Inspection on 30/10/06 for Acorn Lodge Care Centre

This inspection was carried out on 30th October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Acorn Lodge Care Centre 20/10/08

Acorn Lodge Care Centre 03/05/06

Acorn Lodge Care Centre 31/10/05

Acorn Lodge Care Centre 05/05/05

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Acorn Lodge Care Centre 15 Atherden Road Hackney London E5 0QP Lead Inspector Kristen Judd Unannounced Inspection 30th October 2006 08:30 X10015.doc Version 1.40 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 Lodge Care Centre DS0000062717.V316885.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 Older People. 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 Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Acorn Lodge Care Centre Address 15 Atherden Road Hackney London E5 0QP 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) 020 8533 9555 Acorn Lodge Ltd Diane Jureidin Care Home 98 Category(ies) of Dementia - over 65 years of age (77), Old age, registration, with number not falling within any other category (46), of places Physical disability over 65 years of age (10) Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total number of beds 98 to be used flexibly amongst the various categories. With the following categories: Old Age, not falling within any other category (OP) either sex Residents 50 years of age with a diagnosis of dementia (DE) either sex Residents 65 years of age with a diagnosis of dementia DE (E) either sex Residents 50 years of age (PD) either sex Residents 65 years of age PD (E) either sex One named service user to be admitted in the Physical Disability Category under the age of 50 One named service user to be admitted in the Physical Disability Category below the age of 50 3rd May 2006 2. Date of last inspection Brief Description of the Service: Acorn Lodge Care Home is a purpose built 98 bedded care home situated in a quite residential area of the London Borough of Hackney. The home is within easy access of local transport and community facilities. The home was opened in 2005 and is a purpose-built four-storey building. All the bedrooms are single with en-suite facilities. En-suite facilities consist of a toilet and wash hand basin and are accessible to wheelchair users. There is a passenger lift to all floors. The home is registered to take service users who sufferer from dementia. Information on the service at Acorn Lodge is available in the Statement of Purpose, which is available on request. Fees are currently between £529.92 to £650.00 Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and followed up the requirements from the unannounced visit conducted on 3rd May 2006. The inspector spoke with service users, relatives, staff and the management team during the inspection. A tour of the environment was undertaken and samples of records were examined. There have been 13 requirements and 1 recommendations made following this inspection. Verbal feedback was given at the end of the inspection. It was noted that the management continue to receive the verbal findings positively, and respond positively to resolve and further develop those areas where action is now required. The inspector wishes to thank the management team, staff and service users for facilitating this announced inspection and actively contributing to the regulatory process. A feed back card was left for completion. What the service does well: What has improved since the last inspection? What they could do better: Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 6 The registered manager must focus on ensuring that staff received regularly supervision and this must be recorded in line with regulation. The domestic team need to be aware of when they may be areas to be cleaned particular for example the dinning areas after meal times. The registered manager needs to ensure that care practise is consistent throughout the home. 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 Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, & 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The statement of purpose clearly reflects the service provision .The service users are comprehensively assessed prior to admission to ensure that needs can be met. EVIDENCE: The Statement of Purpose and a Service User Guide were seen both documents are in line with Regulation. The registered manager or deputy assess prospective new service users prior to admission to establish whether the service can meet the prospective service users needs. There has clearly been further improvement in the pre admission assessments. Through the discussion with the registered manager the inspector was satisfied that service users are only accepted if deemed an appropriate placement and that staff are able to met needs. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 9 The inspector examined two files of the most recent admissions as part of the case tracking. An assessment had been completed prior to admission, which was followed by the individual care plan being completed; there were also copies of the local authority statement of need. The Statement of Purpose indicates that service users and relatives are given the opportunity to visit the home prior to admission. The home does not provide intermediate care. If, at a future date, the registered provider should wish to provide such care, consideration would need to be given to staffing levels, appropriate staff training and the provision of dedicated space for this purpose. Standards two and four were fully met at the previous inspection. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There has been a clear improvement in the care planning and risk assessments in place for service users however this must be consistent throughout the home. Evaluation must be regularly recorded and any changes to care included into the care plans to ensure that they are accurate and up to date. EVIDENCE: The inspector examined several care plans during the inspection; a sample was taken from each of the floors. It is acknowledged that there has clearly been a continued improvement in the care planning and risk assessments for service users. The new dementia care plans also focus on service users identified strengths and identified difficulties linked to activities of daily living. Service user files showed evidence of management completing audits and highlighting missing information or aspects of the service users needs that required care planning. Staff are given timescale to complete the documentation. