Inspection on 28/02/07 for Acorn Care Home

This inspection was carried out on 28th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Acorn Care Home 24/10/05

Acorn Care Home 14/04/05

Acorn Care Home 15/11/04

Acorn Care Home 22/06/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Acorn Care Home 83 Blythswood Road Seven Kings Ilford Essex IG3 8SJ Lead Inspector Ms Harina Morzeria Key Unannounced Inspection 28th February 2007 10:00 X10015.doc Version 1.40 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 Care Home DS0000025881.V331696.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 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 DS0000025881.V331696.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Acorn Care Home Address 83 Blythswood Road Seven Kings Ilford Essex IG3 8SJ 020 8597 1793 020 8597 1793 bsso@globalnet.co.uk 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) Mrs Sarbjit Soor Mrs Sarbjit Soor Care Home 3 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th October 2005 Brief Description of the Service: Acorn Care Home is a care home providing personal care and accomodation for three older people and is registered to care for people with dementia. 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. At the time of the inspection, the range of fees for the home were between £420.00 and £510.00 per week. A copy of the Statement of Purpose and Service User Guide to the home are made available to both the residents and their family/representatives. A copy of the most recent inspection report is available on request. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection visit in the inspection programme for 2006/ 2007. Discussion took place with the registered manager, and one member of care staff. Care staff were asked about the care residents receive, and were also observed carrying out their duties. The inspector spoke to all three residents. Where possible residents were asked to give their views on the service and their experience of living in the home. They were very positive about the quality of care being provided to them. All parts of the home were visited and a number of staff, care and home records were looked at. The Inspector would like to thank the staff, residents and visitors for their input and assistance during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The registered person is required to ensure that all risks to the health or safety of residents are identified and so far as possible eliminated. The registered person is required to ensure that all staff working in the care home receive appropriate training in the care of people with dementia. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 6 The registered manager to ensure that regular monitoring of residents’ weight is carried out so that appropriate action can be taken where necessary and in a timely manner. ‘End of Life’ care plans must be developed for all residents. The manager and staff to discuss the importance of communicating with residents when undertaking any tasks such as feeding, provision of personal care and activities. The registered manager to ensure that residents live in safe, comfortable bedrooms with their own possessions around them. At the time of finalising this report the registered person had sent evidence of compliance with the requirements. This will be tested at the next inspection. 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 Care Home DS0000025881.V331696.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are being undertaken for all residents prior to them moving into the home. Prospective residents are able to visit the home and come for trial stays before deciding to move into the home. Care plans are drawn up from the information in the assessment, ensuring that the needs of the residents are identified, understood and met. Each resident has a written contract, statement of terms and conditions. EVIDENCE: Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 9 The home’s Statement of Purpose and Service User Guide include information about how to make a complaint, and in line with the home’s complaints policy and procedure. Prospective residents and their relatives/ representatives are encouraged to visit the home prior to making any decision to move in. Pre-admission assessments are undertaken for all residents prior to them moving into the home. Care plans are drawn up from the information in these assessments. Where appropriate, information provided by the placing authority was also on file. The records also showed that residents, where capable and their relatives are also involved in the assessment process. The file for the most recently admitted resident was checked and evidence was seen that an assessment undertaken by the placing authority as well as by the home’s manager was in place. The home does not offer intermediate care. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents’ health, personal care and social care needs are set out in individual care plans and provide staff with the information they need to satisfactorily identify and meet residents’ needs. There are clear medication policies and procedures for staff to follow. Residents are assured that their spiritual needs and wishes at the time of their death will be dealt with sensitively and with respect by staff. EVIDENCE: Files for all three residents were case tracked and their care plans and related documentation examined. All residents had care plans, which were generally detailed and covered health and personal care needs. It was evident that care plans were being reviewed/ evaluated on a monthly basis and reflect changes, which had been identified at the reviews. As part of case tracking the documentation/ health records relating to meeting residents health care needs were examined. These were found to be generally detailed and being adequately maintained. Appropriate professionals are Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 11 consulted via the GP. This is the case for one current resident whose dementia appears to be deteriorating rapidly as observed by the manager and the staff. Risk assessments are routinely undertaken on admission for all residents, but not all risk assessments were being regularly reviewed and updated. An up to date risk assessment is required to be drawn up for one resident who is likely to escape from the home. The manager stated that residents’ are weighed monthly. Records were being maintained and included weight loss or gain, but not all residents were being weighed monthly and gaps were noted in the monitoring of this. Regular monitoring of weight is important so that appropriate action can be taken where necessary and in a timely manner. Records indicated that residents are seen by other health professionals such as optician, dentist, optician, district nurse and GP. There was no evidence in the files of “End of Life” care plans and the importance of developing these was discussed with the manager. However, from conversations with the manager and the inspector’s knowledge of the home it was apparent that staff dealt with a person’s dying and death in a sensitive manner, both for the individual and relatives. Staff were observed to treat residents with respect and the arrangements for their personal care ensure that their right to privacy is upheld. There are policies and procedures for the handling and recording of medicines. An audit was undertaken of the management of medicines and a random sample of Medication Administration Record (MAR) charts were examined. The process for administrating medication is followed by all staff and all appropriate records are maintained. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is a varied programme of activities available which suits individual needs, preferences and capacities. Visiting times are flexible and people are made to feel welcome in the home so that residents are able to maintain contact with their family and friends as they wish. EVIDENCE: The manager and staff take responsibility for organising activities with residents. Some of the activities are individual and others are small group activities such as exercise sessions, quizzes and bingo. Daily news items in the national papers are discussed with the residents to keep them informed of events and generate discussion. One of the residents likes to read a range of magazines which are purchased for her by the staff. Residents can choose whether to participate or not. One of the residents attends a day centre and goes to church every Sunday, which maintains her previous routine prior to coming into residential care. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 13 Relatives are encouraged to visit the home and there are no restrictions on when relatives and friends can visit. Visiting can be undertaken in one of the lounges or in the privacy of the resident’s room. From observation and talking with the residents it was evident that the routines of daily living are flexible and varied to suit the differing needs and preferences of residents. The serving of the lunchtime meal was observed and provided residents with a varied, appealing and nutritious meal. Residents choose to eat in the dining room and one person was helping to set the table and clear up. Residents who required assistance were not hurried but the inspector noted that the person assisting one of the residents did not communicate with her at all. Meal times should be pleasant, social occasions when communication forms an important part of the process. The inspector recommends that the manager and staff discuss the importance of communicating with residents when undertaking any tasks such as feeding, provision of personal care and activities. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and staff make very effort to sort out problems or concerns and makes sure that residents and their relatives feel confident that their complaints and concerns are listened to and will be acted upon. Staff working in the home have received training in Adult Protection/ Abuse Awareness to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a complaints policy/ procedure and the records indicate the number of complaints received and includes details of the investigation, any action taken and the outcome for the complainant. All staff working in the home have received training in adult protection and this includes ancillary staff. Those staff spoken to during the inspection were aware of the action to be taken if they had concerns about the safety and welfare of residents. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 15 Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,23,24,25,26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The atmosphere in the home is welcoming. The home provides safe and comfortable indoor and outdoor facilities. Each Service User has their own bedroom with their own possessions. The home is clean, pleasant and hygienic. EVIDENCE: The building was toured by the inspector, accompanied, by a resident whose room was also seen with her permission. Each of the bedrooms was reached via a stair lift and was adequately decorated. The inspector noted that the bedroom seen was very bare and not personalised at all. This was discussed with the manager who stated that there is an issue about accessing personal items for this resident, which has to be done via social services. However, this issue must be resolved at the earliest opportunity so that the resident can at Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 17 least be surrounded by some of her personal items, which may enable her to settle down better in the home. There were no offensive odours in the home and the home was clean and tidy. The home had a comfortable lounge with easy access to the dining room, kitchen and toilet facilities. The home’s office and utility room had recently been decorated. The manager is now monitoring areas in the home that need routine maintenance and renewal of fabric. The home is kept very clean and hygienic and there is a very homely atmosphere, were the service users feel comfortable. