Care Home: Eltandia Hall Care Centre

What the care home does well People who use the service told us Eltandia does `everything well`. People made positive comments about staff, the food and the care and support they receive. Visitors told us they are made to feel welcome, they feel that their relatives receive the care they need and they told us staff are kind and helpful. Staff told us they have the information they need to provide care and support to people, they said they have the training they need to carry out their role and told us they feel supported by the manager. We saw more staff involved in individual activities with people who use the service. There have been improvements to the training, ensuring staff have up to date information on how to provide good quality care. What the care home could do better: People who use the service generally feel the service could not do anything better. Fromcomments some people made to us, we feel staff could listen and respond to individuals requests. Staff said there could be more staff, especially trained nurses. We saw some improvements within the service and the organisation, manager and staff need to continue with this work to ensure all people who use the service receive the care and support they expect and need. Care plans could be more person centred. Old information should be stored separately to ensure staff access the most up to date assessments and care plans. When health professionals give advice, care plans must be updated, to ensure people receive the care and support they need. A medication audit should be completed to identify the amount of medication people currently have and staff must record any medication carried over on the Medication Administration Record Sheet to ensure the balance is correct and show the audit trail. Consideration should be given to providing rummage boxes to give people who use the service more to do. Mealtimes should be reviewed to ensure they are a more pleasant event for people and any support with eating is given in a respectful and dignified manner. Staff must record and report any bruising to senior staff or the manager so that appropriate investigations take place in timely manner. Staff should receive training on End of Life Care to ensure they are able to provide the appropriate care and support to individuals and their relatives at this time. Random inspection report Care homes for older people Name: Address: Eltandia Hall Care Centre Middle Way Norbury London SW16 4HA one star adequate service 14/12/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Emma Dove Date: 1 6 0 6 2 0 1 0 Information about the care home Name of care home: Address: Eltandia Hall Care Centre Middle Way Norbury London SW16 4HA 02087651380 02087651399 eltandia@schealthcare.co.uk www.schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Southern Cross (LSC) Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 83 Number of places (if applicable): Under 65 Over 65 63 63 0 dementia old age, not falling within any other category physical disability Conditions of registration: 63 0 20 As agreed on 19/06/2006, Service users with Dementia, age 60 years and above can be accommodated within the home. Date of last inspection Brief description of the care home Eltandia Hall Care Centre is a purpose built home arranged over two floors. It has two residential units on the first floor and two units offering nursing care on the ground floor. One residential unit provides a mix of respite and permanent care for older people and the other unit provides long term care for older people with dementia. The Care Homes for Older People Page 2 of 11 1 4 1 2 2 0 0 9 Brief description of the care home nursing units offer long-term care for older people and care for younger adults with physical disabilities. People living there are provided with their own single bedroom accommodation with en suite toilet facilities. The home is situated in a residential area of Norbury. Public transport in the form of local bus services are close by. Care Homes for Older People Page 3 of 11 What we found: This random unannounced inspection was carried out by two inspectors over six and a half hours on the 16th June 2010. We spoke with people who use the service, visitors, staff and the manager. We also had a telephone conversation with the regional manager after the visit. We did not receive the managers self assessment before the visit. We sent surveys to people who use the service and staff. We received nine completed surveys from people who use the service and three surveys from staff. Comments from these surveys are included in this report. We looked at information we have received from the home since the last key unannounced inspection in December 2009. The Statement of Purpose and Service Users Guide have been updated to include details of the new manager. These documents now include photographs, making them more meaningful for people who use the service. Seven people told us in surveys that they had enough information to help them make the decision to move in. We saw assessments in case files. We saw care plans in place and kept under review. These documents could be more detailed to help staff provide person centred care to individuals. One care plan indicated staff should make the person comfy for end of life care, although there were no details of how this should be done. The case file contained a number of assessments and there could be confusion over which is the most current. The district nurse had visited and recommended good oral care and to keep hydrated. This information had not been included in the persons care plan or most recent assessment which means staff may not be able to meet these specific needs. Care must be taken to remove old assessments and information to ensure staff are able to provide appropriate care and support to individuals. When health professionals advise on care needs for an individual, the persons care plan must be updated. The weight chart for one person showed a loss of 7kg over three months but there was no information in the care plan about issues around nutrition or actions staff should take. Although we saw staff give this person appropriate support with eating at lunchtime. While talking to one person who uses the service, they showed us a bruise on their leg and said they did not know how they got it. Staff were not able to say where this bruise had come from and there were no details in the daily record. This must be investigated and staff must ensure they record and report to senior staff or the manager if they see or someone reports that they have a bruise. Discussion with the nurse identified she is not fully aware of the Gold Standards for End of Life Care. This is an area staff should receive training on to ensure they are able to fully meet the specific needs of people during this stage of their life. Care Homes for Older People Page 4 of 11 People who use the service said staff give them the help they need. Eight people told us in surveys that they always and one person said they usually receive the care and support they need. People told us they were not sure who their key worker is or if they meet with staff to discuss their care needs. Nine people told us in surveys they always receive the medical care they need. We saw medication to be generally well managed. The Medication Administration Record Sheets (MARS) for two people were signed and up to date. One MARS was signed as refused. One MARS noted all medications discontinued and this was supported by a letter from the hospital. The count of two medications for one person identified more tablets than there should be. Medication carried over from the previous month had not be included. An audit of medication is required to get the correct balance and staff must ensure they add carried over medication to the MARS or return it to the pharmacy. The eye drops for one person had the date the bottle was opened. One bottle of eye drops did not have the date they were opened, so it would not be possible to dispose of them after twenty eight days as directed. We