Inspection on 26/06/05 for Acorn House

This inspection was carried out on 26th June 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Acorn House 23/04/07

Acorn House 17/01/06

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 Patricia Stanton Unannounced 26 June 2005 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 I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Acorn House Address 28 Somerset Road, Laindon, Basildon, Essex. SS15 6PE 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) 01268 453216 01268 455103 Kingswood Care Services Limited Mr Graham Edward Sheem CRH 6 Category(ies) of LD 6 registration, with number of places Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Care Home, learning disability (6) Date of last inspection 7/10/05 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, or who present with challenging behaviours. Staff training and staffing levels reflect the needs of the residents and enable them to access facilities in the community. The Home actively seeks the advice of health and social care professionals. The home is situated in a residential area and the two storey premises are 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, adult swing and patio furniture. Acorn House is close to the amenities of Laindon town centre Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The routine unannounced inspection too place on the 26/6/2005. During the inspection the registered manager gave the inspector a tour of the premises and records and documents were looked at, including the previous requirements and recommendations from the last inspection. Time was spent with two young adults who were able to communicate chatting and taking notes of their daily routine in the home and the inspector met three other residents during inspection. The residents, registered manager and this staff, were most helpful during inspection, and this was greatly appreciated What the service does well: The home has excellent care plans and risk assessments, which reflect the lifestyles of residents accommodated. Residents are encouraged to be independent as possible and live fulfilling lives. Accommodation is of a good standard. The home has as a monitoring process to ensure the home progresses. Residents are able to exercise choice. The home arranges a wide variety of activities for residents including annual holidays. Staff are competent, supervised and trained to meet residents needs. The home provides transport to take residents out. Communication between staff and residents is positive and mutually respectful. The home arranges outside agencies to deliver psychotherapy for residents. Records are kept of residents’ wishes regarding illness, death and dying. The home meets regularly with residents and staff so they may view their opinions regarding care in the home. The home carries out comprehensive pre assessments for new residents. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 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 House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 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 I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 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) 1,2,3,4,5. Residents have all the information they need to help them make a choice about where they live and the home ensures all individual aspirations and needs are assessed before the resident moves into the home. Residents can test-drive the home before they move in and each resident has an individual contract with terms and conditions with the home. EVIDENCE: The home had only one new admission since the last inspection and records evidenced a comprehensive pre assessment was carried out. The resident lived out of area but the registered manager undertook a pre assessment visit initially at the residents home, followed by a two-day visit to assess the resident’s behaviour. The resident then visited the home twice for two days staying overnight locally the first time followed up by another visit staying at the home. The registered manager visited the resident finally to escort her back to the home to live. The resident appeared very happy and contented at The Acorns and the registered manager was congratulated for the thorough assessment process, which ensured the resident, and homes existing residents were involved. The home has a pictorial service users guide suitable for residents but does not include how residents can complain and details of the CSCI. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 9 One resident spoken to had not seen a service users guide since living in the home. The registered manager was informed and printed off a copy for the resident’s personal use. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 10 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) 6,7,8,9,10. Residents know they’re assessed and changing needs are reflected in individual plans and are involved in decisions about their lives with assistance. Residents are consulted on all aspects of their lives and supported to be independent and take risks. Residents confidential information is handled according to the data protection act 1998. EVIDENCE: Care plans examined were comprehensive and included all aspects of care for the residents changing needs. Sampled care plans evidenced residents assessments for social skills; new skills for developing, self-help skills, full risk assessments plus recommended activity work educational and social placements. Daily notes confirmed residents were encouraged to participate in activities set by the placing social worker. Residents plans evidenced they have access to appropriate health care professionals, psychologists and the registered manager confirmed sexual health education is available for residents if required. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 11 Residents’ files confirmed they are involved in planning with support from significant others. Residents in the home were encouraged to be as independent as possible and encouraged to participate in personal interests. The registered manager handled information regarding residents at inspection in a sensitive way and files were stored in a locked office for security. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 12 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) 11,12,13,14,15,16,17. Residents have the opportunity for personal development and encouraged to take part in age, peer appropriate activities in the local community. Residents engage in personal relationships when required and have the opportunity to keep in contact with friends and relatives. The home is respectful of residents needs with regard to appropriate confidential sexual health information. Residents right are usually respected and the home menus have been updated to include a healthier diet. EVIDENCE: Some of the residents attend college or work placements recommended by the local authority. Two residents stated how they enjoyed working in charity shops. All residents have individual activity plans and staff are allocated to assist with activities for residents. Residents have the opportunity to engage in the community if they wish, attending local pubs and clubs and daily living skills in the home. One resident was able to do his own ironing and other residents were seen to stack the dishwasher at inspection. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 13 Residents confirmed they are able to have free contact with relatives who visit the home often. Residents also visit their relatives frequently and one resident travels abroad each year to visit his family. The registered manager stated at present no resident is in a relationship but appropriate confidential sexual health advises is available from the staff or local family-panning clinic. The home offers various activities in house and arranges trips out weekly. One resident stated that he had not felt like going out much lately, as he had felt depressed. Daily notes confirmed he had gone out with friends and visited museums as well as attended his work placement. At inspection residents rooms were personalised with resident’s individual interest to help engage them. Residents spoken to stated they enjoyed the meals provided in the home. Residents are offered a choice of meals and a record is kept of residents’ intake. Residents confirmed they are able to help themselves to snack but one resident confirmed a staff member locked the kitchen at night on one occasion so he could not help himself to a drink. The resident climbed through the kitchen hatch to help himself. Residents should have access to drinks at all times. One resident stated the portions of food were not sufficient. The registered manager was informed of the comments at inspection feedback. Menus in the home appeared healthy and one carer stated the home has a summer and winter menu, which is reviewed with the inclusion of residents. Minutes of selected residents meetings made no reference to food preferences. Residents are regularly weighed and weight recorded for monitoring. Residents who are less active are on low fat diets and weight records evidenced this is monitored for health reasons. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 14 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) 19,21. Residents receive emotional and physical health care and the home records resident’s wishes in relation to death and dying. EVIDENCE: Files and residents confirmed they receive appropriate health care support as required. One resident was very happy with the emotional support he received from his key workers and a professional psychologist he visits regularly. Care plans confirmed residents attend regular dentist, doctor and optician appointments. The home records residents’ wishes in relation to death and dying. One file confirmed a resident had a different approach to the way he wished to be buried which the homes staff respected. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 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 standard(s) 22,23 Residents usually feel their views are respected, listened and acted on and the home protects residents from abuse, neglect and self-harm. EVIDENCE: Residents spoken to stated the home listens and acts on most issues but one resident was very upset regarding a clash of personality with one staff member and felt he was not being listened to. The resident was not aware of the complaints process in place in the home or the CSCI complaints procedure. The registered manager was made aware of the residents feelings at inspection during feedback and was seen to give the resident a copy of the service users guide with details of the homes complaints procedure and CSCI contact. Record evidenced the resident had brought the issue up in a residents meeting on the 7/3/05. The registered manager was aware of the problem and was addressing the situation. Staff in the home have appropriate protection of vulnerable adults (POVA) training and staff spoken to were conversant with the sign of abuse and the procedures for reporting abuse. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 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 standard(s) 24,25,26,27,28,30 The homes is homely, conformable clean and safe. Residents’ bedrooms suit their needs and lifestyles and promote independence. Residents have sufficient bathrooms and toilets and share adequate communal space. EVIDENCE: The home is bright well decorated modern and spacious. At inspection the home was just about to redecorate the hall and all residents bedrooms are painted frequently in the colour of their choice. Residents’ bedrooms are personalised and reflect their lifestyles and interests to promote independence. Residents help keep their rooms tidy. Bathrooms and toilets are sufficient to meet the needs of residents and communal space is sufficient. The home has a good size well kept garden with paddling pool and swing for residents use. The garden has shrubs and residents assist in gardening. The front garden has a fence and gate to keep residents safe from traffic and cars parked on the drive. This is good practice. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 17 The home has access to a maintenance person employed by the service who makes all relevant repairs to the home. The inspector noted the two showers in the home needed re grouting and one shower needed repairing due to damage. Another resident had one drawer missing in his bedroom. Files confirmed a request had not been put into the maintenance man. The registered manager was seen to action this at inspection. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 18 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) 31,32,33,34,35,36 Residents’ benefit from staff that are clear about their roles and responsibilities being competent supported and supervised to meet residents needs. EVIDENCE: The home’s staff appeared very cohesive and proactive at inspection. The staff had encouraged in house fund raising to enable one resident to go on her first holiday abroad. This is very good practice. Communication between staff and residents appeared very respectful and positive at inspection and residents were seen to trust and feel attached to staff. Staff stated they felt supported by the homes management and deputy manager and receive regular supervision. Staff confirmed supervision is helpful and one staff member stated, “ my supervisor is excellent, supportive and I would like to be like her as she is approachable but firm”. Records evidenced supervision is ongoing and staff are able to give their views and opinions in regular staff meetings. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 19 Staff receive appropriate training including three week induction before they are allowed to start work in the home. One staff member stated the training was thorough and when she came to work in the home she was shadowed and given policies and procedures to read and sign regarding health and safety on her first day. The member of staff employed since the last inspection had received training in health and safety, mental health, MARS medication, POVA, risk assessments. Files evidence the home’s recruitment is robust and all staff have appropriate checks before employment. One staff member stated she was had to have her CRB before employment in the home. Staff are allocated weekly to duties to ensure they are clear about their roles and residents benefit from efficient staffing. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 20 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) 37,38,39,40,41,42. The home is well run lead and managed effectively. The home is monitored and developed to improve care and residents are safeguarded with their health and welfare protected. EVIDENCE: The registered manager can lead and manage the home to deliver an efficient service to residents. The registered manager has recently completed NVQ level 4 in care management and is qualified to assess staff in NVQ training. The home has a quality assurance programme and development plan for 2005 to improve the service and residents benefit from this well run home. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 21 The home ensures residents are protected from harm and all relevant health and safety checks are maintained. Fire logs examined at inspection were up to date and fire drills carried out weekly including response times and number of details of residents involved in fire drills to ensure all residents are involved. This is good practice. The home has a gate in the garden, which is locked. Not all staff have a key to the gate so evacuation may become a hazard. All staff should have a key or the locks changed. The registered manager has appropriate risk assessments in place for individual residents to help keep them safe and infringement of rights as deemed appropriate. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 22 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 4 3 4 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 4 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Acorn House Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 x I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 23 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 YA17 Regulation 16 (i) Requirement Adequate amounts of food should be provided to suit all ages of residents accomodated and drinksand food should not be restricted without reason. The garden gate should be easily opened in case of fire evacuation. Risk assessments should be completed for the homes staircase and front garden to protect residents from harm. Timescale for action 1/7/05 2. YA42 23 (4) iii 23 (2) o 13 (4) a 1/7/05 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 YA3 YA24 Good Practice Recommendations Residents should all have a copy of the service users guide and given feedback on inspection reports. The home could adapt the front garden and staircase to reduce risk of accidents in the home. Acorn House I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 © 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 I56-I06-S18126-Acorn Hse-V223126-20 06 05Stage 4.doc Version 1.30 Page 25 - 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. 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