Care Home: The Elms

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What the care home does well People are provided with a very supportive environment and their needs are well met. People are clearly happy, relaxed and enjoying a really good quality of life while living at The Elms. All of the people we met said they are very happy living there. People are very well supported to attend a range of community based services and activities. What has improved since the last inspection? The home has been refurbished, and redecorated and looks really homely and welcoming. Fire drills are being done regularly to make sure people are kept safe in the event of a fire. Cleaning substances that may be hazardous to peoples health and safety are being stored securely. Electrical appliances are being tested regularly. This is referred to as `PAT` testing and is done to protect peoples health and safety. What the care home could do better: It would be beneficial if the home make sure it has the correct storage cupboard for controlled drugs in the home. This may never be used but is required of care homes in case such medicines are needed. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Elms 28 Elms Way Southbourne Bournemouth Dorset BH6 3HU     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: User doesnt belongs to any group     Date: 1 4 1 2 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. 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 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 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 Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: The Elms 28 Elms Way Southbourne Bournemouth Dorset BH6 3HU 01202431886 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) : elmscare@uwclub.net Elms Care Limited care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 4 The Elms is a small home set in its own mature grounds and is in keeping with all the properties in its immediate vicinity. It is situated in a quiet, residential area of Southbourne and is close to local shops and amenities. Bus routes to Bournemouth and Christchurch are easily accessed. The home is registered to accommodate a maximum of four adults of both sexes with a learning disability and had no vacancies at the time of inspection. The property has limited access to service users with physical disabilities. However, the facilities are appropriate for the intended service group, i.e. adults with learning disabilities. Three residents have single rooms on the first floor and there is a further bedroom on the ground floor. Residents share the use of an upstairs bathroom and downstairs shower room. On the ground floor there is a large lounge with a separate dining area and kitchen. The home is well kept and furnished. Outside there is a garden that provides a seating area for eating out and a storage shed. Service users are offered a wide range of opportunities both within and outside the home. Most service users attend day centres whilst one service user has a daily programme provided by the home. Current fees are between 850 and 200 pounds a week. Fees do Care Homes for Adults (18-65 years) Page 4 of 26 Brief description of the care home not include personal items such as toiletries, hairdressing, cigarettes and sweets. For further information on fee levels and fair terms of contracts you are advised to referred to the Office of Fair Trading website www.oft.gov.uk. The home keeps copies of all inspection reports that are available in the office and can be seen by service users, relatives and professionals at their request. Care Homes for Adults (18-65 years) 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 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: We met all of the four people who live at the home. We spent time talking to the support worker on duty about their role, their responsibilities and training and development needs. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 of 26 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 8 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, 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their representatives have the information they need to make an informed choice about living at the home. Evidence: To see how people and their representatives are helped to find out about the home we read a copy of the service users guide and the statement of purpose. We found that both of the documents have up to date information about the service provided the qualifications of the staff employed and the accommodation. The philosophy of the home and how the service aim to meet people needs is included. The complaints procedure is in the service users guide so people know how to complain. There have been no new people admitted to the home recently however we did look at two peoples assessment records in detail. We saw really detailed information written for each person clearly explaining stating how to assist them with their range of needs. We also saw for each person a health care needs assessment in place. We saw that the assessments records were up to date and had been reviewed regularly.This helps to Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: demonstrate peoples assessed needs are being met. Care Homes for Adults (18-65 years) Page 10 of 26 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. Peoples needs are assessed and their care plans reflect how needs are met. People are well supported to make decisions and to take risks in their daily lives. Evidence: To find out how well people are supported to meet their needs we looked at two care plans. We saw a detailed personal profile completed about each person. This included their personal history and information about their physical and social history as well as a record of important family and friends. There was also an informative plan of care to address the persons physical mental and social needs. The care plans had been written in a simple easy to follow style. We found the current format to be well written as the care plans have been written from a person centred perspective. This should help staff see residents as at the centre of all care. This should also lead to peoples care being personal and individually tailored to their needs. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: We could see that care plans aimed to promote the independence of the person in their daily life. We saw good information written in the records that staff had included the wishes and opinions of the person. We also saw evidence that the care plans had been evaluated and updated on a regular basis. Reviewing care plans regularly demonstrates peoples needs can still be met. People go on out on a very regular trips to places that they like to visit. They also go swimming,shopping and out for lunch. Two people regularly go horse riding. This is very good evidence of how residents are well supported to take risks in their daily lives. Care Homes for Adults (18-65 years) Page 12 of 26 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. People are very well supported to take part in a range of appropriate activities that they enjoy. People are well supported to be a part of the community and to have personal relationships. They are also offered a varied and well balanced diet. People are well supported to make decisions and to take risks in their daily lives. Evidence: People go out with the support of staff on a one to one basis throughout the day to places that they enjoy going in the community. People go out with staff on a very regular basis and attend a range of social and therapeutic activities. People go on very regular trips to places that they like to visit.They also go swimming, shopping and out Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: for lunch. Two people regularly go horse riding. This is very good evidence of how people are well supported to take risks in their daily lives. We saw detailed information included in care plans that set out the potential risks people may face in their daily lives and any risks from particular activities that they take part in both in and out of the home. The care plans clearly set out the preferred approaches staff should take to keep the people safe. The people who live at the home have families and friends. One person we met told us about their friends and family who they see often. The staff also told us that people can visit family and friends when ever they wish to. We looked at the menu record of meal choices was reviewed to see if people are provided with a varied and well balanced diet. There was evidence that peoples choices were nutritionally well balanced and varied.The home also work hard to support people to eat a diet that reflects their religious and cultural beliefs.We also noticed the support worker and one of the people from the home making the Sunday roast together. This shows us people are encouraged and supported to develop different skills in the home. The people we met said that the food at the home was very good. The lunchtime meal choice was a full roast dinner and we were told the lunch was very nice. Care Homes for Adults (18-65 years) Page 14 of 26 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. People are being supported with their needs in the way preferred by them and their needs are being met. Evidence: We observed the support worker, the registered manager and one of the owners we met, all communicate with the people from the home in a really relaxed friendly and kind way . We noticed how comfortable people were approaching the staff. This helps show us that people feel well supported by the staff. We saw a range of up to date information in the daily records that showed us that staff monitor and observe the health of people at the home and call the doctor, if they are concerned. We saw information that showed that people receive support and treatment as required from the specialist Psychiatrist. We also saw up to date information written in the care records, which showed people go to regular appointments at the dentist. We saw information to demonstrate that peoples health care needs are being met. As we have written already in the report we saw detailed Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: evidence in the care records that showed that the preferred daily routine of people and particular likes and dislikes are recorded. This helps ensure peoples needs are met in the way that is preferred by them. The staff we met were familiar with the information in peoples care plans and how best to support them with their care needs. We checked the practices and procedures for administration storage and disposal of medication. We looked at peoples medication administration charts in detail. Medication stock was satisfactorily organised. There was a satisfactory system for ordering and receiving medication and the records were up to date. Medication stock is stored in a cupboard in the office which is kept locked.We advised that ( even though it may not be ever needed ), the home needs to have the correct cupboard to store controlled drugs in in the home. Care Homes for Adults (18-65 years) Page 16 of 26 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. People are well supported to make complaints about the service. People are protected from abuse and the risk of harm by policies and procedures and staff training. Evidence: We saw a copy of the complaints procedure is on display in the hallway. This includes our name and details for anyone who wishes to contact us and make a complaint. The contact details of the owners are included in the complaints procedure and the service users guide. This helps people who wish to contact the owners to make a complaint. There had been no complaints made since the last inspection. We looked at a sample of staff records,these showed staff had undertaken recent training in the topic of the protection and safeguarding of vulnerable adults