Care Home: Glen Eldon

What the care home does well The home provides care support and accomodation in a well-maintained pleasant and welcoming environment by a well-managed supported, motivated, well-trained and qualified staff team who work in a manner that recognises resident`s need for personal privacy dignity and independance. Areas of particular note were the pre admission procedure care planning, activities, protection astaffing and management. What has improved since the last inspection? There were no areas of concern noted following the previous inspection. The home has built on previous good results and achieved improved ratings in the areas indicated in the preceeding section of this report . What the care home could do better: There were no areas of concern. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Glen Eldon Bighton Road Medstead Alton Hampshire GU34 5NA     The quality rating for this care home is:   three star excellent 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: Peter McNeillie     Date: 1 9 0 9 2 0 0 8 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. the things that people have said are important to them: They reflect 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 Adults (18-65 years) 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 Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Glen Eldon Bighton Road Medstead Alton Hampshire GU34 5NA 01420563864 Telephone number: Fax number: Email address: Provider web address: gleneldon@ilg.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mr Stuart Anthony Craven Type of registration: Number of places registered: Iliace Ltd care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 9. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Glen Eldon is care home registered to provide care support and accommodation up to nine people with a learning disabilitie. The home is situated in a large detached property in a rural location within a few miles of the North Hampshire towns of Basingstoke Alresford and Alton. A range of leisure, shopping and recreational facilities can be accessed using the homes own transport. The M3 motorway which is a few miles distant allows easy access to Portsmouth,Southampton Aldershot and Guilford. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 9 Brief description of the care home At the time of the inspection fees ranged from one thousand four hundred pounds to two thousand five hundred pounds per week. Care Homes for Adults (18-65 years) Page 5 of 27 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report was written after taking into consideration a number of sources of information and evidence. These included, the previous report, a site visit to the service, information obtained from examining residents and staff records, personal observations, talks with staff and management, results from an in house quality survey and responses by the manager to a CSCI Annual Quality Assurance Assessment (AQAA) prior to the inspection. This key unannounced visit took place on 19/09/08 between the hours of 09.00 am and 12.45pm during which all of the key standards for care homes for younger adults were assessed. Communication with residents was very difficult, we are therefore very grateful to the care staff for their assistance. The results and findings contained in this report will determine the frequency and type Care Homes for Adults (18-65 years) Page 6 of 27 of future inspections. 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.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 Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a system of assessing and identifying residents diverse needs which ensures residents safety and that their assessed needs can be met that involves residents and/or their representatives in the assessment process. Evidence: Following a referral from the commissioning source usually a local authority, an assessment of needs and risk is catered out in accordance with a corporate admissions policy and procedure that requires that no resident is admitted into the home without a full assessment of need and risk being carried out. The manager and an external placement manager carry out the assessment in consultation with the resident or their representative in tandem with an assessment by the potential residents external care manager. Pre admission assessments of all residents were viewed. All of the records seen were presented in a clear well laid out manner and confirmed that residents were admitted in accordance with the admissions policy and procedure, which included a visit to the home and consultation with other residents. The care and risk assessments were very detailed and contained information that included personal care, Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: communication, social and health needs and any other issues that could affect the manner in which care was delivered. The assessments also included calculations( based on a pre determined formula) over a twenty four hour period of the staff required to deliver the level and quality of care to for the individual as dictated by the needs and risk assessments. This matter is also referred to in the staffing section of this report. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 a system of planning and reviewing care which reflects residents wishes, aspirations and diversity. These ensure residents needs are met within a risk management policy and involves residents, residents representatives or relatives in decisions that affect them. Evidence: All of the residents support/care plans viewed indicated that they were all reviewed by the manager in tandem with the residents key worker on a regular basis. Each plan included confirmation that the resident or their representative had been involved in and consulted about it. All plans viewed were based on an initial assessment of needs and risk ( The previous section of this report refers) which took into consideration residents needs, wishes, choices, aspirations, risks, abilities, details of any health care professional involved, communication methods, dietary needs , help required with eating and drinking and number of staff required to safely deliver the plan. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: Residents right, and the opportunity to take risks is seen as fundamental, however it was clear from records and our observations some residents would have difficulty in totally understanding the concept of risk and risk taking. Despite this, residents were supported to make decisions for themselves within a risk assessment framework with the help of staff. This process identified individual risks and how they were to be managed, enabling residents to take part in activities in a safe manner. Where restrictions were in place these were clearly recorded in the care plan . Staff who had a good understanding of the contents of the care plans and risk assessments and were able to explain how the care plan was put into day-to-day practice. To promote equality and diversity and to ensure that race, gender identity, disability, sexual orientation, age, religion and belief are promoted and incorporated into what they do, in their AQAA the home told us they ensure Staff awareness of equal opportunities and discrimination policy and proceedure during LDAF induction.and that Manager also follows relevancy equal opportunities policy in recruitment, regarding equality and diversity by making vacancies available to ever body. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The social activities family contacts and the provision of varied and nutritious meals were well managed and reflected residents interests and choices. Evidence: A wide range of activities and social opportunities are made available to residents by a team of activities coordinators who also supply a service to a number of local sister homes. The organizers develope a daily plan of specific activities both in house and in the community which are tailored to individual needs and reflect the residents choices and wishes . A wide range of activities is currently being undertaken including, food shopping cooking, music, trampolining, gardening, local activities centre, keep fit, bike riding,swimming,sensory room sessions and holidays to which the home contribute 250 pounds for each resident. At the time of our visit all residents were coming and going as they undertook various activities according to their programmes which were Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: displayed both in a written and pictorial format to assist residents understanding. As part of individual programmes the home is also involved with ACE (Adult Continuation Education) where currently work is being undertaken with a local convent to set up a work project involving residents in gardening. The home views residents activities as very important to the individuals development, consequently, staffing is arranged to ensure residents are supported by people familiar to them and whenever possible no activity is canceled due to lack of staff. We observed staff interacting with residents in a positive, respectful non-patronizing manner. It was evident that caring for the residents was more than a job for the staff who expressed ans demonstrated a total commitment to their residents. Residents families and friends are encouraged to visit at any time. Residents who are free to make and receive telephone calls, receive visitors in private and choose who they wish to see, are supported in maintaining family contacts and establish friendships. Residents are encouraged to participate in the choosing, buying and preparation (with assistance) of the meals. A daily menu based on resident’s likes and dislikes was displayed in both a written and pictorial format. The homes staff and management recognized that alternatives to a written menu is of great importance for some residents who may find the addition of pictures are beneficial to their understanding and assist in them making meaningful choices. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. Satisfactory arrangements are in place, ensuring the personal emotional, health care and medication needs of residents are met. Evidence: Details of the personal care, support and health care needs of residents need were clearly recorded in individual care plans with which staff demonstrated a clear understanding and familiarity with. Guidelines seen and comments by staff indicated that residents were exercising choice in all aspects of their lives including bedtimes, clothes, food, gender of carer, key worker, GP, dentist optician,and how and on what to spend their money. Records indicated that any special medical, health or social care needs would be provided following consultation with the appropriate professional. These might include the local; doctors, district nurses, physiotherapists, occupational therapists, speech language therapists, care managers and any other specialist required especially the community learning disability team. Records were kept of appointments with all health Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: and social care professionals and included details of any advice and treatment given. Medication records confirmed that all prescribed medication, (which was seen to be securely stored) was administered in accordance with a medication policy and procedure by trained staff from a blister pack system dispensed by a pharmacist who also offer support and training to the staff. The record of medication administered to residents and unwanted drugs disposed of were complete and accurate. A procedure that ensures residents can assume responsibility for their own medication was in place. Records viewed confirmed,following a risk assessment no resident was responsible for their own medication. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. The home has clear policies and procedures in place which ensures residents are able to complain and are protected from abuse. Evidence: A whistle blowing and Adult Protection Policy and Procedure have been implemented to work in tandem with the procedure produced by Hampshire County Council. All management staff spoken to demonstrated they were aware of the procedure to follow should they witness or suspect the abuse of a resident. Staff training records indicated all staff had received training in safeguarding issues. The complaints procedure included information on how to contact The Commission for Social Care Inspection (C.S.C.I), was seen, as was record of complaints. CSCI has received no complaints since the last inspection. Due to the problems of communication we were unable to ascertain how residents felt about discussing any concerns they had with the homes manager but staff did state they felt comfortable in discussing issues with management on behalf of any resident. Care Homes for Adults (18-65 years) Page 18 of 27 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 safe, well