Care Home: Esther House

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What the care home does well The homes assessment procedures were very thorough and care plans had been structured to ensure staff recognise the needs of the people they support. Observation of practice and discussion with staff members confirmed the staff team had been provided with appropriate training to assist them in understanding and meeting the needs of the people in their care. We spoke to people during the visit about their experiences living at the home and they told us they liked living there and felt well cared for. One person said, Esther House is a lovely place to live a lot better than the last home I was in. The staff are pleasant, very caring and very friendly. I am very happy living here". Another person said, "I am very satisfied with all aspects of the home. I feel very safe and comfortable. It`s a home from home". Visiting arrangements at the home are informal and family and friends of people who live there are encouraged to maintain contact. Relatives and friends were observed visiting the home throughout the day and were made welcome by the staff on duty. People spoken to said they enjoyed the quality and variety of food being provided and activities organised. One person commented, "The food is very good, plenty of choice and well cooked". One person commenting on the activities organised said, "I enjoy the entertainers who come to the home. They get you up singing and dancing. We have a good time". Staff employed at the home have been well trained and are competent to do their jobs. Observation of care practices throughout the day confirmed the people they support are treated with respect and dignity. The home has been decorated and furnished to a good standard to ensure the comfort of people who live there. People spoken to were happy with the standard of accommodation provided. What has improved since the last inspection? People who move into the home were having a full assessment of their needs completed and this information was being made available to the staff team who when spoken to showed a good understanding of the needs of the people they were supporting. People living at the home told us they were very happy with the care being provided. Staff working at the home were being recruited properly ensuring the protection of people who live there. The homeowners have made some improvements to the environment with the lounge and a bedroom being redecorated and a quiet room being created where people can receive their visitors if they wish. People we spoke to were very pleased with the improvements being made. What the care home could do better: There has been no requirements or recommendations made of the home during this inspection. The home continues to provide a service, which people are happy with and feedback throughout the inspection process was positive about the home and the staff who work there. However, the manager of the home understands there is always room for improvement and they must continue to work hard to ensure the standards presently being provided continue to be met. During completion of the Annual Quality Assurance Assessment form the manager has identified some areas where she thinks the service being provided can be improved. These include continuing with the refurbishment of the environment so that the present standards are maintained and the people who live at the home feel comfortable and safe. They have also recognised the need to keep the service being provided under review to ensure the people in their care feel well supported and are treated with dignity and respect at all times. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Esther House 34 Mauldeth Road Heaton Mersey Stockport Cheshire SK4 3ND     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: Wesley Cornwell     Date: 1 1 0 2 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Esther House 34 Mauldeth Road Heaton Mersey Stockport Cheshire SK4 3ND 0161-4320826 01619479439 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) : Mr. Paul James Kelly,Mrs Angela Kelly care home 15 Number of places (if applicable): Under 65 Over 65 15 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 15 Date of last inspection Brief description of the care home Esther House is a small home situated in the Heaton Mersey area of Stockport, close to local shops and amenities. It is a large detached house set in its own grounds. Esther House is registered to take people whose primary need for care is due to old age. The majority of people living at the home have care needs which are relatively uncomplicated, i.e., help with washing, dressing/ undressing, assistance with toilet, administration of medication, acquisition of medical treatment, as and when necessary. A member of staff is employed to co-ordinate an activities programme to keep people entertained. Eight bedrooms have en-suite toilets. Care Homes for Older People Page 4 of 26 Brief description of the care home The home has a Statement of Purpose and Service User Guide providing information about the care provided, qualifications of the owners, manager and staff and the services people can expect if they choose to move into the home. A copy of the Service User Guide and most recent inspection report are available from the manager to help people make an informed choice whether to move into the home. The fees for staying at the home are three hundred and forty seven pounds. The manager provided this information on 11th February 2009. 