Care Home: Elstree Court Nursing Home

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What the care home does well The home encourages residents to make choices about all aspects of their day to day lives, and be involved in decisions about developing the support they receive, through daily feedback and regular residents and relatives meetings. The atmosphere in the home was comfortable and homely, and communication between residents, visitors and staff was relaxed and friendly. What has improved since the last inspection? There were no requirements made following the last inspection. The activity coordinator has developed a range of activities for residents at the home, which a number taking part on a regular basis. The care planning system has been reveiwed and updated in line with BUPA, they now have details of each persons individual assessed needs. What the care home could do better: No requirements have been made at this time, although some concerns were raised and these have been included in the body of the report. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elstree Court Nursing Home 64 Meads Road Eastbourne East Sussex BN20 7QJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kathy Flynn     Date: 0 3 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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: Elstree Court Nursing Home 64 Meads Road Eastbourne East Sussex BN20 7QJ 01323-732691 0113411534 shormanl@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes (ANS) Ltd care home 34 Number of places (if applicable): Under 65 Over 65 34 0 old age, not falling within any other category physical disability Additional conditions: 0 34 The maximum number of service users to be accommodated is 34 The registered person may provide the following category of service : Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (OP) Physical disability (PD) Date of last inspection Brief description of the care home Elstree Court is a care home registered to provide nursing care for up to thirty-four older people that may or may not have some physical disabilities. The home is part of a group managed by BUPA Health Care. Elstree Court is situated in a residential area, ten minutes from Eastbourne town centre; it is convenient for local shops and public transport. The accommodation is on three floors and offers twenty-eight single bedrooms, some with ensuite facilities and three double rooms. Level access to all areas of the home is provided by a lift, stair lifts and ramps. Care Homes for Older People Page 4 of 26 Brief description of the care home There are three lounges on the ground floor in the home, with a small dining area. The home provides specialist equipment to meet the needs of the people living there, including lifting devices (hoists) and specialist mattresses. An adequate amount of communal bathrooms with either a shower or assisted bath are provided. There are attractive gardens with seating to the front and rear that are accessible to residents and used when weather permits. A gazebo has recently been built in the rear garden. Copies of inspection reports and the homes Statement of Purpose are made available on request prior to admission and a service users guide is in every bedroom. Details of fees charged can be obtained from the home. Additional charges are made for hairdressing, chiropody, newspapers and toiletries. 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection was unannounced and was carried out by Kathy Flynn on the 3rd and 5th June over 8 hours. Information was gathered from the homes care plans, staff files, menus, the activity programme and discussions with people living at the home, their relatives and staff to build up a picture of the services offered at Elstree Court. The Manager also completed the annual quality assurance assessment for the home Care Homes for Older People Page 6 of 26 (AQAA), this was sent to the Commission and included details of how the home supports residents and what improvments are planned to develop the service for their benefit. The reader should aware that the Care Standards Act 2000 and the Care Homes Regulations 2001 use the term service user to describe those living in care home settings. However for the purposes of this report those living at Homlea will be referred to as residents. 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 set out 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. Individuals are assessed to ensure the home can meet their specific needs, before they are offered a place in the home. Evidence: Four assessments for people who have recently moved into the home were examined. They included clear information about their needs, and were used as the basis for their individual care plans. Some residents said that they did not remember being assessed before they moved into Elstree Court, but they were happy with the decision taken by their families to place them there. Others said the home has a good reputation or they had received information about the home and were happy to move in. The manager said that the assessments are completed with the involvement of the Care Homes for Older People Page 10 of 26 Evidence: prospective residents and their relatives, and a place is confirmed in writing when they have all agreed that the home can offer the support they need. 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. The care planning system provides staff with information that enables them to meet the needs of the residents. Staff follow the home policies and procedures for medication which protects residents. Evidence: A new care planning system has been introduced since the last inspection and it now includes a considerable amount of information about the assessed needs of each of the residents. Risk assessments, including pressure relief, falls, nutrition, mobility, moving and handling and for the use of bed barriers are completed for all residents, and staff record the daily support and care they provide. There is also evidence that the care plans are reviewed and updated by the registered nurses on a regular basis, and when the residents needs change. However the records are variable and for one resident the food and fluid charts were not completed for each day, and in some care plans inappropriate comments were used. The manager advised that training can be arranged for staff, to ensure that the Care Homes for Older People Page 12 of 26 Evidence: records reflect the needs of the residents and how these are met. Residents are registered with GPs and are referred to allied health professionals if required, including tissue viability nurse, continence nurse and chiropodist. People living at the home said the staff are very good, they look after us very well and if they need to see their GP or go to the hospital for an appointment then they organise this for us. Registered nurses are responsible for the ordering, storage and administration of medicines at the home, there are policies and procedures in place, and the nurse said they follow these to protect residents. Medicine administration record (MAR) charts were examined and found to be completed appropriately. 