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 11 However it is noticeable that the care plans are of different quality on each floor. For example one care plan examined indicated that the service user often refuses meals and needs encouragement to eat. However the inspector was during the lunch service, the service sat at the table for a short period and prior to receiving the meal got up and left. Staff did not offer any encouragement at all as directed in the care plan. Staff stated that the service user can be difficult and they leave him alone, they stated that they will offer a sandwich later. Whatever direction staff should take must be clearly documented in the care plan. There was evidence that the care plans are generally being reviewed but it was noted that not all are reviewed monthly as required, this was of particular note on the first floor. When they are reviewed monthly there was little evidence of a comprehensive evaluation, which could indicate that the review of the plan has not been meaningful. For example one care plan examined was evaluated with regard to a service user who is prone to wandering stated ‘ x is not better but please keep encouraging’ clearly this evaluation was not in relation to wandering. The registered manager stated that this had been noted to be a problem area. All care must be evaluated and the individual plans updated to reflect any actions to be taken. There has also been an improvement in the risk assessment on service users files. Through the tracking of records it was noted that there had been an incident between two service users. The inspector examined the care plans and noted that one of the service users had a history of aggression however this issue was not on the care plan, and no risk assessment was in place. Another file contained a part completed risk assessment for a service who was prone to falling. Staff must ensure that such documentation is in place and up to date. Evidence was seen of liaison with the tissue viability nurse where appropriate. A nutritional screening had been undertaken for each service user and there was evidence that weight changes were being monitored. Evidence was seen where a service user’s care plans had been updated to reflect what action was to be taken such as high calorie drinks. There was also an improvement noted in the nutritional screening tools being updated regularly. There remain inconsistencies with regard to the monitoring charts. Turning charts were examined for one service user, the care plan did not indicate how often turns should be undertaken however staff stated two hourly. The inspector was later informed by the registered manager that it should be four hourly. The charts completed indicated that on 27/10/06 the service user was turned at 6.00am and not turned again until 14.00, this being a gap of eight hours. On the 28/10/06 the service user was turned at 14.00 and not turned again until 22.00 a gap of eight hours. The records showed large gaps in the recording and some records were not dated which made tracking difficult. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 12 The files showed some evidence that service users are referred to health care services such as dental, optical, chiropodist, and individual referrals for example to the ear nose and throat hospital. Health professional visits are recorded and they are requested to document actions to be taken. The inspector noted that a dietician had seen one service user with regard to ‘peg feeding’. There were concerns regarding lost of weight. The inspector compared the directions given with the recordings made on a daily basis. Concern was raised, as these did not correspond. Through discussion with staff the inspector was satisfied that appropriate the nurse in charge had made decisions however these decisions were not recorded. The registered manager must ensure that staff record such decisions formally. Service users movements are restricted with coded door locks to ensure they cannot leave the unit independently. This has now been assessed on a individual basis and some of the service uses have been given the code. One service user was observed using the key codes during the inspection to access other floors in the home. Pressure relieving equipment is provided random samples were checked during the inspection, there were no concerns at the time of inspection. The inspector did random checks on medication on three floors. There has been a marked improvement. No errors were found and MAR records were in good order. Standard ten was met at the previous inspection. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There has been further improvement in the development of suitable activities. Meals are of a high standard however the satellite kitchens must be maintained to the same standard as that of the main kitchen. Service users must always be offered choice in all aspects of day-to-day care. EVIDENCE: There is evidence that service users are encouraged to bring their own possessions on admission. The inspector viewed a random selection of service users bedrooms and they all contained personal possessions including toiletries, pictures, photographs and ornaments. There is a full time activities coordinator in post in addition to a second person on Wednesdays and Fridays. The activities are conducted on different floors to ensure that even the most dependant services user have on opportunity to join in. During the inspection a group of twelve-service user took part in a bingo session. The service users Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 14 files also contain a social care plan and recording when they undertaken activities. There was evidence of service users who did not take part in the communal activities having one to one sessions. During the inspection service users were sitting in the gardens, listening to music and watching television. However the inspector raised concerns as towards the end of the inspection it was noted on the dementia floor that service users where in the main lounge with one staff member, the television was on and loud music playing over the top. The inspector spoke with the staff member who stated that some service users wanted to watch the television and some wanted to have some wanted music. There are however two lounges on this floor and thus service users can be accommodated separately. This sought of practise must cease and staff must endeavour to meet service users needs in acceptable manners. The inspector noted that a Christmas programme had been developed starting with a Christmas fair, entertainers, a pantomime trip and carol singers coming into the home. Relatives were being invited to join service users for Christmas dinner. Visitors were observed being able to spend time with the service users and were very relaxed in the home. The inspector had the opportunity to speak with several relatives who were present during the inspection was all were very complimentary of the staff and the care provided. One relative commented that they were made to feel welcome and often were invited by staff to stay to eat with their relative. Most service users