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 stars. This means the people who use this service experience good quality outcomes. This unannounced visit was undertaken as part of the homes key inspection. The visit commenced at 9.30am and took place over 5 hours. Prior to the site visit the manager of the home completed an Annual Quality Assurance Assessment form (AQAA) providing detailed information about the service they are providing. The AQAA is a self assessment and data set, which providers are asked to complete each year and is one of the main ways that we obtain information about how they are meeting outcomes for people in their care. A number of people living at the home and staff members were contacted prior to the visit and their views about the home have been included in the Care Homes for Older People Page 6 of 26 report. Staff, care, maintenance and financial records were examined during the visit and a full tour of the premises was undertaken with the manager. The last inspection on this service was completed on 21st November 2007 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 26 There has been no requirements or recommendations made of the home during this inspection. The home continues to provide a service, which people are happy with and feedback throughout the inspection process was positive about the home and the staff who work there. However, the manager of the home understands there is always room for improvement and they must continue to work hard to ensure the standards presently being provided continue to be met. During completion of the Annual Quality Assurance Assessment form the manager has identified some areas where she thinks the service being provided can be improved. These include continuing with the refurbishment of the environment so that the present standards are maintained and the people who live at the home feel comfortable and safe. They have also recognised the need to keep the service being provided under review to ensure the people in their care feel well supported and are treated with dignity and respect at all times. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 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 10 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. The admission and assessment procedures were clear to ensure the care needs of people were met. Evidence: The care plan records of two people admitted into the home had full assessment information including religious, cultural and relationship needs. The assessment had identified the nutritional needs of people and risk assessment information advising staff members of the action to be taken to minimise identified risks and hazards was in place. The staff members spoken to confirmed they had access to this information and showed a good understanding of the needs of people they were supporting. People spoken to during the visit confirmed they were happy with the support being provided and their needs were being met. One person Said, I looked around several homes before moving into Esther House and I felt this was the best. I couldnt be Care Homes for Older People Page 11 of 26 Evidence: happier with the care being provided. The girls are very kind. This home does not provide intermediate care. Care Homes for Older People Page 12 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. Promotion of health is taken seriously, peoples welfare is closely monitored and health needs were met. Evidence: Individual records are kept for each person with a plan of care setting out the action that is needed to be taken by staff to ensure all aspects of health, personal and social care needs of people living at the home are met. Significant events had been recorded and daily entries made setting out the care given. The care plans were structured and were being reviewed with the people or their relative,advocate and updated to reflect any changing needs and these were being actioned as required. The records of two people were looked at and these described their healthcare needs. Discussion with staff members on duty confirmed they were fully aware of the healthcare needs of people living at the home and these are monitored and kept up to date. Entries on care plans showed good communication between the home and healthcare professionals. Daily entries made on care plans showed staff members were Care Homes for Older People Page 13 of 26 Evidence: following the instructions of healthcare professionals and an appropriate level of care was being provided. Observation of practice and examination of care plan records confirmed staff were meeting the diverse needs of the people with specific disabilities and specialised equipment was readily available to assist them with their duties. Discussion with staff members confirmed they were aware of the needs of the people in their care and the level of support that needed to be provided. We spoke to one person recently discharged from hospital and they couldnt speak highly enough about the care they were receiving on their return home. The person said, I couldnt wait to be discharged from hospital.The staff have been kind, caring and patient with me and I am very grateful to them for the care I am receiving. I have lived in three previous homes and the care I am now receiving is by far the best. You wont find anyone who isnt happy living here. The staff members responsible for the administration of medicines had received training to ensure they had basic knowledge of how medicines are used and how to recognise and deal with problems in use. Medication practices observed during the visit were safe and good records had been maintained confirming people received their medicines as prescribed by their doctor. Care Homes for Older People Page 14 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. Social activities and meals are both well managed, creative and provide daily variation and interest for people living in the home. Evidence: People we spoke to said routines in the home were flexible and they were able to make their own decisions about their daily routine. One person said, There are no restrictions here and you can come and go as you like. I go out most days as I like to do a bit of shopping at the local shops. We spoke to people about the arrangements in place for receiving their visitors and were told they were happy with these. One person said, My visitors are always made welcome whenever they come to see me and the girls always offer them a drink People spoken to confirmed they enjoyed the food provided by the home. The staff member responsible for the preparation of meals was able to confirm they had information about people with special diets and personal preferences and