Inspection on 20/02/07 for Acorn

This inspection was carried out on 20th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Acorn 19/02/08

Acorn 02/02/06

Acorn 01/08/05

Acorn 31/01/05

Acorn 02/09/04

Acorn 01/03/04

Acorn 07/11/03

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Acorn 20 Huckleberry Close Purley on Thames Reading Berkshire RG8 8EH Lead Inspector Catherine Kane Unannounced Inspection 20th and 21st February 2006 3:45 Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Acorn Address 20 Huckleberry Close Purley on Thames Reading Berkshire RG8 8EH 0118 9427608 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Purley Park Trust Limited Mrs Kim Marie Facer Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd February 2006 Brief Description of the Service: Acorn House is one of the three original outlying houses within the Purley Park Trust, and is now one of eight separate small units within the estate. The unit now accommodates up to five adults of either gender, with a learning disability, in a pleasant building providing each service user with their own individualised bedroom. Communal accommodation consists of a shared lounge/kitchen/dining area, with comfortable furnishings, bathroom and toilet. The service users in this unit are relatively able and independent and work together with staff on various aspects of the day-to-day running of the unit. The fees for this home range from £607 to £638 per week. The manager of the home has declared on the pre-inspection questionnaire that additional charges are made for toiletries, holidays, chiropodist, newspapers/magazines, some recreational activities and public transport. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 3.45pm on Tuesday, 20 February 2007. She returned on Wednesday, 21 February 2007 to look at staff files. The inspector was in the service for a total of four hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The registered manager and one staff member was on duty on the first day of the inspection visit. The inspector spoke with all five residents. The inpsector saw staff and residents prepare for their evening meal and saw how staff help residents look after and take their medicines. She also looked at residents care plans and other records kept in the home and made a tour of the part of premises. On the 2nd day of the inspectors visit the inspector met with the chief executive of the organisation and two other managers. The inspector would like to thank the manager and her staff team for their assistance with the inspection. She also thanks residents and other visitors who shared their experience of this home. What the service does well: The home continued to have a friendly, relaxed atmosphere with positive relationships between residents and staff. Staff had a good understanding of residents’ support needs. Meals provided are good. Personal care and healthcare support provided in this home is good. The home would be able to meet the needs of individuals of various religious, racial or cultural backgrounds. Residents say they like living in their home. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 2. Quality in this outcome area is good. The homes statement of purpose needs to be updated. The admission procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose document made available at the time of the inspectors visit had not been reviewed or updated since 2004. At the time of this inspection the home had no vacancies. There have been two new admissions to this home since the last inspection. One person has since moved out; their pre-admission assessments and care notes were not available at the time of the inspection visit. The inspector viewed the pre-admission assessment for one other person. These were comprehensive documents, they clearly indicated that the home could meet the individual’s needs at the time of admission and a review process was in place. Generally, admissions would not made to the home until a full needs assessment has been undertaken. The home would then be able to confirm that they can meet the needs of the individual through the service they deliver. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is good. The care planning system in place to provide staff with the information they need and for assessing risk is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the inspector viewed one resident’s care plan. This was easy to understand, written in plain language, considered all areas of the individual’s life including health, personal and social care needs. The plan is regularly reviewed and includes comprehensive risk assessments. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. Opportunities for people who use this service to take part in a variety of interesting activities are excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection the inspector was in the home during the afternoon and early evening. She spent this time with all five residents and the staff on duty. Four of the five residents had very good communication skills, they were confident and able to tell the inspector about their experiences of the home. One resident told the inspector “Staff are getting better all the time, they look after me well. It’s a lovely place to live.” Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 11 Many activities provided in house were based on what residents prefer to do in their leisure time; these included watching TV, reading newspapers and magazines, and helping in the kitchen. Each resident has a full programme of regular activities outside the home that include frequent outings to pubs and meals out, college courses and attending sessions at the day services on site. One resident was told the inspector that they were going out that evening to church bible studies. One resident used to go to work but they have now retired. The manager and one resident told the inspector about the home’s garden and how residents are involved in growing their own vegetables. One resident told the inspector about how the manager and staff support people to maintain their relationships with their friends and family. This was very important for them. One resident has a person, who visits regularly, who can advocate on their behalf and can help them when they need to make important decisions. The inspector was in the home when the evening meal was being prepared and served. Residents have their meal together in the kitchen. The meal was freshly cooked pasta bake followed by ice cream. Two other residents had alternative meals. Regular drinks and snacks are available. A varied menu is provided and residents special dietary needs are catered for. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19, 20 and 21. Quality in this outcome area is good. The personal and healthcare needs of residents are generally well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Essential information needed by staff to be able to provide personal and health care support was included in residents’ files. Staff help residents to look after their own medication and see they get to see their local GP and other community healthcare services when needed. The inspector saw how the home helped residents to access specialist healthcare support when this was needed. This included providing support to residents with a serious illness taking into account and respecting their wishes to be cared for at home. Four comment cards were returned from residents’ GPs and other healthcare professionals. They all indicated that they were satisfied with the overall care provided in this home. They commented that the home has always worked well and in partnership with them. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 13 Residents’ medicines are securely kept in a locked medicines cabinet situated in the home’s laundry room. This room gets hot and humid when laundry equipment is being used. The inspector recommends that the home should consider relocating the medicines cabinet in order to keep residents medicines within the temperatures recommended in guidance on patient information leaflets. The home uses a pharmacist produced medication administration record (MAR). Records seen were neat and well maintained. Most residents medicines are supplied in pharmacist produced monitored dose system. The inspector strongly recommends that the home consider following good practice guidelines for the storage and recording of controlled drugs where this may be appropriate. Records were kept of staff assessed as competent to administer residents’ medicines. The manager has completed training delivered by an appropriately qualified person with knowledge of medicines. During the inspection the manager and another member of staff confidently demonstrated how a residents medicines are looked and how residents are helped to take their medicines. A resident confirmed that the staff did it properly. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. The home has a protection from abuse policy and the complaints procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager declared that home has received no complaints in the last year. The Commission has received no information relating to complaints in the last year. Residents who spoke with the inspector were very clear about whom they needed to speak to if they wished to make a complaint. Staff have attended specific training on protecting vulnerable people from abuse and about local adult protection procedures. Staff who spoke with the inspector were clear about their responsibilities and were aware of the homes ‘whistle blowing’ policy. The Commission has received no information relating to adult protection issues since the last inspection. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 Quality in this outcome area is good. The home was tidy and clean at the time of the inspection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The furniture and fittings are modern and domestic in style providing a homelike environment. The comfortable open plan lounge/dining and kitchen leads to a well maintained the gardens. The home has a programme of repair and renewal. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 24 and 35 Quality in this outcome area is good. This homes recruitment procedures and training for staff to do their jobs well is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the 1st day of inspection visit the inspector spoke with the member of staff on duty. The home has a core of well-established staff that understand residents needs and they relate well to. One staff member has left and one new member of staff has been recruited since the last inspection. Staff commented that morale is high. On the 1st day of the inspectors visit the inspector was informed that staff records were not kept in the home but in an office facility within the Purley Park site. The inspector requested that a staff file be made available for inspection and this was provided. The recruitment process is thorough. These were well organised and contained the necessary documentation. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 17 The chief executive of the organisation confirmed that Purley Park Trust intends to renew the Criminal Record Bureau (CRB) disclosures made on staff every three years. See also Standard 41. The home keeps a record of training completed by staff; staff spoken with confirmed details of the training they have undertaken. Three staff members have completed a relevant National Vocational Qualification (NVQ). Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 41 and 42. Quality in this outcome area is adequate. The registered manager has a good understanding of management areas in which the home needs to improve and has plans in place to address this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The experienced registered manager informed the inspector that she should complete the Registered Managers Award qualification soon. Therefore this standard is rated as ‘standard almost met’ scored 2. The Manger is competent to run the home and meet its stated aims and objectives. She has sound knowledge and experience in care of people with a learning disability, quality assurance systems, equal opportunity issues, development and implementation of the services policies and procedures, good people skills, strong leadership of staff which leads to confident workers, responds to need and provides an excellent role model and manages the service efficiently. She Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 19 has a strong ethos of being open and transparent in all areas of running of the home and is aware of current developments both nationally and by CSCI and plans the service accordingly. The manager is well respected by members of her staff team and is trusted and well liked by the residents of the home. A requirement was set at the last inspection for the registered provider to ensure that proprietors’ representative monthly visits take place and a report produced. Only 5 reports have been produced in the last 12 months. The Commission no longer requires that a copy of this report is sent routinely to CSCI but a copy must be kept in the home and made available for inspection. The registered manager provided details and positive outcomes of her recent quality assurance survey that included the views of residents and their family representative. The Purley Park Trust has achieved and maintained the Investors in People award. At the time of the inspector’s visit there was no proof of identity for staff kept within the home, staff do not carry photo identity badges. Staff records are kept securely in an office within the Purley Park site. However, Care Homes Regulations requires that information about staff must be kept in the home and is available for inspection at all times. The home needs to set up an agreement with CSCI that staff information required may be kept in a separate location and the arrangements for inspection. A checklist, countersigned by the registered manager, which provides proof of staff identity, the job they are to do and details of where the all information is stored should be kept in the home. The home has sound policies and procedures in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. The home works to a clear health and safety policy and checks take place to ensure the home meets relevant health and safety requirements and legislation. Records kept were good and are routinely completed. Where issues have been identified these have been acted upon successfully to ensure residents’ care is not compromised. Purley Park Trust, who run this service, has financial and accounting systems subject to internal and external audits. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 2 X 2 X 2 3 X Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA39 Regulation Requirement Timescale for action 30/04/07 2. YA41 26(2)(3)(4)(5) The registered provider must ensure that the unit is visited in accordance with Regulation 26 and reports are produced. (This requirement from the previous inspection was not fully met.) 7, 9 and 19 The registered provider home 30/04/07 must to set up an agreement with CSCI that staff information required might be kept in a separate location and the arrangements for inspection. A checklist, countersigned by the registered manager, which provides proof of staff identity and details of where the all information is stored must be kept in the home. Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations The inspector recommends that the home should consider relocating the medicines cabinet in order to keep residents medicines within the temperatures recommended in guidance on patient information leaflets. The inspector strongly recommends that the home should consider following good practice guidelines for the storage and recording of controlled drugs where this may be appropriate. 2. YA20 Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Acorn DS0000011169.V325499.R01.S.doc Version 5.2 Page 24 - 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!