Inspection on 27/03/08 for Acorn Nursing Home

This inspection was carried out on 27th March 2008.

CSCI found this care home to be providing an Adequate service.

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 Nursing Home 29/12/09

Acorn Nursing Home 25/09/09

Acorn Nursing Home 06/07/09

Acorn Nursing Home 30/04/09

Acorn Nursing Home 10/02/09

Acorn Nursing Home 02/10/07

Acorn Nursing Home 11/01/07

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Acorn Nursing Home 125 Newton Drive Blackpool Lancashire FY3 8LZ Lead Inspector Christopher Bond Unannounced Inspection 27th March 2008 10:00 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 Nursing Home DS0000068202.V359012.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 Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Acorn Nursing Home Address 125 Newton Drive Blackpool Lancashire FY3 8LZ 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) 01253 392440 01253 305705 matron@acornnursinghome.co.uk Axelbond Ltd Mrs Ann Wilson Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (37), Physical disability (3) of places Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 40 service users to include:*Up to 37 service users in the category of OP (Old age not falling within any other category). *Up to 3 service users in the category of PD (Physical disability). 2nd October 2007 Date of last inspection Brief Description of the Service: Acorn Nursing Home is a large home situated in a residential part of Blackpool. The home is close to Stanley Park and Victoria Hospital. The town centre is approximately two miles away and can be reached by a bus service, which stops near by. There are some small shops in the local vicinity. There are several parking spaces to the side of the house. The building has three floors and a lift is available for the residents to use. Most of the rooms are on the ground floor and the first floor. There are two dining areas and a separate lounge for the use of residents who smoke. The main lounge is at the rear of the house overlooking an extensive garden. There is plenty of space for the residents to sit out when the weather is warm. Information relating to the home’s Service User Guide and Statement of Purpose is included in the welcome pack, which is given to all prospective residents. This information explains the care service that is offered, who the owner and staff are, and what the resident can expect if he or she decides to live at the home. At the time of this visit (27/03/08) the information given to the Commission showed that the fees for care at the home are from £348.23 to £474.00 per week, with added expenses for hairdressing and chiropody. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. As part of the inspection process an unannounced site visit took place over a total of 5 hours on the 27th March 2008. The service users personal files and care plans were examined. Care staff records and recruitment records were also looked at. Safety certificates and medication procedures for the service were also examined. We spoke at length to the Administration Manager of the service during the inspection. Five service users were also spoken to as part of the inspection process. We also spoke to three relatives of people who lived at the home. The Commission for Social Care Inspection also sent out surveys to service users and their relatives/ carers to gather their views about the service they receive. Thirteen of these were sent back to us and the results have been included in this report. We also sent out surveys to the care staff of this home to tell us about their experiences of working at the Acorn Nursing Home. Nine of these were returned to us. Every year the registered person is asked to provide us with written information about the quality of the service they provide. They are also asked to make an assessment of the quality of the service. This information, in part, has been used to focus our inspection activity and is included in this report. After the last key inspection we asked the Company owning the home to complete an improvement plan to tell us how the requirements and recommendations we had made on the report were going to be met. This was received by the Commission and it showed in detail what actions were going to be taken to improve the care practice and documentation at the home. We also completed a random inspection in January 2008 where we found that changes had been made that significantly improved the service. Care planning had improved, as had risk assessment processes. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Everybody who lived at the home had a plan of care that told the care staff and the nurses what care and treatment people were receiving. The last time we looked at these we found that some had not been kept up to date and important information wasn’t being recorded properly. The care plans were looked at during this inspection and were clear and precise, and were reviewed regularly. The information held within them was good and people were receiving better care because of this. Those people who needed bedrails at night could now use these more safely because of proper risk assessment. The complaints procedure was now clear and held the right information. This meant that the residents would have the correct information and timescales should they wish to voice a concern The owner of the home and the manager had rearranged the staff team into four separate teams and shift patterns have changed to suit the needs of the residents. One of the benefits of this was that the care staff had more time to spend with the residents at the lunchtime meal. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 7 There were pressure redistribution aids available for those residents who might develop pressure sores. Several people were using special cushions in the lounge area of the home whilst we were there. There were other pressure area aids available should any one develop pressure sores. There was a clear procedure for the trained staff and care staff to follow for residents who were in need of special care when they were approaching the end of life. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 8 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 Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 9 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): Standards 1 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents were given good information about the purpose and role of this home so that they could make an informed choice about whether they would like to live there. People were assessed properly by the senior care staff of the home to ensure that their needs could be met appropriately. EVIDENCE: The manager of the home ensured that all of the people who were thinking of going to live at the Acorn Nursing Home had clear and concise information about the purpose and role of the home. The Service User Guide was given to new residents and prospective residents to ensure that they had the information to make an informed decision as to whether the home could meet their needs and was right for them. We looked at this document and we saw that a copy of it was available in the vacant bedrooms of the home. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 10 There were good pre-admission assessments held on the residents’ personal files: these were completed before people came to live at the home to ensure that individual needs could be met appropriately by the care staff. Two relatives of people who lived at the home confirmed that an assessment had been completed prior to their family member being admitted. The home does not supply intermediate care and this standard has not been assessed. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9, 10 and 11. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care practices within the home were generally good and thorough care planning helped to improve outcomes for the residents. Some of the care staff, however, did not follow guidelines regarding moving residents. EVIDENCE: We looked at the medication records of the people who were helped to take prescribed medication. These were completed properly and showed that the staff signed for the medication when it was administered. Only trained members of the staff team were able to give out the medication. The medication was stored safely and the room where it was kept was locked when not in use. There were large photographs of the residents before their individual medication records, which helped with identification and minimised the risk of Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 12 mistakes being made. Some of the residents had been prescribed ‘controlled’ medication, which is closely monitored because of its content or strength. We found that this was being stored correctly and the right methods of administration were being used to help ensure that the residents remained safe. We sent out surveys to the residents of the home for them to tell us their thoughts on the quality of care that they received there. A number of surveys were received back. Fourteen people who filled out the surveys (or had help to fill them out) said they ‘always’ or ‘usually’ received the care and support they needed and also the medical support they needed. The same number of people told us that there were ‘always’ or ‘usually’ staff available when they were needed. Two people told us that staff were available only ‘sometimes’. Nine of the care staff that we surveyed said that they were generally happy with the level of care that they provided but there was a lot of frustration because of sickness, and carers not turning in for work, which affected the staffing levels at the home. Some staff said that this impeded the quality of care that they could offer because it gave them less time with each resident. One relative who we spoke to commented, “ We’ve seen a big change in mum, she’s really happy: the staff are always caring and make a fuss of her. It’s excellent here, we’re very happy.” The care plans that we looked at had improved since our last key inspection. There was evidence to show that care pans were more ‘person centred’ and give precise instruction to the care staff regarding how a person should be cared for. This encouraged the staff to look at the strengths of the person and promote their independence. The information held in the plans was in more detail, which should lead to a more consistent level of care. All of the care plans that we looked at had been reviewed on a monthly basis and adjustments were made to reflect the changes in people’s condition. This meant that the care staff had good current information about the person concerned. There was also good information regarding the special diets that some of the residents had and details about the nutritional supplements that were needed. These details were also cross -referenced to the care records of the resident. There were also good risk assessments available for areas of risk within the home, which helped to ensure that the residents were safer. Pressure area care had also improved and there were special cushions available for people at risk of developing pressure sores. These were being used whilst we were there. There was also other specialist equipment available, should this be needed. We found that the nurses and care staff were aware of the individual requirements of each resident. There were also wound care charts available within the care plans. These had detailed instructions and showed that even Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 13 when wounds were healing monitoring still took place and the skin condition was checked for some time after. We also found that residents who needed their blood sugars monitoring were having this done twice daily. Action plans were formulated if the readings were noted to be too high or too low. We still have concerns that instructions regarding moving residents properly and safely are not being properly followed. The manager of the home had arranged training in this area and the care staff that we spoke to said that they had attended. Two care staff were, however, seen using an underarm lift although stand aids and other equipment were available. We talked about this with the carers afterwards and there were conflicting accounts as to which equipment should be used. The care plan for this person did not state how she was to be moved from chair to chair. There were concerns about moving residents during the last key inspection and new equipment and training have been introduced since. Although we also witnessed good practice during this inspection with regard to moving people properly and safely we were disappointed to see poor practice taking place in an area of care that has recently been the subject of enforcement by the Commission for Social Care Inspection. End of life care pathways were introduced for those residents who were terminally ill. The care staff who were spoken to were aware of this process and the benefits that were attained from this kind of care. We also noticed that some of the wheelchairs did not have footplates on them whilst residents were being moved around the home. This can be dangerous and uncomfortable for residents. We also noticed this during the last key inspection of the home and training took place to help ensure that this did not happen. It was disappointing therefore to see that this practice was still in evidence. The Administration Manager said that some care staff removed footplates when residents were travelling in the lift because the lift was small and could not accommodate a wheelchair with the footplates extended. They were being removed and not replaced afterwards. It is important that the manager of the home addresses this issue due to the fact that this was also the subject of a recent enforcement notice issued by the Commission. Overall we found that care practices in the home had improved since our last key inspection. One of the residents commented, “I’m very happy here. I’m looked after very well and the staff are very good. It’s a lovely place.” Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 14 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): Standards 11, 12, 13 and 14. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities were varied and well planned, which contributed to the well being of the residents. Visitors were welcomed and valued family relationships were encouraged. EVIDENCE: The service had it’s own regular newsletter which had been published monthly for some time. This held lots of information about forthcoming events, new staff, entertainment, and support groups. This helped the families and friends of the residents to be involved and informed about what was happening at the home. The care plans held some valuable information about each resident regarding his or her life, occupation, interests and family. This is important because good information helps the carers to develop a good knowledge of the residents and initiate conversation regarding past lives. There was an activities coordinator, who held regular activities, such as bingo, shopping, baking and sing-a-longs. There was an entertainer singing to the residents whilst we were there, entertainers were booked on a regular basis. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 15 The service also had a mini-bus for trips into the community. Daily activities were displayed on the notice board in the hallway of the home. Most of the people who returned surveys to us said that there were ‘always’ or ‘usually’ activities that they could enjoy. The menus for Acorn Nursing Home were available and lunch was being prepared during the inspection. Meals, it was seen, were well planned and nutritionally balanced. Fresh fruit, vegetables and meat were delivered regularly from local suppliers. The dining area was pleasant and tables were set properly and attractively for the lunchtime meal. The care plans showed that the residents’ likes and dislikes regarding food were recorded properly. It was also written down when someone had a special diet, or needed specific help with their eating. The cook was spoken to during the inspection and he confirmed that he was a ware of people’s special diets and nutritional needs. All of the people who we surveyed commented that they ‘always’ or ‘usually’ liked the meals at the home. Two people who wee spoken to during the inspection said that the food was good, and they looked forward to mealtimes. One person commented, “The food is too good, I always eat too much!” The relatives of one resident were spoken to and said, “When mum came she had lost a lot of weight, the staff were very caring with her and spent time encouraging her to eat. She looks like a new person now, and has put on a lot of weight. We are very pleased.” They also commented that they were always welcomed at the home and were offered privacy and refreshments when they visited. Some of the residents were having breakfast when we arrived at the home. This was because they preferred to have a lie in and enjoy a late breakfast. The home had a lounge that was reserved for smokers. One person said that he enjoyed living at the home and felt well looked after. There were regular visits to the home by religious groups who gave services for those wishing to practice their religious belief. A hairdresser made regular visits to the home. One family member commented on how nice their relative looked after having her hair cut and styled. Acorn Nursing Home DS0000068202.V359012.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded through good training, policies and procedures. Complaints are treated seriously to help ensure that the residents’ rights are protected. EVIDENCE: All of the staff that were spoken to said that they knew what to do if someone was unhappy about the service. The complaints procedure was displayed in the home and was part of the Service User Guide. The administration manager was aware of the homes role regarding the complaints procedure and how complaints can be used as a quality tool to ensure that the home is run in the best interests of the residents. The manager of the home also confirmed this in the home’s Annual Quality Assurance Assessment. There were policy documents for the staff to read about how to ensure that people were safeguarded from harm. All of the staff that we spoke to said that they had a good awareness of this important issue and knew what to do if they were not happy about something they had seen. The manager was aware of her responsibilities and knew whom to contact should there be any question regarding how the residents were being supported and safeguarded. Recent training had taken place regarding safeguarding adults for all of the staff. It is important that all of the care staff that work at the home have access to this information as it helps to ensure that people are safeguarded from harm. Copies of all the home’s policies and procedures were available in the main Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 17 office for the staff to read to help them in their roles as carers. There was also a ‘whistle blowing’ policy for staff to report incidents that may happen that they are not sure of. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 18 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): Standards 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are provided with a comfortable, clean, hygienic and homely environment. Bedrooms were personalised, meaning that residents should feel at home with their belongings around them. EVIDENCE: The home was well maintained throughout. The administration manager confirmed that maintenance tasks were generally dealt with quickly so as not to inconvenience residents. All of the rooms were well decorated and there was a nice homely feel to the bedrooms and communal areas. There were three lounge areas, one being at the back of the house. One of these lounges was specifically for residents who smoked. On the day of the inspection the home was warm, clean, hygienic and fresh smelling. We saw the maintenance man / gardener on duty during our visit and it was confirmed that rooms were redecorated when they became vacant. The main corridor had recently been repainted. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 19 Each of the bedrooms that we saw was personalised with belongings, ornaments, pictures and photographs. All the rooms we saw were en-suite, with toilet and basin facilities. There were several communal bathrooms throughout the building with both shower and bath facilities. There was a large garden area to the rear of the house, and plenty of places for the residents to sit out when the weather was good. We also looked at the laundry area where some of the equipment had recently been replaced. There had been problems with the laundry equipment in the past and clothes were being damaged. This has now been resolved. In-house training in Infection Control had been organised on the day we were inspecting this service. This training included the importance of maintaining a clean and hygienic environment to prevent the spread of infection. All of the surveys that were returned to us said that the home was always or usually fresh and clean. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 20 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): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good recruitment procedures at this home help to protect the residents from unsuitable staff. Training for the staff was good, which helps to ensure that the care staff have the skills to do their jobs properly. EVIDENCE: We looked at the way that the service recruits its new staff. There was a strong recruitment procedure in place and new staff had proper check before they began work. These checks included a Criminal Records Bureau disclosure. This process is important because it helps ensure that only suitable care staff are employed in the home and that the residents of the home remain safe. There were enough staff on duty whilst we were there to ensure that the assessed needs of the residents were properly dealt with. There were, however, comments from care staff in the surveys that we sent to them to suggest that sometimes they could not give the level of care that they would like to because of staff shortages through sickness. The administration manager confirmed that the service was sometimes let down by unreliable staff and that action was being taken to rectify this problem. Over 50 of the non- nursing staff had a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). There had been a number Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 21 of training events at the home since the last key inspection. This included instruction in ensuring that residents were assisted to move around the home safely and with dignity. Good, regular training helps to ensure that the care staff have the knowledge, skills and ability to undertake their duties correctly. We asked the manager of the home to improve the storage and content of staff personnel files in our last key inspection report. This had not yet been done and needs addressing to ensure that the information held is clear, concise and correct. Information was still very difficult to find and some of the care staff did not have the required information on their file. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 22 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): Standards 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well, and recent changes have led to improvements in the level of care, and better outcomes for the residents of the home. There are still, however, practices that could affect the safety and welfare of the residents. EVIDENCE: After the last key inspection of this home we asked the company owning the home to complete an improvement plan to tell us how the requirements and recommendations we had made on the report were going to be met. This was received by the Commission and it showed in detail what actions were going to be taken to improve the care practice and documentation at the home. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 23 We also completed a random inspection in January 2008 where we found that changes had been made that significantly improved the service. Care planning had improved, as had risk assessment documentation. The Manager of the Acorn Nursing Home was not available when we inspected the service. We spoke to the Administration Manager, senior nursing staff and some of the care staff during our visit. We also spoke to some of the residents and their relatives. It was clear that the manager and the staff had done a lot of work to since our last key inspection to improve general nursing practices, such as care planning, pressure area care and wound care. There had been a lot of changes and the care staff that were spoken to said that they felt more comfortable in their roles and that they generally had more time to do their jobs properly and more time to spend time with each resident. There had also been changes in shift patterns, the main benefit from this being that the staff had more time to spend with residents over the lunch time period and things were not as rushed. The owner of the home had also been proactive in ensuring that standards at the home had improved. The staff team had been split into four teams with senior care staff being responsible for each team. This had improved the level of care within the home and ensured that each resident was having their care needs reviewed on a regular basis and their care plan updated accordingly. There were records to show that major appliances within the home had been serviced properly and that safety equipment had been examined by suitably qualified persons to ensure that the health, safety and welfare of the residents was being properly addressed. The gas system, electrical installation and lift had been serviced on a regular basis and there were certificates to show that this had taken place. The manager of the home needs to ensure that care staff are using the correct procedures when residents are being assisted to move around the home. We witnessed one person being moved improperly and this affects the safety of the people who live in the home. There has been training for the carers in this area and correct procedures must be used at all times. There were still wheelchairs in the home that did not have foot -plates on. The Administration Manager said that the lift was too small for a wheelchair with the foot -plates extended and some of the care staff removed these prior to escorting people in the lift. These were not being replaced afterwards. Overall, we found that the management of the home had improved since the last time that we undertook a key inspection. One of the staff commented, “It’s a much better place to work, we all know what we are doing and the care plans are much easier to work with, the residents are happier and there’s a better atmosphere.” Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 24 The owner of the home completes regular monthly reports for the Commission for Social Care Inspection about how he finds the service, taking into account the views of the people who live there. He is in contact with the home on a regular basis and makes regular visits. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 25 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 26 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. 1. Standard OP38 Regulation 13 (4) (c) Requirement The manager must ensure that the health safety and welfare of the residents are being addressed properly at all times. This is important when care staff within the home are moving residents. Footplates should be used on wheelchairs at all times to prevent injury to residents unless risk assessments show this to be inappropriate. Timescale for action 15/05/08 2. OP8 13 (4) (c) 15/05/08 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 OP29 Good Practice Recommendations Staff files should be individual and separate and contain full personnel records, including supervision and training records. Acorn Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Nursing Home DS0000068202.V359012.R01.S.doc Version 5.2 Page 28 - 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!