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. A range of activities are offered at the home for people to participate in if they wish. The meals at the home are good, choices are available and staff offer assistance if required. Evidence: A number of residents were enjoying activities in the lounges on the ground floor on both days of the inspection, these included word games, bingo and scrabble. The coordinator works part time, she is supported by another member of staff for 10 hours a week, and has spent a considerable amount of time developing the activity programme, which has been very well received by people in the home. As part of the BUPA programme a cruise has been planned for six weeks starting in July, which will involve meals, costumes, music and decorations depending on the country being visited by the ship. The staff and residents are all looking forward to this and they expect their families and friends to join them for parts of the cruise. Currently the nursing and care staff do not provide activities, therefore they are not offered to residents throughout the day or at the weekends. The manager confirmed that she is looking at reviewing the responsibilities with regard to activities, and Care Homes for Older People Page 14 of 26 Evidence: involving all staff as part of the homes provision of person centred, holistic care. The expectation is that specific activities will also be developed for people living in the home who have a dementia type disability. Relatives and friends can visit at any time and a number were seen in the home. Those spoken with said they are always made to feel very welcome, they can have a meal if they wish and are offered a drink as soon as we arrive. Comments about the care provided for the residents was equally positive, they said the staff know how to look after X, nothing is too much trouble and the manager is very approachable. Staff were seen to be offering residents choices about where they spend their time, what activity they would like to do, as well as what meals and drinks they prefer. Those spoken with said that the staff support them to do anything they want, although they may have to wait depending on how busy they are, and it was noted that the relationship between residents, visitors and staff was relaxed and friendly. The chef advised that although there is a main dish for each meal the residents can ask for anything they want. This was supported by the residents and visitors, who said the food is very good, they are offered a choice and staff assist them if they need them to. The menu is currently being reviewed, a range of new dishes are being introduced and residents are being asked for their opinions. 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. The home has an appropriate complaints system which ensures that any concerns raised are addressed, and training in supporting vulnerable adults is provided to protect the people who live there. Evidence: The complaints procedure has been reviewed and updated since the last inspection and it has clear guidelines for the manager and staff to follow. Information for people who live in the home, and their visitors, is available in the homes statement of purpose and service users guide, and is displayed on the notice board. Residents and their visitors said that if they have any concerns or worries they can talk to the staff or the manager at any time, and they feel that their views are listened to and acted upon. An anonymous complaint was made through the Commission and the manager investigated this. All staff attend training in safeguarding adults. Staff said they have a clear understanding of protecting vulnerable people and what action they should take, including whistle blowing, if they have any concerns. Care Homes for Older People Page 16 of 26 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. Elstree Court offers a comfortable and homely environment, and staff are trained in the control of infection to protect the people who live there. Evidence: The home is a converted older building with an extension to the side and flats attached to the rear. These have been rented out to tenants that are able to use some of the facilities provided in the home, including meals. BUPA have put forward plans to change the use of the flats by converting them into individual rooms appropriate for use by people who need nursing care. As part of this programme some of the smaller rooms in the nursing home itself will be updated to provide en suite facilities for each individual. The work is expected to start in the summer, residents and their relatives or friends have been kept informed of these plans, and some are hoping to move into the rooms to the rear of the home when they are ready. There are three lounges and a separate dining room on the ground floor, with attractive gardens to the rear that are used when the weather permits. The home is well maintained and individual bedrooms have been personalised with small pieces of furniture, pictures and ornaments. The shaft lift provides access to all parts of the home, and there are suitable moving Care Homes for Older People Page 18 of 26 Evidence: and handling aids to assist staff when transporting residents, with assisted baths and toilets provided on each floor of the home. 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. Staff employed at the home receive appropriate training, and are aware of their roles and responsibilities. Robust recruitment procedures protect residents. Evidence: The manager, staff, residents and visitors felt that there were enough staff on duty to meet their individual needs, although they may have to wait sometimes when staff are very busy. Feedback was very positive staff are very caring and they look after us very well. Recruitment files were checked for new staff and robust procedures had been followed, this included a CRB check, all but one had two written references, confirmation of identification and evidence of qualifications. References should be obtained from previous employers rather than work colleagues. New staff are required to complete induction training in line with skills for care, and on the first day of the inspection the manager was providing this training for a new employee. The expectation is that staff will then continue towards the National Vocational Qualifications (NVQ) for their area of work in the home. Mandatory training which includes moving and handling, first aid and infection control is provided for all staff, as part of the induction programme for new staff, and regular updates for all Care Homes for Older People Page 20 of 26 Evidence: staff employed at the home. The manager monitors the training needs of the staff and can access additional training through BUPA if required. The expectation is that training in supporting people with a dementia type disability will be provided for all staff. 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 management style at the home is open and encourages residents, visitors and staff to be involved in decisions about the services offered. Evidence: The manager is a registered nurse with NVQ 4 in management and has been manager of the home for over three years. She has considerable experience in providing care for older people and physically disabled, and her management style has clearly developed to ensure that the support offered is based on the needs and preferences of the residents. The home is well support by BUPA, with a quality assurance team and yearly surveys used to assess the services provided at the home. Residents and relatives are encouraged to be involved in decisions about the support they receive through daily conversations with staff and the manager, as well as regular meetings. Care Homes for Older People Page 22 of 26 Evidence: The home does not take responsibility for residents finances but does hold some money for residents. Records are kept of payments and deposits and these are given to the residents or their representatives each month. The health and safety of residents is protected through staff training and ongoing maintenance of the home. 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 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI 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. 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