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Inspection on 12/04/06 for Acorn Hill Nursing Home

Also see our care home review for Acorn Hill Nursing Home for more information

This inspection was carried out on 12th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service had a number of staff that speak a number of different languages. The staff were drawn from a number of multi cultural back grounds which was reflected in its` resident population and helped to meet the needs of it`s multi cultural resident group. The home catered for residents with varying mental health needs including residents with challenging behaviours.

What has improved since the last inspection?

The home continues to improve its assessment process and both Residential and nursing care plans. Help and guidance was sought from the District Nurses that formed part of the residential residents care plans. There was evidence of improvements in the reviewing processes. There was evidence of activity during the daytime for residents. At lunchtime a number of relatives were present. The staff appeared to interact well with both relatives and residents. The administration and storage of medications were checked against residents` case tracked and showed improvement.

What the care home could do better:

CARE HOMES FOR OLDER PEOPLE Crown Hills Nursing Home C/O Crown Hills Radstone Walk Rowlatts Hill Leicester LE5 4UH Lead Inspector Lesley Allison-White Unannounced Inspection 12th April 2006 09:45 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 Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 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. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Crown Hills Nursing Home Address C/O Crown Hills Radstone Walk Rowlatts Hill Leicester LE5 4UH 0116 2760600 0116 2761428 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) GB Care Ltd Mrs Maria Anne Read Care Home 49 Category(ies) of Dementia - over 65 years of age (49), Learning registration, with number disability over 65 years of age (1), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (49) Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. To be able to admit the named person of category LD named variation application number V8757 dated 11/6/04 2nd September 2005 Date of last inspection Brief Description of the Service: Crown Hills Nursing and Residential Home is a care home offering accommodation for up to forty-nine older people. The home is registered to admit older people with dementia and/or mental disorders. The home is located in a residential area to the east of Leicester. It is easily accessed by road using the outer ring road. The centre of Leicester is approximately fifteen minutes away by car and there are adequate car parking spaces. A bus service is available from outside the home with more frequent bus services available near to the home. The buses Number 54 and Number 16 supply a service passing every ten minutes. The building itself is a purpose built modern property offering accommodation on three levels. The majority of rooms available are situated on the ground and first floors. The home is equipped with a slow moving lift. There is a large garden to the rear of the property with a lawned area, established plants and trees and a patio area with seating. All areas of the home and outside areas are accessible for people with mobility impairments. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on 12th April 2006. The inspection commenced at 09.45am and finished at 5.25pm. There were ten outstanding requirements and seventeen recommendations. To satisfy that these needs had been met two inspectors were present at this inspection. The inspectors used a method called “case tracking”. This meant that the care records of three residents were checked and the clients or their relatives spoken to where possible. Other relatives were also spoken to and the inspector was able to view different parts of the building and speak to staff members. The documentation to track the residents care needs was also inspected. The home has made improvements since the last visit and a number of requirements had been met. The recommendations and requirements arising from this inspection were made as a result of the observations made by the inspector during the inspection. What the service does well: What has improved since the last inspection? The home continues to improve its assessment process and both Residential and nursing care plans. Help and guidance was sought from the District Nurses that formed part of the residential residents care plans. There was evidence of improvements in the reviewing processes. There was evidence of activity during the daytime for residents. At lunchtime a number of relatives were present. The staff appeared to interact well with both relatives and residents. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 6 The administration and storage of medications were checked against residents’ case tracked and showed improvement. 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. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 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 Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 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 the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Safety of residents has been improved by implementing better reporting systems. EVIDENCE: Asian residents had access to staff that spoke community languages. Another resident spoke a number of languages and some of the staff was able to communicate in one of her chosen languages. The home now has number of Polish or Yugoslavian residents. At this inspection they appeared well catered for although no staff was present that could communicate in their community language. The fire doors were alarmed and a resident case tracked was noted to always be trying to leave the building. The fire doors were all alarmed and when opened staff reacted promptly to ensure that no one was in danger and returned any resident quickly and safely to the home. There was an activities person employed for a few hours a week in the mornings but more activities were needed for the afternoons. The home had a cat some of the residents liked the cat. The cat was cared for in the managers’ office. