Inspection on 21/03/06 for Acorn Lodge

This inspection was carried out on 21st March 2006.

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 Lodge 06/02/07

Acorn Lodge 10/01/06

Acorn Lodge 01/03/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Acorn Lodge 12 Grand Avenue Southbourne Bournemouth Dorset BH6 3SY Lead Inspector Stephanie Omosevwerha Unannounced Inspection 21st March 2006 14:00 DS0000062108.V287176.R01.S.doc Version 5.1 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 DS0000062108.V287176.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. DS0000062108.V287176.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Acorn Lodge Address 12 Grand Avenue Southbourne Bournemouth Dorset BH6 3SY 01202 426085 01202 426085 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) Acorn Lodge (Bournemouth) Ltd Mrs Angela Kay Druce Care Home 9 Category(ies) of Learning disability (9) registration, with number of places DS0000062108.V287176.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: Acorn Lodge is registered to provide residential care for up to nine younger adults (aged 18-65). The property is a large family style home, located in a tree-lined avenue close to the centre and to the beaches of Southbourne. The Proprietor maintains one of the bedrooms for short term care. The service users are accommodated on the ground, first and second floor. All bedrooms are single and two have the benefit of en suite facilities. There are bathrooms on each floor. The communal areas are on the ground floor and consist of a lounge, conservatory/dining room and a kitchen. Accessed from the conservatory is the garden, which is level and private. Acorn Lodge is staffed 24 hours a day, with two waking night staff. The Proprietor works in the home full time as the Manager. DS0000062108.V287176.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over approximately 3 ½ hours. It was the second annual inspection carried out as part of the planned inspection programme for care homes undertaken by CSCI. The home had previously been inspected on the 10th January 2006, so because of the short timescale between inspections not all the recommendations made at the previous inspection were addressed. This inspection focussed on the key standards that were not assessed at the last inspection and it is recommended that this report be read in conjunction with the previous report of the home for a fuller picture of the service. The Registered Manager was present for most of the inspection and records and documentation were examined such as service user care plans, medication policy and records, financial records and health and safety records. The lounge and conservatory/dining room were seen and a sample of 3 service users’ bedrooms. The inspector also had the opportunity to talk to service users both in a group and individual basis, although time was limited as this was only a short inspection. What the service does well: Acorn Lodge is well run and benefits from an experienced and well-qualified manager. There is a stable and consistent staff team who are well trained and experienced having a good understanding of service users needs. Observed practice demonstrated service users felt comfortable with members of staff who were accessible and approachable. Acorn Lodge provides service users with a comfortable and homely environment that is well maintained. Service users told the inspector they liked their rooms and were keen to show them to the inspector. Rooms were observed to be well furnished, bright and airy with plenty of space for service users possessions. Service users said the homes routines were flexible and personal care was given in a way that was sensitive and respected individual preferences. The home offers service users a balanced and nutritious diet. Service users are able to participate in menu choices and aspects of meal preparation and told the inspector they enjoy the food in the home. The home has good systems in place for managing various aspects of service users care such as their health and safety, medication and finances, which safeguards service users welfare and promotes their well being. DS0000062108.V287176.R01.S.doc Version 5.1 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. DS0000062108.V287176.R01.S.doc Version 5.1 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 DS0000062108.V287176.R01.S.doc Version 5.1 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): 2. Since the previous inspection, the home has improved the recording of service users views in their assessments providing clear evidence of service users participation in the process. EVIDENCE: There was a recommendation made at the previous inspection that there should be clear evidence that service users views are sought in relation to their assessment of needs. Since this recommendation the home has reviewed its care plans and an example of the new format was shown to the inspector. The new plans contain clear evidence that a discussion has been held with the service users and their representatives where appropriate. A written account is recorded of the discussion and service users sign to evidence their agreement with the plan. DS0000062108.V287176.R01.S.doc Version 5.1 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 and 7. The home has reviewed its care planning process to ensure there is clear evidence of service users participation with their views being clearly recorded in their plans. Service users are encouraged to make choices in their daily lives with staff giving appropriate support according to each individual’s ability to understand and make decisions. EVIDENCE: A recommendation was made at the previous inspection that service users’ views should be sought and recorded when reviewing their care plans. The home have reviewed their care planning documents and introduced a new format, which is based on discussion being held with the service users and their representatives where appropriate. A written account of the discussion is recorded and all parties present sign to evidence their agreement. Service users likes and dislikes were recorded as well as an action plan giving clear guidance for staff about the residents’ needs. Clip art had been used to make the format more accessible to service users to further facilitate their participation in the process. DS0000062108.V287176.R01.S.doc Version 5.1 Page 10 There was evidence that service users were encouraged to make decisions about their daily lives. Regular residents meeting are held every 2-3 months and a weekly meeting is also held to plan issues such as menus and day trips. Discussion with service users confirmed they were able to make decisions. For example, one service users had been moved from an upstairs bedroom to a downstairs bedroom due to mobility problems and told the inspector that he had been involved in this decision and was very happy his new room. The home has information available about advocacy services and their contact numbers are clearly set out for service users. The manager told the inspector that one service user had recently had an advocate involved to support them with issues relating to their personal finances. The home also have organised visits from a local service user advocacy group who have come in to the home to talk to the residents about local issues. All residents have their own bank accounts and their support needs regarding handling finances and budgeting are clearly recorded on care plans. All service users are assisted to manage their money, although two residents are supported by external parties outside the home. A sample of 3 residents financial records was checked and these were found to be accurate and up-todate with receipts of all transactions kept. The manager carries out a weekly audit of all residents’ finances and relatives are also involved in checking accounts where appropriate. DS0000062108.V287176.R01.S.doc Version 5.1 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): 16 and 17. The home’s routines and care practices promote choice for service users, with service users encouraged to take responsibilities in their daily lives. The home provides a balanced and varied selection of food that meets service users tastes and choices. EVIDENCE: Service users responsibilities for housekeeping tasks are set out in the service users guide. In addition, individual care plans specify service users abilities to undertake domestic tasks and the support they need. In response to a recommendation, made at the previous inspection the home had begun to record a checklist of all the domestic activities the service users did. The inspector felt that this practice was not a productive use of staff time and sufficient evidence could be obtained by checking individual care plans and speaking to residents about their participation in house hold routines. The home was, therefore, advised not to continue to use a checklist. DS0000062108.V287176.R01.S.doc Version 5.1 Page 12 Service users dietary needs are recorded on their individual care plans and they are encouraged to follow a healthy eating plan. A sample of the home’s menus was viewed and these were seen to be balanced and nutritious. Service users are involved in planning the weekly menus and an alternative choice is provided if they do not like the main meal. Service users are encouraged to help themselves to their own breakfasts and help make up their lunchboxes. The home have been told by the Environmental Health Officer that service users are unable to go into the kitchen unless they pass a basic food hygiene certificate. This is because the kitchen is classed as a commercial kitchen by environmental health. The home is currently working with service users to help them pass the food hygiene certificates but in the meantime the dining room is being used to undertake activities such as making up lunch boxes or preparing salads or cakes. Service users told the inspector they enjoyed the food in the home. DS0000062108.V287176.R01.S.doc Version 5.1 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 and 20. Personal care is provided in a sensitive way that respects service users’ preferences and promotes their privacy and dignity. The medication at this home is well managed promoting service users’ good health. EVIDENCE: Service user personal care needs are clearly recorded in their care plans as well as their personal preferences. For example one service users support needs for dressing and changing were recorded as “staff to assist with choosing suitable clothes for weather conditions” and it was also noted that the service user “prefers to wear trousers”. Service users confirmed that support was flexible such as times for going to bed and getting up. They also said staff treated them well and supported them in the way that they liked. For example one service user told the inspector that the staff are always very good when they help him have a bath. Service users were observed to have clothes and hairstyles that reflected their own individual styles. The inspector was shown a copy of the home’s policy on the management of medication. The policy was detailed and covered all aspects of the administration of medication. One service user currently self medicates and an DS0000062108.V287176.R01.S.doc