Inspection on 05/07/05 for Acorn Hollow General Nursing Home

This inspection was carried out on 5th July 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Acorn Hollow General Nursing Home 13/11/08

Acorn Hollow General Nursing Home 14/03/07

Acorn Hollow General Nursing Home 08/03/06

Acorn Hollow General Nursing Home 17/03/05

Acorn Hollow General Nursing Home 17/08/04

Acorn Hollow General Nursing Home 16/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Acorn Hollow General Nursing Home Manchester Road Lostock Gralam Northwich CW9 7QA Lead Inspector Joan Adam Announced 5 July 2005 09:00 th 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 Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Acorn Hollow General Nursing Home Address Manchester Road Lostock Gralam Northwich CW9 7QA 01606 45603 01606 45655 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) Mrs Ann Bailey/Southern Cross Healthcare Services Limited Karen Clark Care Home with Nursing 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the maximum of 48, 40 OP beds for nursing care 2. Within the maximum of 48, 13 OP beds for personal care only Date of last inspection 31 March 2005 Brief Description of the Service: Acorn Hollow is a purpose built home registered to provide nursing and personal care for 48 elderly service users. It is situated in a residential area close to a range of local facilities.The home is on two floors with access to the first floor by passenger lift or two internal stairways. All of the bedrooms are single rooms with an en-suite WC and wash hand-basin. Toilets and bathrooms are located around the home. Registered general nurses are employed in the home 24 hours a day. Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit of the home took place over seven hours and was carried out as part of the yearly inspection process. A tour of the home was carried out and care records, fire records and staff training files were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. Five of the staff on duty, eleven residents and four relatives were spoken with during the inspection. What the service does well: Residents’ health needs continue to be met to a good standard, and all of the people spoken with were satisfied with the care that they, or their relative, were receiving. The standard of the care plans at the home is good and regular reviews of the plans of care are undertaken. Visitors are made welcome, and one resident’s relatives said they are kept well informed and are involved in their care. Residents and relatives spoken with felt that the home was managed and run to a satisfactory standard. A good variety of food is provided. The home has a regular group of staff that have worked there for some time and they are well aware of the needs of residents. Staff are friendly and attentive to the residents. Bedrooms are warm, clean and are well personalised with residents’ own possessions Social activities at the home are varied and the residents spoken to were pleased with the way the home is run and the choices they can make. The manager at the home is experienced and competent. Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 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. Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 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 Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 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) 3,6 Assessment procedures before residents move into the home are thorough and allow family members to be part of the process of assessing needs. The home only admits those people whose needs are in keeping with the skills and knowledge of staff working within the home. EVIDENCE: Care plans of three recently admitted residents contained preadmission assessments. The assessments had been carried out by the manager and were supported by additional assessments by other health or social care workers, for example, where people had been admitted from hospital, staff there had carried out discharge assessments. Copies of these were kept in the residents’ files. The manager and other senior staff confirmed that the identified needs were discussed with family member as part of the admission process. The residents said that the manager had visited them prior to their admission to the home. Acorn Hollow does not provide intermediate care Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 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) 7,8,10 Care plans in general at the home are detailed but one plan of care looked at did not document the progress of a residents pressure sore. Staff members working at the home are aware of the needs of the residents. Residents at the home are treated with dignity and their privacy is respected. EVIDENCE: Six care plans were examined. These contained detailed assessments of areas of need, such as mobility, falls, moving & handling, continence, pressure area & tissue viability, nutrition and general dependency. All were up dated and reviewed on a regular basis. Records were also made of support from and visits by other health professionals such as GP’s. One resident had a pressure sore for which a plan of care had been commenced, however the chart to measure the improvement of the pressure sore was not in place. (See Requirement 1) Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 10 Residents spoken with stated that they were happy with the care and attention they received at the home and felt that they are treated with dignity and their privacy is respected. Relatives were also happy with the care their relative received and one said “At Acorn Hollow I discovered people who really care, who go the extra mile and not just for the residents but for friends and family” Residents said that the staff were lovely and always listened to them. All confirmed that staff are aware of their needs. One letter from a relative stated that “ staff made mum feel loved, confident and safe, maintained her dignity and importantly her individuality.” Staff were seen to address the residents in a courteous manner. Staff spoken to were aware of the needs of the residents and of their likes and dislikes. Staff were observed in the routines of providing care and support. This was being done in a very respectful way. Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 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) 12,14,15 Residents living at Acorn Hollow are able to make choices regarding daily routines at the home. The residents enjoy a good and varied choice of wholesome and well presented meals. EVIDENCE: Residents spoken with said that varied social activities take place at the home. A programme of activities was available on the notice board in the entrance hall and in the main corridors of the home. The atmosphere throughout the home was warm, friendly and relaxed. Care plans included rising and retiring times and preferences regarding social activities, likes and dislikes regarding foods. Residents said that they could do as they please and can get up and go to bed as they wish. Residents spoken with also said that there are lots of different activities that they can join in if they want to and that they are enjoying the garden room and the fact that they can get out in the fresh air. Two residents said that they felt that the decking area should be made bigger as it can get crowded especially if there were a few residents in wheelchairs but “ it was good to go in the garden at last” Some members of staff had entertained the residents with a line dancing display and residents and relatives enjoyed this. Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 12 The residents said that all the staff “were good and worked hard but wanted to add their special thanks to Nora the activities co-ordinator “ A trip to Blackpool had been arranged for the near future. Bedroom doors at the home can have locks fitted to maintain residents’ privacy if they so wish. Menus at the home offer choice and snack foods are available between meals if requested. Residents said the food was “really good “and especially liked the puddings. Lunch was observed to be sociable and relaxed. Staff helped those residents that required assistance with eating in a calm and dignified manner. Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 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) 16,18 Complaints at the home are dealt with in accordance with the company’s complaints policy and residents and relatives know who to raise concerns with. The policies, procedures and management at the home protect the residents from abuse. EVIDENCE: No complaints have been made to the home or to CSCI since the last inspection. Complaints recorded at the with the home have been dealt with under the company’s complaint procedure. A copy of the complaints procedure is available in the service users guide. Residents and relatives spoken with said that they had no complaints and that they were aware of who to speak to if they were unhappy about any aspects of the home. A policy on the protection of vulnerable adults is in place and the inspector saw this. Members of staff spoken with confirmed that they were aware of the policy and the No Secrets guidance issued by the Department of Health. Staff received training in the protection of adults in November 2004 and this was recorded in the staff training files. Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 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) 19,20,21,24,25,26 Some areas of the home require attention to ensure that residents live in a safe and well-maintained environment. The home is maintained in a clean condition. EVIDENCE: Since the last inspection the garden area at the home has been made accessible to all residents. New reclining chairs have been purchased to allow some residents, who previously were nursed in bed, to sit and socialise in the lounge. Care call points are located in bedrooms, bathrooms toilets and communal areas. Residents rooms are well personalised with residents’ own furniture, photographs and ornaments. The home was clean and free from unpleasant smells. Residents and relatives spoken with said that the home was always very clean. The décor in the home is looking tired and worn and would benefit from redecoration. The wallpaper in two of the lounges was ripped and peeling. (See requirement 2) Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 15 The bathrooms at the home need assessing as staff are still reporting experiencing some difficulties with using the portable hoists when assisting residents to bathe. One bathroom is fitted with a bath seat but others have domestic style baths that, when used with a hoist, can pose difficulties for staff. The needs of most of the residents at the home are increasing to the level whereby they need full assistance and support when bathing. The introduction of a specialist bath would ensure that residents needs can be met safely at the home. Residents said that are getting bathed on a regular basis. Two residents spoken with said that they preferred a shower and this was recorded in the plans of care. The new shower at the home is not draining correctly causing a permanent smell of stagnant water. The home is attempting to address this problem by contacting the contractor that installed the shower to give advice. (See requirement 3) Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 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) 27,29,30 Resident’s benefit from a service that provides adequate staffing levels and well informed and knowledgeable staff. The recruitment procedures at the home are robust to ensure residents safety. EVIDENCE: Staff spoken to were aware of their various roles and responsibilities, had an understanding of the policies and procedures that directed their work and had a very good relationship with those they cared for. Duty rotas were seen and the staffing numbers at the home are above the agreed minimum staffing levels. Care staff spoken with had detailed knowledge of the needs and personalities of the residents and spoke about training they had received over the last year. This included Adult Protection, Moving & Handling, fire, first aid, infection control Diabetes care, tissue viability, nutritional support and NVQ. The records of two recently appointed staff contained two written references, one of which was from a previous employer, enhanced checks with the Criminal Records Bureau and a health record. New staff were provided with a formal induction that was in the form of a workbook which is based on TOPPS induction. Staff will then complete TOPPS foundation course before undertaking NVQ level 2. Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 17 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) 33,36 38, The management of the home maintains the safety of the residents living there EVIDENCE: Residents living at the home said that their opinions are listened to. Relatives spoken with said that the manager has an open door policy and is always available. Resident/relatives meetings take place on a regular basis and minutes are taking. Items raised are actioned and reported back in follow up meetings. Residents’ choices are recorded in the plans of care. A senior manager visits the home on monthly basis, unannounced and areas checked are health and safety, property and equipment and staffing issues. Discussion with residents and staff, also takes place. These visits and any resulting actions are recorded. A copy of the report is sent to CSCI. Formal supervision for staff takes place six times yearly. Accidents are recorded appropriately. Safety certificates were in place for items such as hoists and passenger lifts. The fire log was checked and staff training in fire safety has taken place and was recorded. Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 18 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 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 2 x x 3 3 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 3 x 3 Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 19 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. 2. 3. Standard op7 op19 op21 Regulation 15 (2) 23(b) 23(2) (n) Requirement Documentation regarding pressure sores must be fully completed. Déco at the home must be improved. Suitable adaptations must be made, and such support, equipment and facilities as may be required are provided for service usersd who are old ,infirm or physically disabled (previous timescale 31/05/05) Timescale for action 16th August 2005 30th September 2005 31st August 2005 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 NONE Good Practice Recommendations Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Acorn Hollow General Nursing Home F51 F01 S18718 Acorn Hollow V228919 050705 Stage 4.doc Version 1.30 Page 21 - 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!