Inspection on 25/10/07 for Acorns

This inspection was carried out on 25th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Acorns 13/10/09

Acorns 13/06/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Acorns Walton Heath Pound Hill Crawley West Sussex RH10 3UE Lead Inspector Mrs J Hough Unannounced Inspection 25th October 2007 12:30 Acorns DS0000066069.V347519.R01.S.doc Version 5.2 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 Acorns DS0000066069.V347519.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Acorns Address Walton Heath Pound Hill Crawley West Sussex RH10 3UE 01293 885331 P/F 01293 885331 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) Evesleigh Care Homes Ltd (ILIACE Group) Post vacant Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th June 2006 Brief Description of the Service: Acorns is a care home registered to accommodate up to five people with learning disabilities. The Registered Provider is Evesleigh Care Homes Ltd (ILIACE Group) part of the Independent Living Group. The manager’s post for the home is at present vacant. The home is a detached property situated in a small cul-de-sac on the outskirts of Crawley town. There is easy access to all community facilities including a local rail and bus station. Limited parking is available to the front of the house. Accommodation is provided over two floors. People have their own en suite bedroom, located on the first and ground floors. On the ground floor there is a comfortable living room with a large T.V. a good size kitchen, a utility room, a dining room, an office and a staff toilet. The garden is accessed via the kitchen door at the rear of the property. There is a large balcony area with decking and steps leading to a small enclosed garden. Current fees are from £1100.00 to £1750.00 per week. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key unannounced inspection was carried out on 25th October 2007 and started at 12:30 hours and finished at 17:30 hours. The previous manager had completed an Annual Quality Assurance Assessment before the inspection that included information about the quality of the service and future planned developments. On the day of the inspection there was no manager or senior care worker working in the home. A senior care worker was informed by telephone of the inspection and kindly came to the home in order to assist in the inspection process. The Area Manager for the registered company came to the home at the end of the day to listen to the feedback from the inspection. Four members of staff, a senior care worker and four people living in the home were spoken to at the time of the inspection. Case tracking was carried out by reading relevant records and information held on staff and the people living in the home. All areas of the home were visited including bedrooms of the people living in the home with their agreement. Samples of records for the running of the home were seen including recruitment records, medication, training records, and financial records. What the service does well: Acorns is a homely and comfortable home for people to live. People are supported and encouraged to take part in a range of social and educational pursuits. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 6 Care plans are detailed and inform staff about the individual needs of the people and how they wish to be supported to maintain their level of independence. People are able to furnish and decorate their private bedrooms with their own personal furniture and belongings. People treat the home as their own and choose how they spend their time. Staff communicate effectively with people and the home has a friendly and relaxed atmosphere. What has improved since the last inspection? What they could do better: Develop an effective quality assurance and quality monitoring system to gain the views of people living in the home, relatives and other professionals. The stair carpet and the sofas in the lounge need replacing. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 7 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. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have the information they need before making a decision to move into the home. People’s needs are thoroughly assessed before they move in. EVIDENCE: There is a Statement of Purpose and Service User Guide available in the home in a suitable format for the people living in the home. Both documents will require updating when a new manager is appointed There have been two admissions to the home since the previous inspection. All the people in the home had thorough assessments carried out before they moved in. The home has a trial visit policy in place so that people can visit and stay overnight or during weekends. The home does not offer a place to people whose needs they cannot meet. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 10 However a new admission is the subject of three monthly reviews to ensure the placement is appropriate. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The changing needs of people are reflected in individual care plans. People are supported to makes decisions about their lives and to take risks as part of an independent lifestyle. EVIDENCE: The care records of three people were looked at in detail and showed care plans are drawn up from the assessments and in the presence of the individual and/or their families. The information was detailed and included information about people’s social and personal care needs. There is a key worker system in place to make sure that individual needs are being monitored monthly by one member of staff who knows the person well. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 12 However due to the high turnover of staff the monthly reviews are not in some cases up to date. People are involved in individual formal reviews that take place every six months that also include relatives, care managers, health professionals etc. Risk assessments are in place where necessary to ensure people maintain their current level of independence. An example of a risk assessment showed an alternative method for making a hot drink for one person to help maintain her present level of independence. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have access to a range of educational and social activities. People are offered a healthy diet that suits their individual preferences. People are able to keep in touch with family and friends. EVIDENCE: A range of activities and social events are provided including trips out to the cinema, pub, shopping and the gym. Some people attend college courses for cooking, pottery and computer skills. Household tasks such as cooking, preparing meals, gardening and cleaning and washing are undertaken by some Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 14 people living in the home. One person said she enjoyed dusting and vacuuming. There was a photo board displayed in the home showing past events and trips out with people living in the home and staff. In the evenings people spend time in the lounge watching television or spend time in their rooms. It is clear from feedback provided that people are encouraged and supported to maintain contact with their family and friends. Two people said they phoned their parents daily and some went home for regular visits. Visiting arrangements in the home are open. Each year a holiday is arranged and plans are in place to arrange a holiday for 2008. People are supported to attend church services of their choice. Weekly meetings are held with people living in the home, and during this meeting menus are discussed and developed. Menus showed a healthy and balanced diet was provided. The main meal is cooked in the evening when people get together and eat in the dining room, apart from one person who has chosen to eat in her room. Some people assist in preparing and cooking the meals. At the last inspection it was assessed that people were not shown respect from some staff, as they were often referred to as “the girls” and excluded from some staff discussions. On the day of the inspection staff introduced people by name and were interacting well with them. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive the personal and health care they need. Medication policies and procedures are in place to ensure the correct and safe administration of medicines. EVIDENCE: Care plans provide staff with detailed information about the needs and preferences of people, with guidance on the way personal care should be provided. Personal choices in relation to what people want to wear and times for getting up and going to bed are recorded. Specialist support and advice is obtained when needed and records show that some people have input from psychologists, continent advisors, district nurses and a behavioural specialist. Appointments are arranged when needed for people to visit other health professionals such as dentists, opticians etc. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 16 It has been assessed that none of the people are able to keep or safely take their own medicines. The medication records seen were up to date and in order. All staff that administer medication have attended training with the supplying pharmacist, on the safe handling and storage of medicines. All medicines disposed of are recorded, signed and dated. One incident involving a medication error had been reported and acted upon immediately, and appropriate actions taken. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are informed and supported on how to make a complaint and their complaint or concern is looked into and action taken to put things right. Staff have training on abuse and understand their responsibilities in protecting people from harm. EVIDENCE: People have a copy of the complaints procedure in a suitable format to help them understand the procedure for making complaints. People are given an opportunity to talk about any concerns as part of the weekly meetings or they can talk to the manager or senior member of staff on a one to one basis if they prefer. The book for recording complaints showed that the home had received one complaint. On speaking with the senior carer it was clear that the complaint had been dealt with following the correct procedures, although details had not been recorded in the book giving the investigations, actions and outcomes. Training records demonstrated that staff have training on abuse and are aware of how to recognise signs of abuse and their responsibility in reporting all incidents. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 18 Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe and well-maintained home that is homely, clean and comfortable. EVIDENCE: All areas of the home were clean and fresh and the staff and people who live in the home take responsibility for keeping it clean and tidy. All private bedrooms have en-suite facilities and people are able to furnish and decorate their own rooms as they wish. The quiet lounge area has now been converted to a fifth bedroom following a variation to the registration of the home from four to five people. Generally the home was well maintained although the stair carpet and the sofas in the lounge are shabby. It was confirmed that these are part of the maintenance programme and will be replaced in the near future. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 20 The garden is small and enclosed and includes a decked area. The garden is well maintained and some of the people assist in the gardening with the maintenance person. The laundry facilities are suitable for the number of people at Acorns. People are supported to do their laundry depending on their level of ability. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by sufficient numbers of staff that are competent and qualified for their work. People are confident in the staff knowing that the home carries out all the necessary checks on new staff to make sure they are suitable. EVIDENCE: Staff rotas show that the manager and /or a senior care worker plus four care workers work in the home throughout the day. At night there are two care workers one awake and one sleeping-in. However the home is at present without a manager due to the previous manager having left. There is an acting manager covering the home until a new manager is appointed. There has been a high turnover of staff in recent months with eleven members of staff having left. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 22 There are six staff currently employed at the home and there are staff vacancies for two full -time care workers. At present bank staff are used to fill vacant shifts. The home is committed to training the staff, and staff confirmed that they have all the necessary training for their work. Staff training records show that mandatory training is updated as required and specialist training is provided to meet the needs of people in the home. The Annual Quality Assurance Assessment shows that three members of staff have achieved a National Vocational Qualification (NVQ) in care. Three staff files were seen to check the recruitment procedures for the home. It was noted that according to the information available, a senior care worker was employed prior to a satisfactory Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) check. It was confirmed that the member of staff was completing the induction training away from the home prior to checks being completed. There was no evidence found in another file of a Protection of Vulnerable Adults (POVA) check prior to employment. It was confirmed that the POVA check was obtained prior to employment and kept on the computer system. It was advised that a copy be kept in staff files as evidence that checks are completed. Staff confirmed that they are given a job description when commencing employment Staff confirmed they had formal staff supervision every month but since the manager left it has fallen behind. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is no permanent manager for the home and temporary management arrangements are in place until a new manager is appointed. The views of people play an important part in future developments for the home. The environment is safe for people and staff because health and safety practices are carried out. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager’s post is at present vacant. The previous manager was in post for almost a year and it was noted that no application was made to register with the Commission of Social Care Inspection (CSCI). The Area Manager was reminded that on appointing a new manager an application to register must be undertaken. Interviews are being held shortly to appoint a new manager. At present there is no permanent managerial cover for the home but plans are in place for an acting manager to be assigned to the home until a new manager is appointed. The Area Manager of the Registered Company also visits the home on a regular basis and is in close contact with staff. A quality assurance survey was last conducted in June 2006 when it was noted that no in-house surveys or questionnaires were available. Following the takeover of the registered company a quality assurance and quality monitoring system is being developed in order to find out the views of the people, families, care managers and other health professionals. However regular meetings held with the staff are opportunities for people to give their views and opinions on the home. A valid insurance certificate covering employer’s liability was displayed in the home. Relevant policies and procedures and risk assessments related to the health and safety and welfare of people living and working in the home are in place and were reviewed in 2007. Accidents and incidents are recorded and reported as necessary. There were two incidents and one minor accident recorded since the last inspection in June 2006. Staff training records show staff have updated training in fire, moving and handling, first aid, infection control and food hygiene. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 25 Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X 2 X X X 3 Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 27 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 YA39 Good Practice Recommendations 39 - Effective quality assurance and quality monitoring systems, based on seeking the views of people are in place and carried out at least once a year. Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Acorns DS0000066069.V347519.R01.S.doc Version 5.2 Page 29 - 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. 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