maintained, clean and suitably furnished home is provided for residents which meets their needs. Evidence: Our observations indicated the home and gardens were safe, well-maintained and met residents individual and collective needs. The building was tidy, clean and free from any adverse odors with no obvious hazards to health and safety. The initial assessments of prospective residents ( referred to in standard two of this report) would consider what personal aids residents required and any adaptations the home needed to put into place too meet their needs. All communal areas were fully decorated, large windows ensured light airy rooms that were equipped with suitable furniture designed to meet residents needs. Not only have the needs of the residents been taken into account, so have the needs of the staff enabling then to deliver a good service in a pleasant safe environment. To ensure the safety of all who use the building as part of the general health and safety arrangements, fire safety policies and procedures were all being observed and an infection control policy and procedure was in place which included and all staff having Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: access to and using aprons, gloves and antiseptic soap. The initial assessments of prospective residents ( referred to in standard two of this report) would consider what personal aids they required and any adaptations the home needed to put into place too meet their needs. Care Homes for Adults (18-65 years) Page 20 of 27 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Resident’s needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. Evidence: At the time of our visit the number of staff on duty in our opinion was sufficient to meet the needs of the residents. In discussion with the manager we established that the staff numbers and their deployment are decided on a needs and risk assessment of residents based on a matrix covering a twenty four hour period as referred to previously in this report. The current assessments had indicated that between 7.30am and 3pm there should be a minimum of two but usually three carers between 2.30pm and 10.00pm a similar number and between 9.30 pm and 8.00am one carer awake with on call telephone back up. The manager would also be available to part of the am and afternoon shift. Staff spoken with were confirmed they were aware of their responsibilities, the limits of their authority and who to contact for advice and support during in the absence of the manager via the on call system to external senior managers. The home has a key worker system whereby a support worker is allocated as the Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: person who will have most contact with the service user and will attend reviews and health consultations. Residents can exercise choice regarding their key worker. Following the last inspection a requirement was made that The registered person must ensure that two written references are obtained for staff before they start work in the home. We viewed three staff recruitment and training files, all of which included evidence that staff are employed in accordance with an equal opportunities robust recruitment and selection procedure designed to protect residents This involves the completion of an application form, the signing of a rehabilitation of offender’s declaration, an interview, satisfactory Criminal Record Bureau (CRB), Protection of Vulnerable Adults (POVA) and reference checks. From the evidence viewed we are satisfied the previous requirement has been complied with. Records seen confirmed all staff who receive regular one to one personal supervision are subject to an in house and induction and compulsory training programme based on learning disability sector skills plus first aid, moving and handling, protection of vulnerable adults (POVA), infection control food hygiene, fire safety (including evacuation), handling medication, challenging behavior and any other topic Dependant on the needs of residents. All staff are also expected to undertake a National Vocational Qualification (N V Q) course. Currently 11 of staff has been trained to at least NVQ level three 33.3 to NVQ two (all on a level three course )and , with a further 55.5 currently on courses. Those responsible for this result are to be commended . Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought. Evidence: The manager who has been in post since June 2006 has been registered since the last inspection, having previously worked in the home as deputy manager. He is experienced in working with residents with a learning disability and is currently involved in training leading to a Registered managers award and an NVQ in care (Level 4). In talking with staff we were satisfied that the home has a clearly defined management structure, staff were aware all of their responsibilities and the limits of their authority. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Staff described the management both internal and external as supportive,approachable, accessible and encouraged them come up with ideas and suggestions for improvement. As part of the homes quality monitoring system, residents and residents relatives/representatives and health /social care professionals are invited to participate in satisfaction surveys. The views expressed in the surveys are seen as key in highlighting areas that may require improvement or attention and the future development of this service. An in house health and safety policy was in place to ensure the day-to-day safety of staff and residents. Procedures include, weekly health/ safety checks, the regular servicing of equipment, staff training in the techniques of moving and handling, infection control, control of substances hazardous to health (C.O.S.H.H.) first aid, health and safety, reporting accidents, and procedures to follow in the event of fire (including evacuation). We were informed all of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all radiators and hot pipes were covered to prevent a resident or staff being burnt. Care Homes for Adults (18-65 years) Page 24 of 27 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 Adults (18-65 years) Page 25 of 27 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 Adults (18-65 years) Page 26 of 27 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 © (2008) 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 Adults (18-65 years) Page 27 of 27 - 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!