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 18 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staffing levels are satisfactory and there are sufficient trained staff on duty to meet the individual assessed needs of the residents. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. EVIDENCE: The home has a small and relatively stable staff team with most staff having worked at the home for several years. The staff team are very committed and understand and fully support the main aims and values of the home. Where possible residents were asked to give their views on the service and the care they were receiving. One resident commented: “I am very happy here, staff are kind to me”. Other comments included: “The carers know how I like things to be done”; and “Everyone is friendly”. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 19 Staff had received training in essential areas such as moving and handling, first aid, fire safety and medication awareness and administration. The home is now registered to provide care to people with dementia but only the manager has completed the ‘Training Skills in Dementia Care’, course. All other staff have completed basic dementia awareness training. This issue was discussed with the manager as all staff must be trained and competent to deliver the care required by the particular group of residents they look after. The manager is required to ensure that all staff working in the home undertake the full training in dementia care, in order to ensure that they are able to understand and meet the needs of residents suffering from dementia. All care staff are qualified to NVQ level 2 or above and this demonstrates a very positive commitment to this training by both the registered provider/manager and care staff. A random sample of personnel files of the most recently recruited staff were inspected. These were found to be in good order with necessary references; criminal records bureau disclosures and application forms duly completed. There is an in-depth induction booklet completed by the most recently appointed member of staff and the Manager. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 20 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33, 34,35,36,37,38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents financial interests are safeguarded by the policy and procedures of the home. The staff team work well together to make sure that residents are safe and secure whilst living at Acorn. Staff are appropriately supervised. Residents’ rights and best interests are safeguarded by the home’s recordkeeping policies and procedures. Residents’ and staffs health, safety and welfare are promoted and protected. The registered manager is qualified and has the necessary experience to manage the home. EVIDENCE: Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 21 The manager has the required qualifications and experience and is competent to run the home. Feedback from both the residents and staff was positive about the way in which the home is run. A quality assurance survey to seek satisfaction levels amongst the residents and relatives is undertaken by the manager showing that the registered provider/manager is monitoring the service provided in the home. The inspector is notified of any significant events and developments in the home. The home has an appropriate policy and procedures regarding safeguarding residents’ finances. If they wish and are able to, residents are helped to take responsibility for managing their own money. They are provided with facilities to keep their valuables and money safe. Where the home is responsible for resident’s money it maintains clear records that are routinely kept up-to-date and can be used to track individual resident’s finances. Staff files were checked and the inspector was informed by the manager that all staff receive supervision on a regular basis. The manager ensures that all supervision records are kept up-to-date in order to evidence supervision received by staff. The manager adheres to keeping records up to date. The home has carried out all health and safety checks. A wide range of records were looked at including fire safety, water temperature checks, accident/ incident reports. These records were found to be up to date and accurate. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP7 Regulation 13 Requirement Timescale for action 31/05/07 2 OP30 18 The registered person must ensure that all risks to the health or safety of residents are identified and so far as possible eliminated. The registered person is required 31/05/07 to ensure that all staff working in the care home receive appropriate training in the care of people with dementia. 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 OP8 Good Practice Recommendations The registered manager to ensure that regular monitoring of residents’ weight is carried out so that appropriate action can be taken where necessary and in a timely manner. ‘End of Life’ care plans must be developed for all residents. The inspector recommends that the manager and staff DS0000025881.V331696.R01.S.doc Version 5.2 Page 24 2 3 OP11 OP15 Acorn Care Home discuss the importance of communicating with residents when undertaking any tasks such as feeding, provision of personal care and activities. 4 OP24 The registered manager to ensure that residents live in safe, comfortable bedrooms with their own possessions around them. Acorn Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 Care Home DS0000025881.V331696.R01.S.doc Version 5.2 Page 26 - 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. 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