The home have their own policy and procedure in relation to the protection of vulnerable adults. This is kept in the staff office so that all staff are aware of what they need to do to protect people from harm and abuse. Care Homes for Adults (18-65 years) 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, 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. People live in a home that is domestic and provides a really comfortable environment that is suitable for them and meets their needs. People also benefit from an environment that is clean and hygienic. Evidence: The Elms is a newer building set in a quiet residential area near to the town of Bournemouth. It is close to local shops and people use local amenities every day. We saw a garden and seating area for people to use. Since the last inspection the home has been redecorated and refurbished. We found the standards of the fixtures and fittings and the decoration is really good and looks homely and relaxing to live in. The environment was clean tidy and satisfactorily maintained in all areas. Three of the people who live at the home kindly showed us their bedrooms. We were told by the people we met that they really like their rooms. Each bedroom looks different and has been made to look personal and individual and reflect the interest and taste of each person. There is an open plan lounge and dining room for people to use. We noticed how Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: people looked to be really comfortable and really relaxed sitting in the lounge area. Care Homes for Adults (18-65 years) 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, 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs met by enough competent qualified staff who are supported and supervised in the work that they do. Evidence: We had a detailed read of the staff duty rota for the last two weeks to see if the number of staff on duty is enough to support people to meet their needs. There are at least two staff on duty during the day and one staff member two staff at night. The manager also works full time hours and is supported in their work by a deputy manager. The people who own the home also take a very hands on approach to their running of the service. One of the owners came to the home unannounced during the inspection. We noticed how happy the people at the home seemed to be to see them there. We looked at the staff recruitment records of two support workers to see if the home carry out the required employment safety checks on all staff before they start work. The staff records demonstrate the necessary checks before employing new staff are being carried out. Specifically there were two written references taken up for all new staff before they start work. We saw there are criminal records bureau disclosures Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: checks and protection of vulnerable adult first checks carried out on all new staff. This demonstrates to us that people are protected by the homes recruitment procedures. The support worker we met told us the manager and the deputy manager provides them with supervision and support to assist them in their work. We saw recent supervisions records that also showed us that staff are well supervised in what they do. Care Homes for Adults (18-65 years) Page 21 of 26 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. People who live in the home benefit from a stable and well run service. The views of the people who live at the home are central to how the service is run. The health and safety of the people at the home is overall protected. Evidence: Mrs Greenwood is a qualified learning disabilities nurse. She has a number of years of experience working with people who have learning disabilities. She is registered with us as the manager of the home. This demonstrates Mrs Greenwood is suitable and qualified to fulfill the role of registered manager. We noticed how the people who live at the home were very relaxed and friendly with Mrs Greenwood. We saw people approach her and engage her in social conversation and come into the office to talk to her. The people who own the home take a very hands on approach to the running of the service. As we have already mentioned we met one of the owners who came to the home for an unannounced visit. They told us that they like to keep in close touch with Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: matters going on in the home. The home has a simple quality audit system used to assess the overall quality of the service. The views and outcomes for the people who use the service are used as the main way of judging the quality of care. We also met one of the owners who had come to the home for an unannounced during the inspection. This is another really good way to monitor the overall service and care that the people at the home are receiving from the staff. We checked the fire logbook record which showed the required weekly and monthly tests of the fire alarms and the fire fighting equipment are being carried out and are generally up to date. However there had been two recent checks that had not been carried out for two and three weeks, instead of being done weekly as required. We reminded the manager of the homes responsibility to make sure these checks are done consistently regularly to protect everyone in the building. We saw that the environment looked safe and satisfactorily maintained in all areas viewed. We saw in the training records that staff have done training in health and safety matters including first aid and moving and handling practices. This should help protect peoples health safety if staff are knowledgeable and well trained. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 1 19 13 The home must have a controlled drugs cupboard. Safe storage of medication. 20/04/2009 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 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. 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