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Inspection on 06/02/09 for Acorn Retirement Home

Also see our care home review for Acorn Retirement Home for more information

This inspection was carried out on 6th February 2009.

CSCI found this care home to be providing an Good 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Acorn Retirement Home 102 Birmingham Road Walsall West Midlands WS1 2NJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Wendy Grainger     Date: 0 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Acorn Retirement Home 102 Birmingham Road Walsall West Midlands WS1 2NJ 01922624314 01922634549 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Lloyd Davies,Mrs Margaret Davies Name of registered manager (if applicable) Mr Lloyd Davies Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Acorn retirement home is a large detached house situated in an established residential area set back from a main route close to Walsall town centre. The house has well maintained and pleasant gardens to the rear and car parking space at the front. The home has been adapted for provision of care to older people.The home is owned and managed by one of the providers. There is also a deputy manager with an established staff team consisting of care staff, cooks and cleaners. Fees charged range from £425 to £346 per week with £346:26 for respite care per week. The fees were current at the time of the inspection. Readers may wish to contact the service for the current fees. 0 Over 65 18 care home 18 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The overall quality rating for this service is 2 star. This means that the people who use the service experience good quality outcomes. This unannounced key inspection was carried out by one inspector who used the National Minimum Standards for Older People and outcomes for people using the service as a basis for the inspection. We were provided with documents on request, which included:staff training, menus, medication administration records and care plans. We spent time with the people who use the service and observed the lunch and medication administration. We spent time with and spoke to a number of the people who were present at the service during the day. Care Homes for Older People Page 5 of 26 Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and combined Service USers Guide is over subscribed with information that is not needed. It would make understanding easier if only what needs to be included is in there. Our pharmacist has made a requirement for the provider to purchase an approved controlled drugs cupboard. This is so that this type of medication is stored safely and it is secure. The purchase of alginate bags to transport and wash soiled linen in would better prevent any risk of spread of infection. Care Homes for Older People Page 7 of 26 Review of the staff supervision record by including an audit of staff training would be an improvement and better evidence that it meets staff needs and therefore needs of the people who use the service. Better fire risk assessment processes such as; completing contingency plans in the event of an emergency would better ensure the safety of people using the service and staff. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may wish to use this service receive all the information they require to allow them to make a choice about its suitability for them. People are properly assessed so that they can be assured the service can meet their needs. Evidence: The Statement of Purpose we saw contained numerous documents. It would be easier to understand and more user friendly if only the most needed and relevant information was included. We saw that the Statement of Purpose detailed the weekly fees charged for recieving the service. We were told in the services completed Annual Quality Assurance Assessment (AQAA) that the service had an assessment of need document. We saw one of the assessment documents which was detailed and identified the prospective persons needs. We found that following the assessment being carried out by the provider an invitation for a lunch visit is offered. This is good as it means that people are given a chance to try the service to help them decide if it will meet their Care Homes for Older People Page 10 of 26 Evidence: needs. We told the person in charge during our inspection that admission processes could be improved by confirming in writing to each person that their needs can be met. This would then give people clear assurance that their needs will be met. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service meets the personal, health and emotional needs of the people who use the service. Evidence: Information provided by the manager in the completed AQAA told us that care plans contained relevant information to ensure the care required was provided. During our observations of staff on duty it was clear that they knew each person well and their individual needs. We looked at two care plans and saw that a corporate care plan form was being used. This system could be improved if individulised care plans which would better capture peoples personalised needs. were introduced. The daily reports that we looked at were very limited to one word for example, fine or slept well. We were told that these are the guidelines from the provider and any issues that were identified in the reports are dealt with. From the evidence seen some written concerns had not been followed up in writing. We suggested that the person responsible for the report should sign the entries as this would better audit care provided and how any problems or changes identified had been dealt with. Staff on the day were seen and heard to be Care Homes for Older People