CARE HOMES FOR OLDER PEOPLE
Acorn Care Home 83 Blythswood Road Seven Kings Ilford Essex IG3 8SJ Lead Inspector
Harina Morzeria Announced Inspection 14 April 2005 09:30 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 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 Older People. 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 Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Acorn Care Home Address 83 Blythswood Road, Seven Kings, Ilford, Essex IG3 8SJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8597 1793 020 8597 1793 bsso@globalnet.co.uk Mrs Sarbjit Soor Mrs Sarbjit Soor CRH Care Home 3 Category(ies) of OP Old age (3) registration, with number of places Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 15 November 2004 Brief Description of the Service: Acorn Care Home cares for three older people. The home is a corner house, in a residential area of Ilford, close to a busy main road and within easy reach of local facilities and transport links. All the bedrooms are located on the first floor and a stair lift is available for easy access. There is a separate lounge and dining area downstairs, with a small well-maintained garden to the back of the house, which is accessed via the dining room as well as the kitchen. There is a communal bathroom and toilet upstairs as well as a shower facility and toilet downstairs. Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over six hours and was carried out as part of the inspection process. A tour of the premises took place and staff and care records were inspected as part of the inspection process. All three service users were spoken to as well as the manager and one member of staff on duty. What the service does well: What has improved since the last inspection?
All staff working within the home, except the most recently appointed member of staff, have completed NVQ level 2 qualifications. The manager has continued to encourage staff to attend relevant training courses. The manager herself continues to up-grade her training so that the home can continue to progress and meet the service users’ changing needs.
Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 6 The manager has also worked hard to ensure that all the service users receive their weekly personal allowances from their relatives to spend as they require. 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. Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4. The admission procedure used in this home ensures that there is a proper assessment prior to people moving into the home. This ensures that the staff are aware of service users needs and will be able to meet them. Service users and their representatives know that the home they enter will have the knowledge to meet their needs. EVIDENCE: The admission procedure seen for one of the most recently admitted service users showed that it is adequate to guide staff on the actions to be taken to make sure that the new resident’s needs will be properly assessed and planned for. The manager and staff were able to discuss the service user’s needs and how to meet these. Individual records are kept of the service users and inspection of the records showed that proper assessments are carried out before prospective residents move into the home. Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. The inspector was pleased to see that the healthcare needs of the service users are identified and met promptly. The medication at the home is administered by the staff, who have received training from the pharmacist regarding medication administration. All the service users said that the staff are very caring and treat them with respect. EVIDENCE: Individual plans of care are available for each service user, which identify all aspects of health, personal and social care needs of the service users. Care plans are in place and daily entries into case records are made, which indicate the actual care given. Discussion with the manager and staff suggested that they constantly observe and talk to the service users, so that they can take swift action if anyone becomes unwell. The medication at this home is well managed, promoting good health. All the staff working in the home have received adequate training from the Pharmacist. The Pharmacist carries out unannounced visits every two months, in order to ensure that the medication procedure is followed.
Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 10 All service users spoken to said that the staff treat them with respect and pay attention to their privacy when giving personal care, as well as at other times. Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Social activities and meals are both well managed, creative and provide daily variation and interest for the service users living in the home. EVIDENCE: All service users spoken to in the home said that the food is always good and they are given choices from the planned menu which is again discussed each morning. Menus were inspected and found to be balanced and interesting and mealtime arrangements are flexible enough to accommodate individual preferences. The food stocks were sufficient to provide menu options. The staff in the home take responsibility for arranging activities, which include light exercises, reading through newspaper articles and discussing these daily, listening to music tapes and CDs, playing cards. Outings are also arranged, especially during fine weather. One service user attends a church service every Sunday. Service users also go out with their relatives and friends. One service user also spoke about their holiday at the seaside last year. Visiting times are flexible and the service users said that their relatives and friends can visit at any time. Previous comments received from the visitors indicate that they are always made to feel welcome by staff. Service users are able to receive visitors in one of the lounges or in their own rooms, as they wish.
Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 12 Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a satisfactory complaints’ system, with evidence to show that service users feel that their views are listened to and acted upon. The home also has a good Vulnerable Adults procedure to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a clear complaints’ procedure, which is followed when a complaint is received. At this visit, the complaint record did not show any complaints. However, at previous inspections, records have shown that the procedure has been followed and the manager has clearly recorded the outcome of any complaint investigation. A policy and procedure for responding to allegations of abuse is available and all staff members have received training regarding this. The home’s practices regarding service users’ money, safe storage of money and valuables is also good. Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The general décor in the home is adequate for its stated purpose and service users live in safe, comfortable surroundings. EVIDENCE: Although the general décor is adequate, a programme of routine maintenance and renewal of the fabric and decoration of the premises needs to be developed, together with a plan about how this will be achieved within set timescales. One area which requires attention in particular is the utility room, where there is evidence of damp and flaking paint. The inspector was shown evidence that the home complies with the requirements of the local fire service and environmental health department. The electrical safety certificate as well as the gas safety certificate were checked by the inspector. Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 15 The premises are kept clean and hygienic. Policies and procedures for control of infection are in place and staff have received training regarding infection control. Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 The staffing levels at the present time are sufficient to meet the needs of the service users. The procedures for the recruitment of staff are robust and provide the safeguards to offer protection to people living in the home. Staff do receive sufficient training and are competent to do their jobs. Newly recruited staff receive full induction training within six weeks of starting their job. EVIDENCE: The home has a stable team of staff, with one or two staff leaving. The staff files checked for two members of staff showed that the home has undertaken all the necessary recruitment checks to ensure protection of residents. Criminal Records Bureau checks have been undertaken for all members of staff and references are available on all the staff files seen. The services users spoken to said that staff at the home were kind and caring and do look after their needs. There is one member of sleep-in staff on duty at night. The manager has been asked to do a lone working risk assessment, to ensure that the service users are protected in relation to staff working alone, and also that the member of staff is supported and protected, for example, in the event of an emergency arising such as fire, accident or illness. One member of staff spoken to stated that they are continuously encouraged to attend relevant training courses and this was confirmed upon checking staff records.
Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 17 The inspector noted that a newly appointed staff member had begun her induction training to NTO specification within six weeks of joining the staff team. Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38 The management of this home is satisfactory overall, with the manager, who is also the proprietor, offering leadership, guidance and direction to staff to ensure that the service users receive consistent quality care. This results in staff working to practices that promote and safeguard the health, safety and welfare of the service users using the service. EVIDENCE: The management of the home has remained consistent, which has therefore ensured that the service users and staff receive consistently good support and leadership. Staff are aware of what is expected of them and that the home must be run in the best interests of service users. The home regularly reviews aspects of its performance through a good programme of consultations, which includes seeking the views of service users, staff and relatives. The inspector saw evidence of positive comments from all
Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 19 of these groups. The manager also holds meetings with the service users’ friends and relatives to seek their views and records these. Satisfactory comments have been received from the relatives and friends of service users. Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2
COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 3 Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 21 No 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 19 Regulation 23 Requirement The manager must ensure that the utility room is re-decorated as required. The manager is also required to develop a programme of routine maintenance and renewal of the fabric and decoration of the premises. Timescale for action 31.07.05 2. 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 Good Practice Recommendations Acorn Care Home G55_S0000025881_Acorn Care _V223810_140405_Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford IG1 4PU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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