Version 5.1 Page 14 appropriate risk assessment was in place. Medication is kept in a locked cupboard in the office and records were checked and found to be up-to-date and accurate. All service users sign an agreement to consent to staff supporting them with managing their medication and copies of these were seen on individual service users files. Details are kept of all medication taken by each service user and information is available about possible side effects. In addition a list of homely remedies is kept which has been signed and agreed by the service user’s G.P. All staff responsible for administering medication complete an external course in the safe handling of medication and also have a signed in-house certificate of competence in the administration of medication. DS0000062108.V287176.R01.S.doc Version 5.1 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): These standards were assessed at the previous inspection. EVIDENCE: Two recommendations were made at the previous inspection, however, because of the short timescale between inspections, these recommendations were not assessed at this inspection and have been carried forward to be addressed at the next inspection of the home. DS0000062108.V287176.R01.S.doc Version 5.1 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): The key standards were assessed and met at the previous inspection. EVIDENCE: DS0000062108.V287176.R01.S.doc Version 5.1 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 The staff team is well qualified and competent ensuring the home is well run and organised, supporting the assessed needs of service users at all times. EVIDENCE: The manager stated that the staff team is stable and there is low use of agency staff. The home employs 12 staff and there is a mix of genders and age groups within the staff team. Most staff have relevant experience of care work prior to commencing employment in the home. 9 staff currently hold a NVQ Level 2 qualification or equivalent including 2 staff that are qualified learning disability nurses. Service users spoke positively about the staff and observation of practice showed that staff were accessible to and comfortable with the service users they were working with. DS0000062108.V287176.R01.S.doc Version 5.1 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 and 42. The registered manager is well qualified and experienced which ensures the home is run effectively to meet its stated purpose, aims and objectives. Practices in the home promote and safeguard the health, safety and welfare of the residents. EVIDENCE: The registered manager of the home is Angela Druce. She is well qualified and is a Registered Nurse as well as achieving a BS Honours in Interprofessional Health and Social Studies and a Diploma in Management. She has managed the home for 5 years and prior to this she worked for the Health Authority as a community psychiatric sister working with adults with mental health and learning disabilities. There was evidence that she regular updates her knowledge and skills and she had recently updated her food hygiene training and taken part in assessors’ information days on the new induction standards and new NVQ standards. DS0000062108.V287176.R01.S.doc Version 5.1 Page 19 Records showed that the home was meeting the requirements of other agencies such as Dorset Fire and Rescue Service and Environmental Health Department. Certificates were in place demonstrating that equipment and facilities were regularly serviced and maintained. A written health and safety policy for the home has been completed and records are maintained evidencing the home carries out checks for example fire precautions log book. The manager confirmed her awareness of relevant legislation and certificates were in place showing staff had attended various training courses in safe working practices. The accident book was seen and although the manager reported that incidents had been investigated and risk assessment up-dated accordingly there was no reference to this on the accident form. It is recommended that reference be made on the accident forms to show the action taken following the reporting of an accident. DS0000062108.V287176.R01.S.doc Version 5.1 Page 20 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 3 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 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 3 X X X X 2 X DS0000062108.V287176.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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 DS0000062108.V287176.R01.S.doc Version 5.1 Page 22 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 YA22 Good Practice Recommendations The complaints procedure should contain more detail about how staff are to manage complaints and how service users can raise complaints (verbally, with advocacy etc). This recommendation was made at the previous inspection but was not assessed on this occasion. The home’s policies on adult protection need to be redeveloped to ensure they give accurate & up to date advice This recommendation was made at the previous inspection but was not assessed on this occasion. There should be an annual development plan for the home made available to the Commission and to other interested parties. A record should be kept of the discussions and outcomes following service user statutory reviews. This recommendation was made at the previous inspection but was not assessed on this occasion. It is recommended that reference be made on accident forms to show what action had been taken following the reporting of an accident. 2. YA23 3. YA39 4. 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