Page 12 of 26 Evidence: sensitive to peoples needs, one member of staff was observed to assist a person during lunch. We saw that she spoke to the person and encouraged her to enjoy the meal. We were told in the services completed AQAA that two staff had attended the Mental Capacity Act awareness training, further training was planned for the remaining staff later in the year. We were told that staff had received training in the care of people with dementia, this was a short course of half a day and it was agreed that more training was to be sourced this year. This will better ensure that all the staff had the ability and knowledge to deliver the appropriate care to people with a dementia. We were told in the services completed AQAA that the staff had received training for the safe handling and administration of medication. Staff need to ensure that at all times they observe that the medication was taken by the individual prior to then signing the medication record. Medication should be administered to the individual from the container in the trolley and not taken to the person in an uncovered pot. We looked and found that the records for the administration of medication were satisfactory. The provider was later advised by our pharmacist to provide a controlled drugs cupboard and to locate it in an alternative area from the present medication. It is advised that on the Medication Administration Records (MAR) to provide written information to where prescribed creams should be applied. Arrangements were in place the continued health needs of the people who use the service. We were unable to speak to any professional on the day. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are offered choices regarding their preferred daily routines. People are encouraged to maintain contact with their family and the community. Meals provided are appropriate to peoples needs. Evidence: We were told in the services AQAA that the service promotes daily activities. The service keeps a record of all activities undertaken. During the morning some people read the newspapers and just talked together. A person said, It is quiet here we just talk to each other in the mornings. During the afternoon we saw people doing a crossword with a member of staff. We were told by one person that, It keeps my brain going. Staff told us,people are good at doing the crossword. Other activities include knitting and craft work. We saw some of this work displayed in the entrance hall. People told us the enjoyment they had experienced by joining in the bird count for the Royal Society for the Protection of Birds (RSPB) and the selection of birds they see come to the garden. We see so many birds that came for the food. Spiritual needs were recognised and respected,. We were told that some people who use the service had independently started a small, monthly, prayer meeting. The service operates an open door policy for visitors with the stipulation in the Care Homes for Older People Page 14 of 26 Evidence: Statement of Purpose that visiting at meal times for peoples privacy is best avoided. We saw that the menu offered a balanced diet. We observed the lunch time. Food served was well presented and portions were of a good size. People had the choice of the main menu or an alternative option. We observed one person being sensitively assisted to eat by a member of the staff. We were told that the food was good. Staff training information told us that a Food and Hygiene course has been booked for March 2009. I enjoyed my lunch. I can have as much or as little as I want. Its good food here theres always a choice. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make a complaint. Procedures and staff training ensure taht people using the service are safeguarded and protected from abuse. Evidence: We had not received any complaints about the service since the last inspection in 2008. The complaints procedure was available in various documents and is made available to all the people who use or visit the service. The Owner is going to review complaint documents to ensure that any needed contact details were current. We were told by people that they were aware who they would speak to if they had a complaint. I would speak to my son. I would tell Mr Davies or Ruth. Staff told us how to implement the procedure to raise a complaint with the manager/provider or us. Staff training records we looked at evidenced that the staff had received training in the recognition of abuse. The staff on duty confirmed to us that they were aware of the procedure to follow if they had any concerns. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service were provided with a warm, safe and comfortable environment. Evidence: We looked around the premises, in general the overall condition was satisfactory although a number of the chairs seen in the lounge would benefit from replacing or the cushions upgrading to ensure the comfort of individuals. We were told that the dining room was going to be the next for re-decorating. Each of the areas seen were warm and well ventilated. Bedrooms seen were personalised to suit individuals tastes. During looking around the service we identified that the wardrobes were not secured to the walls, this was fully discussed with the provider who told us he was unaware of the health and safety problem this posed. The provider agreed with us a time scale for the work to be completed. We have since the inspection been contacted by the service to inform us the work had been completed the following day. The home is located on a busy main road, no external sound emits into the service. We saw that there are well maintained gardens at the rear for people to enjoy and parking space at the front. The laundry, while small was able to meet the needs of the people who use the service. There was a need to provide alginate bags to prevent any cross infection and Care Homes for Older People Page 17 of 26 Evidence: further protect the staff and people who use the service while washing and transporting soiled linen. Staff confirmed to us that they had access to protective equipment, which was observed within the laundry. We made observation in the kitchen the fridge/freezer was in a poor condition and needed replacing. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well-trained staff team support the people who use the service ensuring they are safe. Evidence: The provider ensured that all the relevant checks and references would be obtained prior to any new employment ensuring that the people who use the service are safeguarded. Staff confirmed to us that they had had checks prior to working at the service. An inspection of two staff files found that they contained the required information, plus mandatory training and extra training relevant to the care of people could be identified. We were told in the AQAA that the service had achieved the required National Vocational Qualifications level 2 no person on the staff had level 3. During the time spent in the service the staff demonstrated their knowledge and competency in their role of carers. They supported individuals and interacted in a relaxed manner. We evidenced the staff supervision records, a suggestion was made to simplify them to provide the provider with an audit trail and ensure that all staff are trained to meet the needs of the people using the service. Care Homes for Older People Page 19 of 26 Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are safeguarded by the competent manager and staff team. The service operates to the best interests of the people who use it. Evidence: Prior to the inspection we had sent out an Annual Quality Assurance Assessment (AQAA) for the manager to complete, this was returned to us prior to our visit and within the requested timescale. The document we received was detailed and provided us with information about the service. The completed AQAA is a legal requirement and it enables the service to undertake a self-assessment, which focuses on how well outcomes are being met for the people who use the service. It also gives us some numerical information about the service. We received positive feed back during the day and from the questionnaires given to the people who use the service by the provider which included: I feel at home we like Mr Davies he is very nice. Everyone is very kind to me. Care Homes for Older People Page 21 of 26 Evidence: If I have a problem I can speak to Ruth. I have pretty well of visitors from the church. The provider has had over twenty years in the caring profession and had the experience to run the home. We were told that he is considering enrolling on the Leadership and Management course later in the year. On this visit we did not checkout all the Quality Assurance records but from the records the system is reviewed twice a year. The provider is developing a fire risk assessment for the people who use the service and contingency plans in the event of an emergency. Records and certificates evidenced that equipment was serviced to meet the guidelines of the manufacturers and legislation. We evidenced from the staff files that supervision takes place on a regular basis to ensure that the staff have the support they need to meet the needs of the people who use the service. Finances held on behalf of the people were sampled at random the records were found to be satisfactory Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 The registered person has confirmed in writting to the person that having regard to their needs and following the assessment that the service can meet all the person physical, emotional and health needs. Care records should clearly show what action has been taken when concerns or changes are identified. It is important that the daily staff reports are followed up and confirmed in writing to ensure that there is an audit trail of concerns raised. To ensure the safety of the people who use the service, medication administered should be observed to be taken by the person. Medication should be administered from the trolley and not transported across an area in an open pot. To ensure the Misuse of Drugs Act is complied with a recognised controlled drugs cupboard must be purchased. It is recommended by the pharmacist consulted that the cupboard is sited in a cooler location. To ensure that food is stored appropriately for the safety of the people the fridge- freezer needs to be replaced. To review the contact details for the Commission for Social Care recorded in the Statement of Purpose and Service Page 24 of 26 2 3 7 7 4 9 5 9 6 7 15 16 Care Homes for Older People Users Guide are updated, ensuring the details are current. 8 26 To prevent any cross contamination while transporting and washing soiled linen, it is important that alginate bags are purchased and used by the staff. To maintain the food safety for the people who use the service it is advised that the combined fridge and freezer is replaced It was suggested that the supervision records for the staff were simplified to provide an audit trail ensuring the staff are confident that the time during supervison is focused on the outcomes for them also. It is important that the fire risk assessment for individuals and contingency plan is completed for the safety of the people who use the service. It is important for the safety of all the people and staff that records identify all the staff have been part of a fire drill. 9 26 10 27 11 38 12 38 Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!