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Care Services

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Elton Hall Care Home, Elton, Stockton On Tees.

Elton Hall Care Home in Elton, Stockton On Tees is a Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs, caring for adults under 65 yrs, dementia and mental health conditions. The last inspection date here was 7th December 2019

Elton Hall Care Home is managed by Bondcare (Ambassador) Limited who are also responsible for 1 other location

Contact Details:

Ratings:

For a guide to the ratings, click here.

Safe: Good
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Good
Overall: Good

Further Details:

Important Dates:

    Last Inspection 2019-12-07
    Last Published 2017-05-19

Local Authority:

    Stockton-on-Tees

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

27th April 2017 - During a routine inspection pdf icon

This inspection took place on 27 April 2017. This was an unannounced inspection which meant that the staff and registered provider did not know that we would be visiting.

The service was last inspected in February 2016 and at that time met the requirements of the regulations we inspected against.

At this inspection we found that medicines were now administered safely and all counts were correct. We also found the dining experience had improved.

Elton Hall provides care and accommodation for up to 70 older people, people with dementia and people with mental health needs. Accommodation is provided over two floors and includes communal lounges and dining areas. Bedrooms are single occupancy and have en suite facilities which consist of a toilet and wash hand basin.

There was manager in place who was going through the registration process with the Care Quality Commission. The manager had worked as a registered manager at another Bondcare home and came to Elton Hall in September 2016. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Risks to people arising from their health and support needs and the premises were assessed, and plans were in place to minimise them. Risk assessments were regularly reviewed to ensure they met people’s current needs. A number of checks were carried out around the service to ensure that the premises and equipment were safe to use.

There were enough staff to meet people's needs. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began working at the service. Staff were given effective supervision and a yearly appraisal.

Staff understood safeguarding issues, and felt confident to raise any concerns they had in order to keep people safe.

Staff received training to ensure that they could appropriately support people, and the service used the Care Certificate as the framework for its training. Staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) training and clearly understood the requirements of the Act. This meant they were working within the law to support people who may have lacked capacity to make their own decisions. The manager understood their responsibilities in relation to DoLS.

People were supported to maintain a healthy diet, and people’s dietary needs and preferences were catered for. People told us they had a choice of food and everyone enjoyed what was on offer.

The service worked with external professionals to support and maintain people’s health. Staff knew how to make referrals to external professionals where additional support was needed. Care plans contained evidence of the involvement of GPs, district nurses and other professionals.

We found the interactions between people and staff were cheerful and supportive. Staff were kind and respectful; we saw that staff were aware of how to respect people’s privacy and dignity. People and their relatives spoke highly of the care they received. People had access to a wide range of activities, which they enjoyed.

Procedures were in place to support people to access advocacy services should the need arise. The service had a clear complaints policy that was applied when issues arose. People and their relatives knew how to raise any issues they had.

Care was planned and delivered in way that responded to people’s assessed needs. Plans contained detailed information on people’s personal preferences. However, although staff could tell us about people’s life history’s not all of it was documented in the care plans.

The manager was a visible presence at the service, and was actively involved in monitoring standards and promoting good practice. Feedba

11th February 2016 - During a routine inspection pdf icon

We carried out this inspection on the 11 February 2016. The inspection was unannounced which meant the staff and registered provider did not know we would be visiting

Elton Hall provides care and accommodation for up to 70 older people, people with dementia and older people with mental health needs. Accommodation is provided over two floors and includes communal lounges and dining areas. Bedrooms are single occupancy and have en suite facilities which consist of a toilet and wash hand basin. At the time of our inspection there were 31 people using the service.

The home had a registered manager in place that started in May 2015. They registered with the Care Quality Commission since 8 February 2016. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection April 2015 we found two breaches of regulation. These were in relation to the safety and condition of premises and care being delivered without people's consent.

The registered manager had knowledge of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards [DoLS]. The registered manager understood when an application should be made, and how to submit one. Since our last inspection the majority of staff had received training in MCA and DoLS. At the time of our visit there were 13 people living at the service who were subject to a DoLS authorisation.

People had access to medicines and these were stored and administered safely. However a count for one person’s medication was incorrect, not all handwritten medication administration records (MAR) had two signatures and there was no record to show that the amount of medication received from the pharmacy for a controlled drug (medicines liable to misuse) was correct. We made a recommendation about medicines management.

Risks to people’s health or well-being had been assessed and plans put in place to protect people. However in two people's care files not all risk assessments were reviewed monthly.