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 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 the following standard(s): 7,8,9,10 Judgement in this area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans identified individual needs and evidence of evaluation and review ensuring all of the residents care needs were met. EVIDENCE: One of the case tracked Nursing Care residents showed care planning and mapping of pressure sores. There was evidence of better accountability and responsibility by the staff. Specific tasks were now allocated to the senior care assistants. They were responsible for ensuring the catheter care on the residential residents followed the directives from the District Nursing notes. A resident with dementia with little physical needs also had her needs identified which indicated a need for a different type of care approach. On inspection it was noticed that some of the medicine kardex’s were hand written and new labels were not used when new medications arrived in the home. The medication incident was dealt with by the Care manager who contacted the Chemist to provide printed labels to the home before the inspector left. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 12, 13,14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users experience a homely lifestyle. EVIDENCE: Residents appeared comfortable. Some residents sat quietly in one of the four lounges of their choice. On the morning of the inspection an activities coordinator visited. It was noted that residents had a limited variety of planned activities, and the activities organiser mainly focused these in morning sessions, though these sessions are culturally appropriate, but for only a small number of the current resident group. The inspector was able to see from the daily activities book that many of the activities were done in groups. In the case of some of the case tracked residents it was indicated that they enjoyed knitting this had not been a planned group activity that the coordinator offered as there were issues of security with the use of knitting needles and no one to one activity had been identified in the care plan. It was noted that some residents became restless in the afternoon and wandered about with no planned activity to take part in. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 11 Some residents received visitors and they told the inspector that they usually visited near meal times to help assist their relative with their meals. Lunchtime was observed and the staff on the floors appeared to cope with the many varieties and needs of the residents. One to one care and conversation took place. A number of residents’ relatives were visiting at the time of the inspection, and indicated that visiting times were unrestricted and openly encouraged. Community contact remained in place, with a number of service users continuing with contact arrangements organised prior to admission. Two cooks were employed and assisted in the provision of meals; working in conjunction they offered a balanced diet and number of meal choices for service users. Specialist diets were catered for, though the provision of culturally appropriate meals was limited. One relative stated the food was “always good” another stated that it was “well presented” and service users were offered a “good choice”. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are protected by having information about the complaints procedure. EVIDENCE: The registered person has now supplied the staff with appropriately updated information to enable complaints to be brought to the notice of the current management. Staff have begun to have information and training regarding the Adult Protection policies and procedures (pova), and staff interviewed showed an awareness of the policies and procedures. A service users relative visiting the home stated if a problem occurred he would speak to the manager. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 19 & 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are protected by a well-maintained and hygienic environment. EVIDENCE: The fabric and décor within the home are well maintained; there is a specific programme in place to indicate timescales on outstanding work awaiting completion. Public areas of the home were viewed, as were bedrooms of service users who were part of the case tracking at this inspection. The environment of the home is pleasant and hygienic; staff are aware of issues surrounding cross infection and cross contamination, and take appropriate action to ensure the safety of themselves and residents in the home. There are policies and procedures in place for the control of infection in the home; staff interviewed showing a good knowledge of these, so protecting Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 14 service users in the home. One the day of inspection it was a dark day. The corridors were dark. Staff should check that extra lights are switched on in the upstairs corridors to reduce the potential risk of accidents. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. 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. There is a good skill mix of staff to meet the needs of the residents. EVIDENCE: Staff on duty appeared to cope with the needs of the residents. There was a sufficient number of staff for care, laundry and kitchen. The rotas were checked. The staff had different skill mixes and ethnic backgrounds. The staff attended to the needs of the residents. The staff were allowed to lock the doors of residents rooms from out side the corridor. Staff and relatives spoken to appeared comfortable with this arrangement as they explained that it ensured that other residents could not wander into another persons room without permission. Staff carried a key to the rooms. It was explained by the manager that the doors were not locked in this way at night. Staff spoken to were aware of the protection of vulnerable adult procedures, accident and incident reporting and how to handle complaints. The deputy manager was currently studying for a managers’ award. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37,38 Quality in this area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not safeguard the best interest of its service users, finances. EVIDENCE: Day to day operations show clear evidence of the presence of a management team. There is a need for the wishes of residents and their relatives’ opinions to be included in any planned activity affecting the home. The home pools the residents’ finances’ which is not good practice. The fire, accident and incident records were inspected and were satisfactory. Staff spoken to felt there was a good level of commitment and on going improvements within the management of the home. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 17 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 2 x 3 3 Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 18 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. Standard Regulation Requirement Timescale for action 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 OP34 Good Practice Recommendations To provide individual balances for resident’s money. Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 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 Crown Hills Nursing Home DS0000001897.V289344.R01.S.doc Version 5.1 Page 20 - 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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