CARE HOMES FOR OLDER PEOPLE
Acorn Hollow General Nursing Home Acorn Hollow Manchester Road Lostock Gralam Northwich Cheshire CW9 7QA Lead Inspector
Joan Adam Unannounced Inspection 8th March 2006 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 Hollow General Nursing Home DS0000018718.V279737.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. Acorn Hollow General Nursing Home DS0000018718.V279737.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Acorn Hollow General Nursing Home Address Acorn Hollow Manchester Road Lostock Gralam Northwich Cheshire CW9 7QA 01606 45603 01606 45655 Acornhollow@schealthcare.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) Southern Cross Healthcare Services Limited Karen Clark Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Acorn Hollow General Nursing Home DS0000018718.V279737.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Within the maximum of 48, 40 OP beds for nursing care Within the maximum of 48, 13 OP beds for personal care only Date of last inspection 5th July 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 DS0000018718.V279737.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced visit of the home took place over six hours and was carried out as part of the yearly inspection process. Care records, fire records and medication records were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. Residents, visitors and staff members were spoken with during the inspection. What the service does well: What has improved since the last inspection?
All staff have undertaken clinical practice training to improve the day-to-day care of the residents living at Acorn Hollow. There has been some improvement made in two of the bathrooms. The baths have been raised and a hoist tracking system has been installed to enable easier access for the staff to bathe the residents.
Acorn Hollow General Nursing Home DS0000018718.V279737.R01.S.doc Version 5.1 Page 6 The manager of the home has decorated one lounge. More recliner chairs have been purchased for the comfort of the residents. A 5ft water feature and a large canopy have been purchased for the garden area out of the residents’ funds. 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 DS0000018718.V279737.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 Acorn Hollow General Nursing Home DS0000018718.V279737.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): EVIDENCE: The key standards were assessed and met at the last inspection. Acorn Hollow General Nursing Home DS0000018718.V279737.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): 7,9 Care plans at the home are detailed and address the changing care needs of the residents. Medication is administered, recorded, stored and disposed of correctly to maintain the safety of the residents living at Acorn Hollow. EVIDENCE: Care plans were looked at for five residents living at the home. The care records contained a range of care plans that identified the care to be given in relation to a specific need/problem. A record was also made of support from, and visits by other health professionals such as GP’s. Appropriate risk assessments were in place and these had been signed by residents or their relatives. Resident choices were documented such as times of rising and retiring and likes and dislikes of food. These had all been reviewed and updated as appropriate. Acorn Hollow General Nursing Home DS0000018718.V279737.R01.S.doc Version 5.1 Page 10 Medication recording, management and storage were inspected. Medicine Administration Records were examined and found to have been completed correctly. Medicines were stored and disposed of appropriately. However, the home has a large stock of medications such as paracetamol, which are only given when residents require them. It is recommended that this problem should be addressed. Acorn Hollow General Nursing Home DS0000018718.V279737.R01.S.doc Version 5.1 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 the following standard(s): 13 Residents have regular contact with the local community. Visitors are made welcome and can visit the home at any time. EVIDENCE: Relatives spoken with said that they could visit at any time and were always made welcome. Residents said that they could go out with a staff member or on their own ”As long as you let someone know you are going” Two residents were taken to a local pub for lunch and as they retuned to the home they said” What a great time, we do this regularly” Trips out that had been arranged were a visit to the Anderton boatlift for May and the residents had been to the Opera and to see a Male Voice Choir which some said was “ wonderful” “ a real pleasure” “ something different, it was great” Acorn Hollow General Nursing Home DS0000018718.V279737.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): EVIDENCE: The key standards were assessed and met at the last inspection. Acorn Hollow General Nursing Home DS0000018718.V279737.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): 19,21 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 more reclining chairs have been purchased for the comfort of the residents living at the home. One lounge on the ground floor has been redecorated by the manager of the home. The décor in all areas of the home is looking shabby and worn and the home would benefit from a complete assessment of all areas for redecoration and improvement. The wallpaper in one of the lounges was ripped and peeling. Acorn Hollow General Nursing Home DS0000018718.V279737.R01.S.doc Version 5.1 Page 14 Residents and their relatives said that “ the home is looking dated”, “ the whole place could do with a coat of paint”, “ the lounge looks lovely but our manager shouldn’t have had to do this herself” and “the staff and the care is excellent but the environment spoils it” The upstairs corridor carpet is stained despite deep cleaning and should be replaced. The home was clean and free from odours. There has been some improvement made in two of the bathrooms. The baths have been raised and a hoist tracking system has been installed to enable easier access for the staff to bathe the residents. The new shower is still collecting water at the base despite the home trying to improve this. Acorn Hollow General Nursing Home DS0000018718.V279737.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): EVIDENCE: The key standards were assessed at the last inspection and were met. Acorn Hollow General Nursing Home DS0000018718.V279737.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): 31,35 The management of the home ensures the health and safety of the residents. Clear individual financial records are in place for all residents living at Acorn Hollow. EVIDENCE: The manager at the home is a trained nurse and is competent and experienced. Both the manager and deputy manager have completed NVQ level four in management. Clear individual financial records are in place for all residents living at Acorn Hollow. The fire log was checked and staff training in fire safety has taken place and was recorded.
Acorn Hollow General Nursing Home DS0000018718.V279737.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 X X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 2 X 3 X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X x Acorn Hollow General Nursing Home DS0000018718.V279737.R01.S.doc Version 5.1 Page 18 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 OP19 Regulation 23 Requirement A complete assessment of all areas of the home should be made and an appropriate programme of redecoration must be implemented. (Previous timescale of 30/09/06 not met) The upstairs corridor carpets must be replaced. Timescale for action 31/04/06 2. OP19 23 31/05/06 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 OP9 Good Practice Recommendations It is recommended that excess stocks of medications be returned to the pharmacy. Acorn Hollow General Nursing Home DS0000018718.V279737.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Northwich Local Office 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
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