these were being accommodated. One person commented, The meals are lovely. Good home cooking. I can honestly say Ive never had a meal I havent enjoyed. I aways look Care Homes for Older People Page 15 of 26 Evidence: forward to my meals. Meal times were served in a relaxed and unhurried manner. Staff members were observed being very attentive to the needs of people who required assistance. People we spoke to said they were happy with the arrangements in place for social activities. These were varied and arranged individually and in groups. One person said, A good range of activities are on offer all the time Care Homes for Older People Page 16 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. Complaints are handled well and taken seriously ensuring people feel listened to. Evidence: The home has a detailed complaints procedure, which is made available to everyone on his or her admission. People we spoke to were aware of how to make a complaint and felt these would be listened to and acted upon. One person said, Perfectly happy and I have no Complaints. At the time of this visit no complaints had been referred to the Commission for Social Care Inspection. The home has a procedure in place for dealing with allegations of abuse. The staff members spoken to had received training in the protection of vulnerable adults and showed a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. Staff members spoken to said they wouldnt hesitate to report any concerns they had about care practices to ensure people living at the home are protected from potential harm or abuse. At the time of this visit the Commission for Social Care Inspection had not received any safeguarding referrals about staff working at the home. 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. People live in a comfortable, homely, clean and safe environment Evidence: The home has been well maintained and decorated for the comfort of the people living there. We spoke to people about the standard of accommodation being provided and they told us they were happy with this and felt at home. Since the last inspection the lounge has been redecorated and a quiet room created where people can go to read or receive their visitors. The manager said the refurbishment of the home was ongoing and there plans for the hallway to redecorated. People spoken to were very happy with the improvements being made. A tour of the building confirmed people had been encouraged to personalise their bedrooms with their own belongings. People we spoke to said they were happy with their rooms and confirmed they had the choice of spending time on their own or in the lounge areas. One person commented, Always have nice clean bedding. Toilet and washing facilities are spotless. No nasty smells at all. Hot water temperatures were checked throughout the home and found to be delivering water at a safe temperature in line with health and safety guidelines. Care Homes for Older People Page 18 of 26 Evidence: It was observed during the visit the home was clean and hygenic ensuring a pleasant environment in which to live. 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. Staffing levels are sufficient to meet the needs of people living at the home. Evidence: Staffing levels were sufficient for the number of people living at the home. People spoken to said they were happy with the care they were receiving and they were well treated by the staff. One person commented, The staff are always available when I need them. Staff spoken to said they were clear about their role and work well as a team to ensure the individual and collective needs of the people in their care are met. People we spoke to were happy with the care they were receiving and spoke very well about the staff. One person said, All the staff are very helpful and do all they can for you. Records show all staff members have access to a structured training and development programme ensuring the people in their care are being supported by a well trained and competent staff team. In addition 70 of staff members have achieved National Vocational Qualifications (NVQ) ensuring people are in the safe hands of qualified and competent staff. Examination of staff records confirmed the home has thorough and robust systems in Care Homes for Older People Page 20 of 26 Evidence: place for recruiting staff members ensuring the protection of people living there. 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 well run and ensures the health and safety of staff and people living there are promoted and protected Evidence: The manager of the home has many years experience in caring for elderly people and has achieved recognised care and management qualifications. She is well supported by the owners of the home who visit regularly. She has access to training to ensure her knowledge and skills are updated and the home continues to be well run and for the benefit of the people who live there. People we spoke to were very positive in their comments about the manager and her staff who were described as being very caring friendly and helpful. The manager and her staff work very hard and they are very caring people. I am very happy in this home. Care Homes for Older People Page 22 of 26 Evidence: The home has in place quality assurance systems to gather the views of people and keep them informed about events being organised. These included meetings with people who live at the home and questionnaires which are available in the hallway for vistors to complete providing their views about the service being provided. People we spoke to confirmed they are consulted about changes taking place within the home and kept fully informed about forthcoming events being organised. Financial records were well maintained and up to date ensuring the interests of people are safeguarded. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation providing a safe environment for people to live. 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: 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 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. 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!