Inspection on 23/04/07 for Acorn House

This inspection was carried out on 23rd April 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Acorn House 17/01/06

Acorn House 26/06/05

Acorn House 07/10/04

Acorn House 12/05/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Acorn House 28 Somerset Road Laindon Basildon Essex SS15 6PE Lead Inspector Vicky Dutton Unannounced Inspection 23rd April 2007 09:00 Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 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.V336290.R01.S.doc Version 5.2 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.V336290.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Acorn House Address 28 Somerset Road Laindon Basildon Essex SS15 6PE 01268 453216 01268 455103 kingswood@donna-higby.freeserve.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) 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.V336290.R01.S.doc Version 5.2 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 17th January 2006 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 patio furniture and a barbeque area Acorn House is close to the amenities of Laindon town centre The previous inspection report was readily available for residents or visitors to the home. The home’s Statement of Purpose and Service Users Guide were also available in the home. The weekly charge as quoted in the home’s Pre Inspection Questionnaire is £1,100. An extra fee is charged where one to one staffing is required. Additional charges to residents include personal requirements, transport costs, and holidays Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced ‘key’ site visit. The visit took place over a four and a half hour period. At this inspection all the key standards were considered. The home had no previous requirements. Prior to the site visit the home had submitted a pre-inspection questionnaire (PIQ), and provided additional information that assisted with the inspection process. At the site visit a partial tour of the premises took place, care, staff, medication and other records and documentation were selected and various elements of these assessed. During the site visit time was spent interacting with residents, some of whom have limited verbal abilities. Pictorial surveys were left with the manager for use with those residents who are unable to verbally express their views about the home. Some of the homes staff were spoken with. As part of this key inspection questionnaires were sent out in the post to relatives and health and social care professionals. Staff surveys were given out during the site visit. The views expressed at the site visit and survey responses have been incorporated into this report. The inspector was assisted at the site visit by the registered manager and other members of the staff team. Feedback on findings was given during the visit with the opportunity for discussion or clarification. A feedback card on the inspection process was left at the home. The inspector would like to thank the manager, staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the service does well: Acorn House continues to deliver a high quality of individualised care to residents who have complex needs. Residents are supported to live as fulfilling a life as possible. Residents are encouraged to maintain strong links with families and friends and supported to make use of the local community. Relatives are very satisfied with the service offered at Acorn House. One said ‘they listen to …….’s views, encourage their creativity, offer them friendship and allow them to enjoy things such as going out for the evening or buying new clothes.’ Another said ‘they provide a secure and stimulating environment for my relative, they have never seemed happier than since they moved to Acorn House.’ One member of staff said, ‘the home is a happy place to live and work and is always full of chatter and laughter.’ Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 6 Acorn House provides residents with a comfortable and homely environment which is well decorated and maintained. The registered manager is experienced, qualified and has a proactive approach that seeks to develop and move the service forward for the benefit of residents. Staff morale is high and staff are generally well trained to provide good care and support for residents. 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. The summary of this inspection report can be made available in other formats on request. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 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.V336290.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Previous admissions to the home have been well planned with people given sufficient information about the service, and having their needs assessed. EVIDENCE: No residents have been admitted to the home since the previous inspection. The home has previously demonstrated their robust and thorough approach to the admission process. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents living at Acorn House can expect to receive excellent care and support. Residents can be involved in making decisions about their daily lives, and are supported to take risks as part of an independent lifestyle. EVIDENCE: Each resident at Acorn House has a comprehensive care file in place. Care files cover all aspects of residents’ care, social and behavioural needs. As far as possible within individual abilities, residents are involved in developing and agreeing their care plans. The home has started to develop pictorial sections to help residents understand their care files. A strong key worker system is in place to support residents. The whole ethos of the home is to support residents as individuals to live their lives as independently and as flexibly as possible within a residential environment. Through interactions during the site visit it was seen that residents are very much encouraged to be self-determining. Where residents Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 10 need support to make decisions, staff do this in a sensitive manner in line with their assessed needs as documented in care planning information. Residents’ meetings are held regularly and records of these meeting show that residents are consulted about all aspects of daily life in the home, and their views listened to. The home are developing new ways of recording these meetings and decisions made in a way that records residents comments in pictorial or other formats that they will be able to understand. Care plans showed that risks to individual residents are robustly assessed and strategies in place to reduce risk. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. At Acorn House residents will have the opportunity for personal development and be able to participate in appropriate activities. Residents can maintain contact with friends and family. EVIDENCE: Staff support residents to take part in educational and other activities outside of the home. A number of residents undertake courses in a local adult education centre. Subjects such as IT, music appreciation, art and cookery are enjoyed. One relative commented that it was noticeable how communicative and happy their relative had become since moving to Acorn House. Residents enjoy using the local community. The home has two vehicles available to support this. Residents with communication difficulties keep a Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 12 diary which provides a pictorial record of some of the many social occasions and trips out enjoyed. Residents told the inspector about their neighbours and how they support one of them, and involve them in the life of the home. Residents are supported to follow their individual interests. A member of staff said that residents are encouraged to be as independent as possible, and their individuality celebrated. A garden workshop has been developed for one resident who does not wish to attend college courses or other activities. The workshop allows them to follow their particular areas of interest. The home has a range of games/activity equipment available for residents. One resident told the inspector about a forthcoming holiday which they were looking forward to. Families are always made welcome at the home, and residents are encouraged to maintain family contacts. A relative said that they can visit at any time and kept in regular contact by telephone. One resident told the inspector about forthcoming family birthdays and a planned celebratory barbeque. Another was looking forward to a parents visit on the following day. A member of staff said ‘family and friends are welcome at any time, and are always offered refreshments and meals.’ Staff were observed to treat residents respectfully at all times and respect their need for privacy. Residents said that they were happy with the food at the home and are offered choice. Residents are involved with menu planning. The home has been praised by a dietician for developing and encouraging healthy menus at the home. Residents are however still offered choices. At lunchtime during the site visit one resident requested cold spaghetti which staff prepared for them. The home has a rota for residents to help in the kitchen with food preparation and clearing up. Residents spoken with were happy with this arrangement. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents can expect to receive good personal, healthcare and emotional support based on their individual needs. Their medication will be managed safely. EVIDENCE: Care plans give staff clear guidance and instructions on how to support residents with personal care. Staff have a detailed knowledge of residents needs. Routines at the home are flexible and governed by residents’ needs and choices. Records show that residents’ health is monitored and appropriate actions taken when needed. Residents at Acorn House have a range of healthcare professionals involved with their care and are supported by staff to attend appointments and other healthcare checks. A professional involved with most residents at the home said that they thought the service was excellent and that the staff were ‘skilled, sensitive and sensible.’ Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 14 Medication at the home was seen to be well managed and audited on a daily basis. It was advised that the temperature in the medication storage area is monitored to make sure that medicines are stored at optimum temperatures. This is generally below 25 degrees Celsius. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at Acorn House are able to raise concerns and have access to a clear complaints process. Residents will be protected from abuse. EVIDENCE: Residents at the home are aware of how to raise concerns, and said that they would talk to the manager or staff. Due to the open nature of the home there is constant interaction/dialogue between residents and staff in a family like atmosphere. Therefore any concerns are openly discussed and dealt with. One member of staff said, ‘residents know that any worries or problems they have, however small, they will always get help and support from staff and the home manager.’ The home has a clear complaints process in place. This is also displayed in pictorial form. The home’s complaints procedure needs some updating to include details of funding authorities who have a duty to investigate complaints, and the correct current local office address for CSCI. Pictorial information is available to residents about the homes complaints process. No complaints or concerns about the service have been raised with the home or CSCI. Staff training records showed that staff have previously undertaken training in adult protection. Records showed that all staff at the home are to undertake refresher training in the next few weeks. All staff have received appropriate training in managing behaviour that challenges. However many staffs’ training in this area dated from 2001/2/3/ and 4. Care plans are clear about individual residents potential behaviours, and how these are to be managed by staff. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Acorn House is a welcoming, comfortable, clean, and hygienic place to live. EVIDENCE: Acorn House is situated in a residential area. The home is well maintained and provides sufficient space for residents. Residents are involved in making decisions about the environment. On the day of the site visit a discussion was underway about what colour to redecorate the dining and lounge areas of the home. This work is planned in the very near future. The manager also said that the home was due to have a new kitchen fitted. Residents all have single rooms, three of which have an en suite area. Residents’ rooms reflect their individual personalities, and again they can choose their own colour schemes etc. On the day of the site visit the home was clean and well presented. The home has an adequate laundry area. This is situated off the main lounge. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff who are well trained, safely recruited, and available in sufficient numbers to meet their needs. EVIDENCE: Residents at Acorn House clearly have a relaxed and good relationship with the manager and staff at the home. Relatives praised the staff at the home. One said ‘they are exceptional people.’ Staff training records and discussion with staff showed that (apart from where elsewhere identified,) the staff team at Acorn House are well trained and skilled in delivering care and support to residents. The home benefits from a low staff turnover creating a stable environment for residents. Staff are happy working at the home and one said ‘I would not change anything.’ One resident is funded on a one to one basis and sufficient staff are provided to provide support the other residents. The home has a basic level of four staff on each shift during the week (increased to five on two busier days), and three at weekends when one resident is away. The manager said that these levels are flexible according to need. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 18 It was reported that no new staff had been recruited by the home since the previous inspection (although some staff have transferred to Acorn House from other homes in the Kingswood Care group.) The home has a history of carrying out staff recruitment to a high level. Staff spoken with confirmed that they received a good induction into the home and that a good level of training opportunities were provided for them. An in house induction is completed that is to Skills for Care standards. It was seen that all staff have a personal development portfolio in place. This links in to National Vocational Qualification (NVQ) training. Most staff at the home hold an NVQ at level two or three. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a home is well run home and has clear leadership and good management. EVIDENCE: The home benefits from having a qualified and competent registered manager in post. The manager is proactive in their approach, keen to keep fully up to date and move the service forward. Since the previous inspection a new office area has been created. This has enabled the administration of the home to be organised and managed more effectively. Staff and residents spoke favourably about the manger. The smooth running of the home is further enhanced by staff being given specific areas of responsibility such as medication and residents’ files. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 20 Kingswood Care Services have strategies in place for monitoring the quality of the service offered. A development plan was in place for 2005/06, but has not yet been produced for this year. The home is managed in a safe and effective manner. Risks are identified and managed. Staff training in core areas has taken place but, as the manager recognised, update training is required in many areas. This includes health and safety, food hygiene and, although no residents currently require this level of assistance, moving and handling. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 22 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. 2. Refer to Standard YA23 YA42 Good Practice Recommendations Staff should have the opportunity to update their skills in managing behaviour that challenges. Staff should keep knowledge and skills up to date by having regular update training in core areas such as health and safety. Acorn House DS0000018126.V336290.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000018126.V336290.R01.S.doc Version 5.2 Page 24 - 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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