CARE HOME ADULTS 18-65
Acorn House 2 Eastbourne Terrace Westward Ho! Bideford EX39 1HG Lead Inspector
Adele Adams Announced 11 August 2005
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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Acorn House Address 2 Eastbourne Terrace, Westward Ho!, Bideford, Devon, EX39 1HG 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) 01237 424248 01237 423623 arkcarehomes@hotmail.com Ark Care Homes Ltd Mr Bruce Ashley Martin Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Room 6 must not be used to accommodate a service user until:1. En-suite facilities are fully fitted in the identified adjacent room 2. Certified by Building Control department 3. Approved by the Fire Authority 4. National Minimum Standards are met Date of last inspection 5th November 2004 Brief Description of the Service: Acorn House is registered to accommodate 6 service users who have a learning disability and are within the age range of 18 – 65 years. The home comprises of a three storey terraced double fronted property situated in the seaside village of Westward Ho! The house is in a single terrace of houses situated on a quiet road (access only) to the front, this provides direct access at one end onto Northam burrows. At the other end, the road joins another road, which provides a level walk to the beach and village amenities. The house has a pleasant private garden to the front and an enclosed secure courtyard to the rear. Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection has introduced “Key Standards “ to be inspected over each inspection year. Therefore, unless it is felt necessary by the inspector, some standards will not be inspected. To obtain a full picture of the home it is recommended that all reports written within an inspection year (1st April to 31st March) be taken into consideration. This inspection was announced and took place between 10:00 and 15:10. During the inspection, the inspector spent time speaking with residents, the manager of the home, and deputy manager and briefly observed and spoke with care staff. The inspector toured the home and was invited into the rooms of the four residents. The inspector some spent time chatting to residents, who later went out for the day. Time was also spent time reading documentation, which included; residents’ records, staff records and policies and procedures. What the service does well:
Acorn House was recently registered as a care home for six residents with a learning disability. The home has an enthusiastic Registered Manager and deputy manager who are working hard to meet the National Minimum Standards. The priority of the service has been to ensure that the new residents settle well into their new home. The service works hard when accepting new referrals at making sure that not only is the house, staff and service suitable to meet the new resident’s needs and expectations but also consider carefully about the effects a new resident may have upon the current residents in what is their home. This inspection found that the four residents have settled really well into the homely environment provided at Acorn House. Each resident has their own spacious, comfortable and well-furnished room; each room clearly shows the taste and likes of each resident. Residents are each also provided with their own bathroom facilities. The residents are supported and well cared for by an appropriate amount of staff and each resident’s individual needs are clearly recorded and these needs are understood and met with good support and guidance from the staff at the home. The staff at Acorn House are good at ensuring that the residents are able to access the local and surrounding community and that the residents live full and varied lives as their individual abilities and wishes allow them. Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 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 House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 and 5. The provision of clear well written information in the home’s Statement of Purpose, Service User Guide and Service user contract helps potential residents and their families to gain a good understanding of the care and environment provided at Acorn House, this information together with an assessment of need well informs both the residents, families and the service to decide whether their needs can be suitably met by staff, service and environment. EVIDENCE: The inspector read the home’s Statement of Purpose, Service User Guide and Service user contract, which are also available in Braille, Makaton and audio versions. The inspector discussed these documents with the registered manager and deputy manager – some minor amendments are necessary and the manager advised these would be addressed. The inspector read two residents records and observed that the assessment information gathered is detailed and the inspector was provided with the home’s assessment record. No relatives had chosen to be in attendance at the inspection and therefore their views in relation to these standards could not be gained. The inspector did not discuss these standards in depth with the residents. Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Each resident living at Acorn House has a good individual detailed assessment and plan of their assessed needs recorded, which is reviewed regularly and residents are clearly supported to make decisions about their lives, part of which includes being able to take appropriately assessed risks. EVIDENCE: The inspector read two residents records, which contained comprehensive assessment information and psychosocial details. The records clearly demonstrate that the residents and / or their families participate in a regular review of their planned and assessed needs and the reviews take place more regularly than recommended by the standard. The residents’ records also contain a comprehensive risk assessment. The inspector was informed by the registered manager of a change in practice for one resident to enable them to be less restricted which was being managed carefully by staff at the home and had been accepted positively by the resident, this is recognised as good practice. The inspector observed the staff and residents interactions, which included the facilitation of decision-making with a resident about a health need. The inspector saw evidence of good practice in relation to a monitor being used for a resident’s safety and how the decision-making process ensured the resident ‘s rights were protected in the process.
Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 10 Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14,15 and 16. Residents at Acorn House are fully supported to live full and varied lives as they are able and wish to. EVIDENCE: The inspector saw evidence in residents’ records of consultation with their families such as supporting visits. Records clearly demonstrated their involvement in a range of varied activities, such as a barbecue at the house, going to the beach, shops and visiting the park. Two of the residents discussed activities with the inspector and photographic records of activities and occasions that have been celebrated were also viewed. The residents and staff went out on a trip for the day late morning on the day of the inspection. The manager and deputy manager discussed the way residents make decisions about where they wish to go and how independence is enabled within the home. The inspector saw in the contract and policy that reference to drugs has now been included following the previous inspection in the rules about smoking and alcohol.
Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 The home’s approach re medication does not fully support residents - the option of self – medication is not included. EVIDENCE: The inspector read the medication policy following guidance made at the previous inspection and the necessary amendments have been made, however the policy does not recognise or make explicit residents right to self- medicate when able. The inspector was informed that all staff have been undertaking an accredited medication course and the four staff that have completed the course and passed their examination are awaiting their certificates of achievements. Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 There is a clear complaint procedure in place in a variety of formats ensuring all residents are able to access and understand it and residents are protected from abuse by well-informed staff. EVIDENCE: The complaints procedure was read by the inspector and was seen also in the Statement of Purpose and Service User Guide, the procedure is also available in Makaton. The manager informed the inspector that no complaints have been received by the home. The home has a clearly written abuse policy in place, which is clear to follow, the home also has a copy of recommended guidance such as, the Alerter’s Guide, The Department of Health Guide and a poster is also on display in the office. The deputy manager advised the inspector of what is covered by the in house training that is provided to all staff. A letter confirming that Devon County Council approves the Protection of Vulnerable Adults training provided to staff was seen by the inspector. Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26 and 27 Acorn House provides residents with a homely, comfortable and safe home to live in. EVIDENCE: The inspector spoke with all of the residents who showed the inspector their rooms – all are happy with their rooms, which are large, light, well furnished in a homely style and individualised by each resident. The inspector toured the home – all of which is homely, clean and tidy. There is enough room to supplement each resident’s individual rooms – this includes 2 ‘sitting’ rooms and one resident has their own sitting room in addition to their bedroom. All but one resident has their own en suite bath/ shower room and the resident that does not have en suite facilities has exclusive use of a bathroom. Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34 and 36 Residents at Acorn House are cared for by staff that have been recruited following the correct guidance, who understand their own and others responsibilities at work and who are supervised and well supported at work. EVIDENCE: The inspector discussed staff supervision; staff recruitment and staff job descriptions with the manager and deputy manager – staff and service users views were not sought at this stage as they were out of the home on a trip. The inspector read the letter sent to all staff detailing their individual supervision time and date, this was seen to be scheduled into the diary and the inspector also read staff supervision records. The home now has a policy in place to support and guide recruitment practice. The inspector was provided with the home’s staff job descriptions, the manager and deputy manager confirmed that care staff (together with themselves) are now in possession of these. Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 40 Satisfactory policies and procedures that safeguard residents’ rights and interests have been developed; these now need to be put into practice. EVIDENCE: The inspector discussed the development of the policies at Acorn House with the manager and deputy manager and was shown the completed policies as held on the homes computer. It was agreed that these will now be put into action. Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 x 3 Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 x x x Standard No 11 12 13 14 15 16 17 x x 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 x x 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Acorn House Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x x 2 x x x D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 18 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. 2. 3. 4. Refer to Standard 20 40 Good Practice Recommendations The registered manager and staff encourage and support service users to retain, administer and control their medication within a risk management framework. The homes recently developed policies and procedures should be implemented. Acorn House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 House D54-D07 S60241 Acorn House V215246 110805 Stage 4.doc Version 1.40 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. 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!
