide, which explains all about the home. This could also be made available in audio form, on request, to assist those who may have difficulties with the written format. Care Homes for Older People Page 10 of 26 Evidence: All placements are reviewed after six weeks to ensure that people are happy and that the service is meeting their needs. This home does not offer intermediate care so standard 6 does not apply. Care Homes for Older People Page 11 of 26 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. Arrangements for meeting the health care needs of residents, including the administration of medication, are in place and staff treat them in a kind and respectful way. Evidence: Each resident has an individual care plan, the documentation is a standardised Southern Cross format. This is comprehensive and focuses on the resident using a person centred approach with all aspects of their physical and mental health care considered. It includes risk assessments, nutritional assessments and moving and handling plans. The plans are reviewed regularly so that any changes are identified and can be addressed and realtives would be encouraged to participate in the process where the resident was not able. Each resident is allocated a named nurse and a key worker who have a special role to play in monitoring their care. The key worker will also make sure that the resident has enough supplies of any personal items that they might need, liaising with their relatives or perhaps doing the occasional bit of shopping. Care Homes for Older People Page 12 of 26 Evidence: Those people who are not able to access health care services are visited by a local GP as required and other professionals, such as the dentist and chiropodist attend the home as necessary. Those people who are nursed in bed because they are unwell or are thought to be at risk of developing pressure sores have all been provided with appropriate equipment such as pressure relieving mattresses and cushions. Medication is only administered by trained nurses and storage and administration procedures are monitored and audited regularly by either the manger or her deputy. They are also checked by a company representative as a part of the monitoring process required by Regulation 26 of The Care Standards Act. We were told that the systems had recently been checked as part of some training provided by the Primary Care Trust, so, on this occasion we just looked at some of the administration sheets to make sure that they were in order. Staff are working to achieve accreditation for the home in relation to The Gold Standard Framework (GSF). This is an initiative which ensures the best possible care and support for those people who are nearing the end of their lives and their families. This is undertaken in conjunction with staff from St Christophers Hospice who work with staff and support them. There are also regular meetings with the homes psychiatrist and Community Psychiatric Nurse. Relatives are invited to be involved in discussions which explain the role of the GSF and staff say that it has lead to a deeper understanding of all of the issues that are involved and unwanted hospital admissions have been minimised. Care Homes for Older People Page 13 of 26 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to make choices in their lives as much as their frailty allows and activities are arranged which staff hope will interest them. Mealtimes are seen as an important event and people seem to find them a pleasurable experience. Evidence: The people who live in this home all have dementia to some degree and for many of them this means that their ability to make choices is limited and they are very dependent on the staff. However,we could see that staff try to involve them in discussions about what they would like to wear, to eat and how they might spend their day. Relatives have been encouraged to participate in the care planning process and to provide information that helps staff to understand more about residents past lives and achievements in order that they can provide activities which will interest and stimulate them. There is a full time activities person, and a dedicated room where various sessions including arts and crafts can be done. Musical entertainers come to the home regularly and a clothing company visits so that residents are able to choose and buy their own clothes. A reflexologist holds weekly sessions and some people benefit from having massage which we are told helps them to relax. Calendar events such as easter, and Care Homes for Older People Page 14 of 26 Evidence: valentines day are celebrated and there is a summer fete and Christmas party. Meals in the home are served in the dining rooms on each floor. Tables are set with cloths, flowers and a copy of the days menu. Residents are helped to make a choice from two options and there is help available for anyone who needs it. Some of the residents in the home are Caribbean and African and the cook includes several meals a week which reflect their different cultures. She also provides cakes to celebrate residents birthdays. A recent visit from the environmental health officer did not raise any concerns about the procedures and standards of food hygiene in the kitchen. Visitors are always welcome in the home although the manager is trying to introduce a protected mealtimes policy asking them try to avoid coming in at mealtimes. There is a concern that this might distract people from eating, and it also allows the staff to have time to be able concentrate on helping them. Care Homes for Older People Page 15 of 26 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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. Should anyone wish to raise a concern about the service, information would be readily available to help them and the issues would be addressed promptly. Policies and procedures are in place to ensure the protection of those who are living in the home. Evidence: Southern Cross, as a large provider, have a clear corporate complaints policy which is made available to everyone. Copies are in the entrance hall and given to residents and their families. Records are kept of all complaints and they are responded to promptly. The Registered Manager views complaints as a positive process that highlight areas where the service can be improved. She has an open door policy whereby she is always willing to discuss any issues of concern and she holds a Surgery once a week where she is available to speak with people. There is currently one outstanding complaint being addressed in accordance with the local authority safeguarding procedure. The Commission is always informed of any untoward incidents in the home, in line with Regulation 37 of The Care Standards Act. We were told that all staff have received training regarding recognising and reporting adult abuse and those we spoke with had a clear understanding of what they should do. They were also able to explain how they could progress any concerns that they Care Homes for Older People Page 16 of 26 Evidence: might have, through relevant people within the organisation. All of the staff employed in the home have had the relevant checks undertaken, prior to starting work, to ensure that those who have been judged as not being suitable to be working with vulnerable adults are prevented from doing so. The manager has received training in Deprivation of Liberties Safeguarding and The Mental Capacity Act however this does not seem to have been cascaded down to other staff. In view of the poor mental capacity of many of the residents, we have discussed the need for this training to be escalated to all staff. Care Homes for Older People Page 17 of 26 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, 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. 