People were provided with a meal choice and enjoyed the food on offer. However the dining experience for people living with a dementia needed improving.

Staff we spoke with understood the principles and processes of safeguarding, as well as how to raise a safeguarding alert with the local authority. Staff said they would be confident to whistle blow (raise concerns about the home, staff practices or provider) if the need ever arose.

Accidents and incidents were monitored each month to see if any trends or patterns were identified. At the time of our inspection the accidents and incidents were too few to identify any trends.

Staff received relevant training and competency assessments took place. Staff received support through supervisions and appraisals

Staff knew people well and were caring and respected people’s privacy and dignity.

People were supported to access healthcare professionals and services.

The service had a vacancy for an activities coordinator. Staff were working extra duties to cover activities and this was working well. People were happy with the activities on offer.

People’s care records were person centred. Person centred planning provides a way of helping a person plan all aspects of their life and support, focusing on what’s important to the person.

We found people were cared for by sufficient numbers of staff. Recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

We saw that the service was clean and tidy and there was plenty of personal protection equipment [PPE] available.

Staff were supported by the registered manager and were able to raise any concerns with them.

We saw certificates for safety checks and m

2nd April 2014 - During a routine inspection pdf icon

Our inspection team was made up of two inspectors. We gathered evidence against the outcomes we inspected to help answer the five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

In this report the name of a registered manager appears who was not managing the

location at the time of the inspection. Their name appears because they were still a

registered manager on our register at the time of inspection.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. Safeguarding procedures were robust and staff understood how to safeguard the people they supported. Comments we received from one relative of a person who used the service were very positive stating “Staff are really good, lovely” and comments from people who used the service were “Staff are marvellous and would do anything for you” and another said “Staff are fantastic”.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. Although more robust action plans are needed to include what actions were to be taken, by whom and by when. .

Risk assessments were carried out to ensure that both people and staff members maintained a safe working environment.

The service was undergoing a refurbishment. Peoples rooms and communal rooms were safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

They were awaiting start dates for a new manager and new staff. A manager from a sister home was supporting them at the time of the inspection

Recruitment practice was safe and thorough. No staff had been subject to disciplinary action. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

Support plans and risk assessments were written with the person receiving the service and their family and carers and their wishes and preferences were clearly recorded. People were also supported to give their consent so information the service held about people, was used appropriately with staff and other professionals on a need to know basis.

People’s needs were taken into account with signage and the layout of the service enabling people to move around freely and safely.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people, treating people with dignity and respect.

Is the service responsive?

The service had a complaints procedure in place. Staff were aware of this procedure and stated they would feel comfortable making a complaint if needed. The provider needs to ensure that people who used the service and relatives are also aware of the complaints policy. The service performed monthly audits on medication, care plans, mattresses and infection control, they identified issues but the action plans need to be more robust to make sure the identified issues were addressed. People completed a range of activities and there were plans for more daily outings once the weather improved.

Is the service well-led?

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. Staff were knowledgeable about people’s needs. Daily records were kept up to date and we observed how these linked in with the multi-disciplinary teams such as the GP, and optician. This helped to ensure that people received a good quality service at all times.

25th April 2013 - During a routine inspection pdf icon

We spoke with five people who used the service, the relatives of two people, the manager, six care staff and the cook. People who used the service expressed satisfaction with the care and service that they received. One person told us, "Staff help with everything." Another person told us, “The staff are excellent.” One of the relatives we spoke with told us their relative, “Was well looked after.” We used a number of different methods to help us understand the experiences of people who used the service, because some people had complex needs which meant they were not able to tell us their experiences.

Where able, people could make their own day to day decisions and lifestyle choices. We saw there was a friendly and relaxed atmosphere between people living and working at the home. Staff interacted well with people and supported them, which had a positive impact on their wellbeing. We found that people had their needs assessed and care plans were in place. People's views were taken into account in the assessment and care planning process.

People were provided with a choice of suitable and nutritious food and drink.

The environment was clean and well decorated and systems were in place to ensure maintenance was carried out.

Staff received appropriate training and had regular supervision and appraisals.

The quality of the service was monitored and reviewed on a regular basis.

1st January 1970 - During a routine inspection pdf icon

We carried out this unannounced inspection on the 7 and 9 April 2015. We last inspected this service in April 2014. On the first day of inspection the registered manager was on annual leave.