finances are either managed by the home or the service users families. Records were seen during the inspection. There is a robust system in place. Finances checked were deemed correct on the day of inspection. It is clear that much work has been undertaken in this area. The inspector observed lunch service; the presentation of the food was good. The inspector noted that staff served up a pureed meal for one service, and took time to separate the individual foods/tastes as sent up by the kitchen. However the inspector raised concerns as a staff member was observed to mix the meal prior to assisting a service user with feeding. The staff member when question as to why this was the practise stated that the service user ate better if the food was mixed. The inspector is concerned at such practise, if service users need there meals being prepared in a particular manner this such be clearly recorded in their care plan and the kitchen informed so that the service users meal can be presented in a suitable manner. The inspector also noted that staff did not offer any choice and service users were given drinks even though there was a choice available. There were also Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 15 concerns at the manner as to how service users were assisted to feed but this will be addressed later in this report. The inspector spoke with the kitchen staff; at present the menus are on a fourweek cycle. Menus seen were found to be balanced and interesting, offering culturally appropriate meals on occasions. Service users spoken to during the inspection commented that the food was good. Most foods are home made including cakes for afternoon tea. A relative who stayed for a meal on the day of inspection was also complimentary. The cook was cooking home made cake for a service users birthday the day following the inspection. On inspection the kitchens were clean and well organised. The inspector saw the food storage facilities; fresh, frozen and dry stocks were appropriately stored. Fryer oils were very clean. Staff maintain relevant daily checks on the temperatures of the fridge and freezers, records were seen that were up to date. The inspector however checked the satellite kitchens during the inspection and noted that food was not dated when opened, or wrapped correctly. Two of the fridges required cleaning. These fridges must be maintained to the same standards of those in the main kitchen at all times. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are clearly recorded, investigated and outcomes/actions were noted. EVIDENCE: The complaints policy and procedure includes the information that complainants can approach the Commission without going through the formal complaint procedure of the home. The contact details given for the Commission are correctly given. The registered manager investigates complaints and concerns that service users, relatives or staff may have. Through discussion with the registered manager it appears that relevant procedures are followed and formal complaints are dealt with appropriately within stated timescales. Records of complaints were seen which clearly recorded the investigation that took place and the outcomes. The registered manager informed the inspector that all service users been entered onto the electoral role .The inspector evidence the home financial systems in place. The system seems robust and records were easily accessible. Standard 18 was met at the previous inspection. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is of a high standard however there needs to be systems in place to address cleaning issues as they occur. EVIDENCE: The location and lay out of the home is suitable to meet the service users needs. A tour of the premises was conducted. The home is situated in a quite residential area of Hackney is within easy access of transport links and the local community. The home is within walking distance of some local amenities; there is a small garden area surrounding the home. There is parking available. The home is a purpose built premises, on four floors. All of the bedrooms are single, having en-suite facilities. There are main communal areas on each floor and small satellite kitchens. The staff provide snacks and drinks from small satellite kitchens, which are on each floor. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 18 Random selections of bedrooms were seen; all of which had been personalised and were comfortable. It is was recommended in the previous inspection that as staff complete a handover in the service users individual rooms that any such issues are raised at this time and reported to the domestics on a daily basis. The inspector noted that such issues are now being recorded in the communication book on the individual floors. There was evidence of appropriate aids and adaptations available for service users including mobility aids and hoists with accompanying slings. The bathrooms have suitable equipment to meet the need of service users. There is a call system throughout the home. Specialist equipment is available for transferring service users. All of the communal areas and service users bedrooms were of generally of adequate cleanliness. However there were areas such as the 3rd floor dinning areas that were not to standard with some dried food noted on the walls and the floor required cleaning. The inspector also noted that following meals service the floors in the dining areas were not cleaned. This was of particular concern on the ground floor as the activity for the afternoon was being held and there was much evidence of what held been for lunch evident on the floor. It was also noted that on the dementia floor and first floor there was a smell of urine. Although this reduced during the day it was clearly evident. The inspector was made aware that particular service users were the cause however this must be appropriately/ controlled to reduce the odours. Domestic staff are allocated to each floor, which allows for responsibility to be clear this support is provided seven days a week. There is additional support between 5-8.00pm each day in the home from one domestic that covers all areas of the home. There is a separate laundry facility, which was very clean and tidy on the day of inspection. During the inspection the inspector noted that service users beds had lovely laundered sheets on them. The laundry staff are commended for maintaining high standards in this area. The lint is removed from the dyers daily, records are maintained which were seen. The staff use degradable bags for soiled items, to limit infection spreading. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There has been improvement in this area noted however staffing must be in line with service users needs particularly meal times to ensure that they receive one to one care if needed. Staff need to reflect on their individual practise and the impact that has on individual service users care. EVIDENCE: Rotas indicated that staffing levels are satisfactory with regard to staff to service user ratios. At the time of inspection the staffing was 1 to 5 residents. However the inspector noted that one of the registered Nurses on duty had worked two waking nights followed by a late shift. This meant that she had a gap of 5.45 hours between the twelve hours night shift and the next shift. Such practise is concerning and the registered manager must monitor such issues. As previously stated in this report the inspector raised concern during the lunch service with regard to staff not offering any choice. It was also note that during the lunch service there was no interaction between staff and service users at all. Meal times are an ideal opportunity of staff and service user interaction. The inspector spoke with the staff on the third floor about this at the time of inspection. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 20 The inspector also noted one staff member supervising and assisting three service users at the same time. The staff member did not sit down and did not interact at all with the services at this time. Service users requiring any assistance with feeding must receive such care on a one to one basis. Two staff members were observed assisting service users with feeding in their rooms, as they were bed bound; once more there was no interaction at all such practise is concerning. The inspector acknowledges that this was observed on one floor only. There was evidence during the inspection of staff on the dementia floor clearly interacting well with services user during the breakfast period. The inspector saw the training records and was satisfied that the registered manager is actively addressing the training needs of staff. In particular there has been emphasis on dementia care and this is clearly been reflected in the improvements noted with in this report. The registered manager confirmed that out of 48 care staff 11 had completed NVQ Level 2, 10 were on the course and due to complete, and 12 had been registered to commence the course. This will exceed the 50 target required. Standard 29 was met at the previous inspection. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This report clearly reflects the impact that good management has had on achieving standards. There is still further work to be achieved however the inspector is satisfied that this is an ongoing process and that the registered manager is endeavouring to exceed the National Minimum Standards. EVIDENCE: The inspector is satisfied that the registered manager is appropriately qualified and experienced for the role. The inspector acknowledges that the registered manager has undertaken much work since the previous inspection, which is evidenced in this report. The inspector continues to be satisfied that the home is managed in an open and positive manner. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 22 The inspector was informed that the monthly-unannounced visits have not been undertaken over recent months, as the nominated responsible individual has based at the home over recent months. The inspector was informed that the responsible individual/proprietor is now going to undertake the visits in line with regulation. Service users finances were seen; a clear system has been set up following the previous inspection. This was seen and appeared a robust system robust. The registered manager stated that supervision with staff had commenced with some staff although this was clearly not up to standard. The inspector saw some records that indicated some staff had received one or two supervision sessions whilst other had received none. The registered manager has now developed a recording tool for the supervision sessions. However this remains an outstanding requirement that must be addressed as a matter of urgency. Relatives meetings are being held although minutes reflected that they are poorly attended. The registered manager is hoping that this will improve. Health and safety checks are undertaken and relevant and valid certificates were available for inspection. Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x 3 3 3 3 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 3 3 1 3 3 Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? yes 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 OP7 Regulation 15.1 Requirement The registered manager must ensure that there is consistency in the standards of service users individual plans and that they are accurately updated following monthly reviewing and evaluation. The registered manager must ensure that risk assessments are fully completed for all service users and are updated following incidents if services user could potentially be at risk. The registered manager must ensure that any decisions with regard to service users acre are accurately and appropriately recorded. The registered manager must ensure that all monitoring records pertaining to service user care are accurately maintained. The registered manager must ensure that the practise as stated in this report ceases. The registered manager must ensure the satellite kitchen fridges are cleaned and that DS0000062717.V316885.R01.S.doc Timescale for action 31/12/06 2. OP7 15.2(b) 31/12/06 3. OP7 17.1 31/12/06 4. OP7 17.3 30/11/06 5. 6. OP12 OP15 18.1(a) 16.2 30/11/06 30/11/06 Acorn Lodge Care Centre Version 5.2 Page 25 7. 8. 9. 10. OP15 OP26 OP26 OP27 12.2 16.2(k) 16.1 19.5 11. OP27 18.1 (a) 12. OP33 26.3.4 13 OP36 18.1(c)(ii) foods are correctly stored at all times. The registered manager must ensure that service users be offered choice at mealtimes. The registered manager must ensure that offensive odours in the home are eliminated. The registered manager must ensure that dinning areas are cleaned following meal times. The registered manager must ensure that staff do not work long shifts without reasonable breaks. The registered manager must ensure that service users received one to one care when requiring assistance with feeding. The responsible individual must ensure that monthly visits are conducted and reports are made available for inspection. The registered manager must ensure that all staff in the home be appropriately supervised at least six times a year. Supervision records must be maintained. (Timescale of 28/02/06 not met) 30/11/06 30/11/06 30/11/06 30/11/06 30/11/06 31/12/06 31/12/06 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 OP15 Good Practice Recommendations The registered manager should ensure that food is served in an appetising manner Acorn Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East London Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Lodge Care Centre DS0000062717.V316885.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!