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. Although the size of the home means that it does not present as homely, it is comfortable, clean and well maintained and their aids and adaptations in place to help the people who live there. Evidence: Elmwood is quite a large home, of 60 beds arranged over three floors. Although it is comfortable it has not got a homely feel to it, however it is well maintained, clean and generally free from any unpleasant odours. Aids and adaptations are in place to help those with limited mobility including assisted baths and showers. Corridors are wide with handrails either side and door keypads prevent residents from using the stairs unsupervised. Bedrooms are a mixture of single and double occupancy and the majority have ensuite facilities. Residents and their relatives have been encouraged to bring in possessions from home and personalise their rooms and they all have televisions and telephone points. Some of the rooms, where residents have difficulties with continence, and the dining rooms, have laminated floors in order to reduce odours. Letterboxes and door knockers have been put on bedroom doors and also pictures of the resident, which helps then to identify their own room. There are dining rooms and lounges on each floor, the latter all have television, video Care Homes for Older People Page 18 of 26 Evidence: and hi-fi equipment. There is pleasant well maintained rear garden and some of the residents have been helping to plant flowerbeds and hanging baskets. We were told that some of them like to eat their meals out there when it is fine and those people who smoke are encouraged to do it out there. Policies and procedures are in place to help with the control of infection and protective gloves and aprons, liquid soap and hand towels, are available to staff. We did comment on the fact that, as we found before, the intercom on the front door does not appear to work. There is an administrator now in the office on the ground floor who also has the role of opening the door to visitors however, it is somewhat off putting to press the buzzer and not be acknowledged. Care Homes for Older People Page 19 of 26 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. There are enough appropriately trained staff on duty in the home to met the needs of the people who live there. Evidence: Elmwood is staffed throughout the 24 hour period by a mixture of trained nurses and care staff, in sufficient numbers to meet the needs of the people in the home. The manager told us that that these numbers can also be increased should care be needed for any resident whos behaviour is particularly challenging. Clinical staff are supported by domestic and catering staff and a maintenance person. Both male and female care staff are employed, in order to allow residents a choice and the majority of carers have achieved an NVQ qualification to at least level 2. The staff that we met were friendly and approachable. We could see that they treated residents very kindly. Comment cards that were received told us that relatives find them very helpful and caring. One person told us they manage to treat people with great care, and still as a part of the human race, they always have a smile even though they may be dealing with problems. Southern Cross have invested in staff training and all of those nurses and care staff that we spoke with were able to tell us about sessions that they have attended, these have included caring for those who may have challenging or aggressive behaviour. Care Homes for Older People Page 20 of 26 Evidence: Some training is delivered by a senior nurse in the home and the company also employs trainers. Several of the care staff are undertaking courses in dementia awareness run by Greenwich University. New staff undergo a comprehensive induction period, working with experienced carers, and we were able to speak to one of them about what they had learnt while doing this. All the staff have regular supervision sessions and a yearly appraisal system is in place. There are also monthly meetings held for them. Robust recruitment procedures are in place to ensure the safety of residents and all of the necessary checks are done to ensure that they are protected from those who have been judged as being unsuitable to be working with vulnerable adults. We looked at a sample of personnel files and saw that all of the information required by the regulations was in place. Care Homes for Older People Page 21 of 26 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 safe and well maintained and managed by a suitably qualified person, in the best interests of those people who live there. Evidence: Prior to Southern Cross owning this home, there had been frequent changes amongst owners and key personnel. More recently, although there have been changes in the organisational structure, the Registered Manager of the home has provided continued stability for both staff and residents. She is a trained nurse who has additional management qualifications and many years of experience and some of the surveys, that we received from staff, mentioned that they always felt supported, if they ever had a problem. The home is run in the best interests of the people who live there. Regular meetings give them, and their relatives, the opportunity to comment on the services that are provided. The company also employs quality assurance inspectors who monitor the home in order to ensure that the aims and objectives, as set out in The Statement of Care Homes for Older People Page 22 of 26 Evidence: Purpose, are being met. Some money is managed on behalf of some of the residents in the home although it is all banked centrally. We were able to see that proper and accurate records are kept of all financial transactions and the system allows interest to be paid on their individual accounts. The information that we have from the home states that equipment and services are all maintained properly. A recent visit by the environmental health officer confirmed that kitchen practises were satisfactory and the building complies with fire safety regulations. We are always notified of any incidents in the home in accordance with Regulation 37 of The Care Standards Act. Care Homes for Older People Page 23 of 26 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 Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 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 Older People Page 26 of 26 - 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!