Elton Hall provides care and accommodation for up to 70 older people, some people living with dementia and others with mental health needs. Accommodation is provided over two floors and includes communal lounges and dining areas. Bedrooms are single occupancy and have en suite facilities which consist of a toilet and wash hand basin. At the time of our inspection occupancy was 32

The home had a registered manager in place and they have been in post as manager since May 2014. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff we spoke with understood the principles and processes of safeguarding, as well as how to raise a safeguarding alert with the local authority. However, we saw only 15 out of 48 staff had received training in safeguarding. Staff said they would be confident to whistle blow [raise concerns about the home, staff practices or provider] if the need ever arose.

People living at the service said they felt safe within the home and with the staff who cared for them. Relatives of people who used the service also indicated that their family member was safe.

We found that medicines were stored and administered appropriately. We were told that one person received their medicines covertly, however we were unable to see a Mental Capacity Assessment [MCA] and best interests meeting records. The registered manager said this person no longer received covert medicines, this information needs to be passed onto all staff so they are aware.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The registered manager had sought and acted on advice where they thought people’s freedom was being restricted. This helped to ensure people’s rights were protected. Not all staff we spoke with had a good understanding of the Mental Capacity Act (MCA) and how to ensure the rights of people with limited mental capacity to make decisions were respected. At the time of our visit five people were subject to a DoLS authorisation.

Three peoples care files we looked at showed staff did not understand what a best interest decision was and how to implement one. We found staff were preventing one person from leaving the building alone because of sensory impairment. We could see no evidence of consent to this and without their informed consent staff were restricting this persons access to the community.

There were gaps on the training chart for mandatory training such as food hygiene and infection control and only 15 out of 48 staff had received training in safeguarding. The registered manager said they are arranging training sessions to cover these gaps. Staff had regular supervisions and appraisals to monitor their performance and told us they felt supported by the registered manager.

Staff were observed to be caring and respected people’s privacy and dignity. People who used the service said that staff were caring and kind. However, improvements could be made to the level of interaction between staff and people who used the service while care was being provided. We observed staff hand out food without plates, therefore people had to balance the food on the arm of their chair which is not very hygienic.

The service employed an activities coordinator who was on annual leave on the first day of our inspection. We found that not all people who used the service had access to opportunities for social stimulation or activities that met their individual needs and wishes. It was a large building with people spread out that the activity coordinator struggled to occupy everyone. Staff downstairs did not interact much with people at all. Upstairs staff sat with people and we could see lots of conversations taking place.

People’s care records confirmed that an assessment of their needs had been undertaken, thereafter care plans were developed detailing the care needs/support, actions and responsibilities, to ensure personalised care is provided to all people. The care plans were found to be detailed outlining the persons ‘needs/risk’, the ‘aims/objectives’ and the ‘care and intervention.’ However it was difficult to gain a clear overview of people’s needs and the support they required. We found it a complex care file system, with lots of information [numerous care plans] and difficult to navigate which meant that people’s needs may be missed or overlooked.

Accidents and incidents were monitored each month to see if any trends were identified.

We found people were cared for by sufficient numbers of suitably qualified and experienced staff. Recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. However, there were some gaps in peoples employment history, for example one person’s application stated the month they started working at a previous employment but no year was documented and nothing to say where they had worked at previously to this. We discussed this with the registered manager who was going to update the records. We saw they had obtained references from previous employers and we saw evidence that a Disclosure and Barring Service [DBS] check had been completed before they started work in the home. The Disclosure and Barring Service carry out a criminal record and barring check on individuals who intend to work with children and vulnerable adults, to help employers make safer recruiting decisions and also to minimise the risk of unsuitable people from working with children and vulnerable adults.

We saw that the service was clean and tidy and there was plenty of personal protection equipment [PPE] available. There were some issues with staff wearing nail varnish and false nails. We discussed this with the registered manager.

We observed a lunchtime meal upstairs on the dementia unit. We found the food was well presented, well cooked and plentiful. People were asked if they wanted more.

Staff were supported by their manager and were able to raise any concerns with them. Lessons were learnt from incidents that occurred at the service and improvements were made if and when required. The service had a system in place for the management of complaints. The registered manager reviewed processes and practices to ensure people received a high quality service.

We saw safety checks and certificates that were all within the last twelve months for items that had been serviced such as fire equipment and water temperature checks. Maintenance staff completed monthly health and safety audits but did not always act upon them.

We asked to see an environmental risk assessment for the staircase. The service has a large staircase that goes up and round to the first and second floors. Once on the second floor there was a sheer drop that could be considered dangerous. People on the mental health unit had free access to this staircase. No one had considered this an issue in the past. We recommended that the registered manager refers this to health and safety for advice.

We found there were two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report.

 

 

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