Enter & View Report

Good practice observed on our visit and Recommendations

Hospital Discharge: Recommendations

• It is recommended that the home look at the form ‘ All About Me’ (Appendix 2). This form was developed by Grovelands Care Home and used with Yeovil District Hospital to limit some of the problems experienced by residents who needed hospital treatment. It is recommended the form be adapted for use by the Elms and its use be discussed with the hospital.

Staff – Good Practice:

• Training is given to all staff in 18 mandatory training topics.
• Training is purchased by a scheme called ‘Red Crier’ this scheme provides materials for in house training which is then externally validated. It was thought to be a good system as once purchased there are no additional charges for undertaking new training and training updates.
• Care staff are involved in all roles and do not ‘key-work’ or take any particular responsibility for any one resident.  Noted as a good approach for a smaller homes.
• Bank Staff are used as opposed to agency.

Activities Good practice:

• Quizzes
• Bingo
• Exercise (by a trained instructor twice a week)
• Music (visiting) at least once a month
• Flower arranging
• Occasional Owl sanctuary visits
• Vegetable garden – residents tend not to participate but one resident enjoys looking and giving advice
• Occasional trips out for shopping and to the garden centre.
• Computers

Activities Recommendations:

• It is recommended that the home consider some of the activities from the list below which has been mentioned by residents during the visit or gathered during previous E+V visits:
• Visits by the ‘Old Fashion Sweet Shop’ (based in Taunton)
• Visits by Clothes Direct.
• Visits by the Donkey Sanctuary.
• Model making.
• Visits by the local vintage motorcycle club or classic car club (often these clubs organise charity ride outs and welcome the opportunity to stop of for a tea break).
• Wii exercise.
• DIY group.
• It is recommended the home discuss activities regularly with residents and visitors (at least monthly in addition to the 3 monthly meetings). Meal times may offer an ideal opportunity when most residents are already in the dining room.
• It is recommended that residents are encouraged to take some responsibility for helping to organise activities as this can be a meaningful activity in itself.
• It is recommended that  the home research  volunteer car schemes in the area or find out if there are any local clubs or ‘Active Living Centres’ that may be willing to share transport. It is recommended the home contact the local volunteer bureau and also try local Stroke or RNID organisations or similar, to find out if transport can be shared or rented.

Control and Choice:  Good Practice

• Staff ask before offering assistance.
• Secret signs were used to label residents’ rooms relating to the palliative care wishes of the resident and palliative care wishes and instructions noted on residents care plans.
• Use of mobile panic button to enable residents to have more freedom and walk outside the home.
• In house church service provided monthly.
• Residents able to purchase their own phone line in their room if they wish or use the office phone.
• Residents can bring in their personal effects as far as room permits.
• Residents can bring in their own pet.
• Staff support is given to residents to make decisions.
• Toiletries and other items available for residents to purchase.
• Residents are encouraged to maintain life skills.
• 3 monthly meetings are arranged for residents, staff and visitors. Menus activities and updates are discussed.
• Residents have a choice of where they eat meals.

Control and Choice: Recommendations

• It is recommended home consider adapting the ‘All About Me’ form to aid in the gathering of personal information and life history.
• It is recommended the home identify which residents prefer to rise early, and look at adapting the staffing rota to accommodate their preference.
• Communication: Good Practice
• Suggestion box was displayed.
• 3 monthly meetings with staff, residents and families take place to discuss finance, activities, food and to update on decoration.
• Government grant  ’Get Connected’ received for specially   adapted and simplified computers set up for residents use.
• Residents have pictures on their doors and names plus personal items to aid their memory.
• ‘Keep-sake’ boxes given to all residents and sometimes used when spending time with staff aiding conversation and memory and staffs understanding of a resident’s past.

Communication: Recommendations

• The E+V team recommend that all residents are consulted about the use and volume of music at meal times and are involved in agreeing a solution or compromise.
• Eating and Nutritional Care: Good Practice
• Residents always asked before being given assistance with cutting up food.
• Staff had been observed to be very attentive to the needs of residents and no resident had to wait for assistance during lunch.
• Snacks available between meals.
• New additional kitchen area available to able residents and visitors.
• Residents’ dietary needs are catered for and a notice board was observed in the main kitchen displaying residents’ individual dietary needs and preferences.
• Vegetarian options were available for residents or visitors on request.

Eating and Nutritional Care: Recommendations

• It is recommended that if possible staff have their meals with residents to support conversation and socialising.
• Hydration: Good practice
• A kettle was observed to be available for families and capable residents.
• Food and fluid monitoring charts are used as required.

Hydration: Recommendations

• It is recommended that jugs of drinks be placed on tables for those able to pour it themselves so as they don’t have to ask staff.
• Pain Management in Practice: Good practice
• District nurses visit as required.
• Dental checks are received at the home and dentist visits regularly.
• Hearing and sight tests are provided regularly at the home.

Personal Hygiene: Good practice 

• Alcohol gel dispensers were located throughout the home but not observed to be intrusive or clinical.
• Hair dresser visits fortnightly.
• Toiletries available for purchase by residents.

Personal Hygiene: Recommendations

• It is recommended that residents are provided with choice and are enabled to take a bath as often as they wish.

Practical Assistance: Good Practice

• Talk planned for relatives and carers on ‘Cost of Care and finances’ by ‘Care fees’.

Privacy in Practice: Good Practice

• All rooms have en-suite toilets and wash basins.
• Doors lock from inside plus residents can have their own key if they wish.
• Staff were observed to knock before entering residents own rooms.

Social inclusion in Practice: Good Practice

• Visitors spoken to noted they were welcomed at the home and able to eat meals with their relative or friend.
• The local Brownies group have visited the home.
• The home has an Annual Fete for relatives, friends and local people.

Social Inclusion in Practice: Recommendations

• It is recommended that the home research what other local services and clubs may be available such as coffee mornings, hobbies clubs, luncheon clubs etc. A list of these could be available for residents and visitors. It may be possible to arrange for residents to attend these either with support from families and friends or community and volunteer transport services.

For more information

For more information, read the full report or contact Jonathan Yelland on jonathon.yelland@helpandcare.org.uk.