CARE HOME ADULTS 18-65
Acorn House 28 Somerset Road Laindon Basildon Essex SS15 6PE Lead Inspector
Patricia Stanton Unannounced Inspection 17th January 2006 13:00 Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 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 House DS0000018126.V265504.R01.S.doc Version 5.0 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 Adults 18-65. 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 House DS0000018126.V265504.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Acorn House Address 28 Somerset Road Laindon Basildon Essex SS15 6PE 01268 453216 01268 455103 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) Kingswood Care Services Limited Mr Graham Edward Sheern Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Personal care to be provided for up to six younger adults. Personal care to be provided for up to six younger adults who have a learning disability. The maximum number to be cared for shall not exceed six. Date of last inspection 26th June 2005 Brief Description of the Service: Acorn House provides a high standard of care and accommodation for six adults with a learning disability who also have complex needs such as superimposed mental heath problems, autism and or present with challenging behaviours. The home is situated in a residential area and is in keeping with other houses in the locality. Each of the six residents has a single room, three of which have en-suite facilities. In addition there is a shared bath and shower room and a ground floor toilet. There is a choice of two lounges and a separate dining room. The rear garden is secure and contains a summerhouse and patio furniture. Acorn House is close to the amenities of Laindon town centre Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The routine unannounced inspection too place on the 17/01/06. Records and documents were looked at, including the previous requirements and recommendations from the last inspection. Time was spent with four young adults who were able to communicate taking notes of their daily routine in the home. Two staff members, the deputy manager and registered manager were all spoken to and most helpful during inspection. This was greatly appreciated. What the service does well: What has improved since the last inspection?
The home has met all the requirements and recommendations from the last inspection. These include introducing new diets for all individual residents to suit their health needs resulting in improved behaviour plus additional risk assessments and fire safety procedures. Resident have pictorial service users guides and appeared much happier with staff members working in the home.
Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 6 Residents are healthy and happy able to communicate more and leading fulfilling lives. Residents have experienced holidays abroad for the first time and have kept memory pictures of holidays, days out, work placements and sporting activities. The home has a new sensory room for one resident. Residents appeared to have close relationships with their key workers who work very hard to meet the needs of the residents. 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 DS0000018126.V265504.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 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 the following standard(s): 6, 7, 8. Care plans are comprehensive and reflect residents changing needs. Residents are consulted on all aspects of their lives and participate in aspects of life in the home. EVIDENCE: The atmosphere in the home was very positive and all residents appeared happy. One resident who did not like to go out very much appeared to have made remarkable progress since the last inspection. The resident was more relaxed, outgoing and happy enjoying taking part in cooking and socialising. The resident communicated more verbally since the last inspection and appeared more content. Staff stated how the resident now asks to go out and her family are very happy with her progress, as they believe their daughter is much happier and more affectionate. Another resident who wished to be totally independent was spoken to and said the home allows him to be independent but he can join in activities in the home when he likes. Minutes examined confirmed the resident was able to participate in decisions made in the home. The resident was very positive of the home and the care he received.
Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 10 One resident spoken to appeared very happy with his key worker and demonstrated his affection by leaning on him for a hug. The resident was verbally more communicative and stated how he enjoyed playing sport with his key worker. Both the key worker and resident were planning a holiday to Spain together. One resident had previously told the inspector her dream was to go to Disney land. Staff stated the resident had never been abroad but at inspection the resident told the inspector she had met Mickey Mouse and had a great time. The residents face lit up as she spoke about her holiday experience that staff arranged. Care plans examined contained all relevant details of the residents’ lives including changing needs and development. One placing social worker requested the staff ensure one resident remain living in the home, start an activities programme, budget with support, monitor health and continue her good progress made at Acorn House. The files confirmed the resident went to college on trips, socialised with others in the community, budgeted and attended health appointments. Care plans contained residents likes and dislikes in guidelines with daily routines. Key working records evidenced one to one support is offered and goal plans reviewed regularly. Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 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 the following standard(s): 11 ,12, 13, 14, 15, 17. Residents have the opportunity for personal development and participate in peer appropriate activities maintaining contact with friends and family. Menus in the home have been improved with positive outcomes. EVIDENCE: Residents are individually asked what they would like to do and say. Minutes of residents meeting and key working sessions confirmed residents’ views are sought and signatures obtained to evidence decisions. One meeting confirmed residents were asked, “Are you happy living at Acorn House”. One resident stated “I am happy in the house and want to stay here” another stated “I am happy and do not need anything”. Comments were noted from a resident who does not speak that seemed happy. Residents are asked to choose holidays, days out, activities and college courses with support from staff. Four residents told the inspector they were happy at Acorn House. Two residents confirmed they visited friends and had a friend visit them in the house. Relatives are encouraged to visit any time.
Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 12 Since the last inspection the registered manager has sought the advice of a dietician with regard to food in the home. The dietician devised individual menus for each resident, which were low in additives, sugars and fat. The dietician stated this might help reduce behavioural problems and address overweight residents. It was noted residents on the new healthier diet were more active since loosing weight and happier. Behavioural charts examined confirmed the home had less behavioural incidents since the introduction of the menus. Two residents stated how they liked the food in the home and confirmed food stocks were plenty. Some residents are supported to prepare meals and one resident had his own separate food shopping list and supply. The registered manager was congratulated on the work done in the home with residents’ menus. Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 18,19,21. Residents receive personal, physical and emotional support as required and are protected by the homes polices and procedures for administering medicines. EVIDENCE: Care plans gave staff clear guidance and instructions on how to support residents with personal care. All residents appeared clean and tidy dressed in age appropriate good quality clothing. Key workers are given responsibility for assisting residents to budget, buy clothes and toiletries. The registered manager stated staff are instructed to ensure residents have the best. One resident who attended a sensory activity in the community was unable to go as it had closed. The key worker sought advice from a sensory provider in her own time on the internet and purchased all equipment to make the residents bedroom a sensory room to relax in. The inspector noted how enthusiastic the key worker was. The room was appreciated by the resident and looked nice. Medication procedures were examined and no errors found. The home stores and administer medication appropriately and keeps signatures of staff who
Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 14 administer medicine, training records, photos of residents’, and medication breakdown. The home managers’ audit medication stocks weekly. Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 22,23. Residents are listened to and protected from abuse, neglect and self-harm. EVIDENCE: From examined residents meetings, staff meetings, key working sessions and care plans and talking to residents confirmed resident are listened to and that staff act upon their wishes. Staff had received protection of vulnerable adults training and were conversant with the signs of abuse and procedures for reporting abuse, including the whistle blowing policy. The complaints procedures contain details of the CSCI. Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 24,26,29. Residents live in a home, which is welcoming, comfortable, clean, hygienic and decorated to a very good standard. EVIDENCE: The home and residents bedrooms are decorated to a high standard suiting their individual lifestyles. The home is bright, kept in good order with sufficient space for residents needs. The home has a very small staff office and no Internet access for residents or staff. Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 17 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,36. Residents’ benefit from staff that are competent and qualified in sufficient numbers to meet residents’ needs. Staff are supervised and supported by a good manager to deliver good quality care to residents. EVIDENCE: Staff numbers at inspection matched the number of staff on duty and appeared to be sufficient to meet the needs of residents accommodated. Staff files confirmed staff are regularly supervised and appraised to identify their needs and skills. At inspection a list of staff training was being negotiated following appraisal and most of the homes staff have qualification in NVQ care. The registered manager has an assessor’s qualification and was assessing one staff member and supporting one member staff to develop their career. The staff team appeared very happy working in the home and staff turnover is very low. Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 18 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38. Residents’ benefit from a well run home that has leadership and good management. EVIDENCE: The registered manager has the experience and qualification to help progress Kingswood Care Services. The home is run very well and all residents and staff were happy. The home has a quality assurance system for monitoring and improving the service and ensures health and safety checks are regularly completed with records of tests, evacuations, timescales and attendees. Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 19 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 X X X X x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 4 X x Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X 3 X X 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Acorn House Score 3 3 X 4 Standard No 37 38 39 40 41 42 43 Score 3 4 X X X X X DS0000018126.V265504.R01.S.doc Version 5.0 Page 20 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. 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 YA29 Good Practice Recommendations The home could provide internet access for residents and staff for educational purposes, communication, planning and to share good practice. Acorn House DS0000018126.V265504.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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