saw some people involved in a group activity with staff, some people watching the televsion, reading magazines, meeting with visitors and talking with staff. In one unit the television and the radio were both on. Six people told us in surveys that the home always and two people said usually arranges activities they can take part in. Eight people said they always and one person said they usually like the meals. We saw the lunch in two units. The mealtime was not a social event, staff were quite task focussed and the meal was over for most people within twenty minutes. We saw staff provide some appropriate support to individuals with eating, although we saw two members of staff helping two people at the same time. This practice is not person centred or dignified for people who use the service. A review of mealtimes should be carried out to ensure the needs of people who use the service are fully met in a dignified and respectful manner. Consideration should be given to protecting mealtimes, enabling more staff to provide support to individuals. We saw the days menu on the dining tables, although this is in written format and only available once people have gone to the dining room for their meal. More could be done to inform people who use the service what the meal is and staff should be able to talk with people during the morning about the menu. The complaints procedure is included in the Service Users Guide in peoples bedrooms. Nine people told us they are aware how to make a complaint and said they have someone they can speak to about any concerns. People we spoke with did not have any worries, concerns or complaints. One relative spoke about an issue which they raised with staff and was addressed during our visit. We saw some areas of the home to need redecorating. Bathrooms still need some work to make them less clinical and to help make the bathing experience more positive for people who use the service. We saw books, magazines and photograph albums in lounges but we still feel there could be more for people to do. Consideration should be given to providing rummage boxes Care Homes for Older People Page 5 of 11 with different articles for people to look at, encourage conversation and stimulate memories. There are photographs displayed on the walls in each unit, these are all from trips and outings during 2008 and 2009. Eight people told us in surveys that they home is always and one person said usually clean and fresh. We saw all areas of the home to be clean and domestic staff staff working hard to keep it clean and fresh. More nurses have been employed to meet the needs of the people who use the service. The manager has been supported by a deputy from another of the organisations homes, although this person has now returned to their service. The manager told us the organisation has advertised for a new position of Clinical Lead, to provide support. Comments about staff from people who use the service included, staff help, staff listen and theyre kind. One person said some staff are better than others but was unable to identify why this was. One person said staff dont pay much attention but do things if I ask. One relative said staff listen and are good. Seven people told us in surveys there are always and two people said usually staff available when they need them. Seven people told us that staff always and one person said staff usually and sometimes listen to what they say. Three members of staff told us they had the appropriate checks before they started work. Two staff told us their induction covered most and one staff said all they needed to know. Three members of staff told us they have access to relevant training to help them carry out their role. Staff have completed training in caring for people with parkinsons and people who have had a stroke, ensuring they provide more appropriate care. The manager has not applied to register with the Care Quality Commission. More managerial support is required to ensure continued improvements to the quality of care and support provided. What the care home does well: What they could do better: People who use the service generally feel the service could not do anything better. From Care Homes for Older People Page 6 of 11 comments some people made to us, we feel staff could listen and respond to individuals requests. Staff said there could be more staff, especially trained nurses. We saw some improvements within the service and the organisation, manager and staff need to continue with this work to ensure all people who use the service receive the care and support they expect and need. Care plans could be more person centred. Old information should be stored separately to ensure staff access the most up to date assessments and care plans. When health professionals give advice, care plans must be updated, to ensure people receive the care and support they need. A medication audit should be completed to identify the amount of medication people currently have and staff must record any medication carried over on the Medication Administration Record Sheet to ensure the balance is correct and show the audit trail. Consideration should be given to providing rummage boxes to give people who use the service more to do. Mealtimes should be reviewed to ensure they are a more pleasant event for people and any support with eating is given in a respectful and dignified manner. Staff must record and report any bruising to senior staff or the manager so that appropriate investigations take place in timely manner. Staff should receive training on End of Life Care to ensure they are able to provide the appropriate care and support to individuals and their relatives at this time. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 7 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must be updated to reflect changes in need. This will ensure that any changes in need are recorded and can be met. 30/04/2010 2 21 23 Shower rooms and 25/06/2010 bathrooms must be decorated and maintained to a good standard. This will ensure the home is at a good standard for the people who live there. Care Homes for Older People Page 8 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 Records must be kept of 06/08/2010 medication carried over when new supplies are received. This will ensure the count of medications for individuals is correct and gives an audit trail. 2 18 Staff must ensure they record and report to senior staff or the manager if they see or someone reports that they have a bruise. This will ensure that people are protected from harm. 06/08/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Care must be taken to remove old assessments and information to ensure staff are able to provide appropriate care and support to individuals. Care plans could be more person centred and include more information to help staff provide appropriate care and Page 9 of 11 2 7 Care Homes for Older People 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 support. 3 8 When health professionals advise on care needs of an individual, the persons care plan must be updated to reflect this. An audit of medication should be carried out to ensure staff are recording medication received at the home and administered to individuals. Consideration should be given to providing staff with training on end of life care, to ensure they are able to fully meet the specific needs of people during this stage of their life. Consideration should be given to providing rummage boxes and items and for people to look at and interact with around the home. A review of mealtimes should be completed to ensure people are receiving the support they need in a dignified manner. Consideration should be given to protecting mealtimes to enable more staff to be in the dining rooms to support people. More could be done to make mealtimes a more social and pleasant occassion for people who use the service. The manager should apply to register with the Care Quality Commission. 4 9 5 10 6 12 7 15 8 9 15 31 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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