Inspection on 12/12/05 for Acorns Care Centre

This inspection was carried out on 12th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Care Centre 23/01/07

Acorns Care Centre 21/07/05

Acorns Care Centre 05/11/04

Acorns Care Centre 17/06/04

Similar services:

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Chirnside House

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

CARE HOMES FOR OLDER PEOPLE Acorns Care Centre Parkside Hindley Wigan Greater Manchester WN2 3LJ Lead Inspector Lindsey Withers Unannounced Inspection 12th December 2005 08.20 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 Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 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. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Acorns Care Centre Address Parkside Hindley Wigan Greater Manchester WN2 3LJ 01942 259024 01942 259024 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) Mr Kevin Hall Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39), Terminally ill over 65 years of age (2) of places Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Total number of places - 39. That at all times a suitably qualified registered nurse is working in the care home. minimum staff ratios are as adhered to That at all times suitably qualifed, competent, and experienced persons are working in the home Within the total registered number of 39 , there can be up to 2 TI(E) which will be service user specific places for the duration of the placements. 21st July 2005 Date of last inspection Brief Description of the Service: The Acorns Care Centre is located on the outskirts of Hindley town centre, close to shops, a park, and other amenities. The main bus route runs close by. The Acorns is purpose-built, and accommodation for service users is provided on three floors. Accommodation is provided for a total of 39 service users, both male and female, who are over the age of 65. The Acorns provides nursing and personal care. Within the total of 39, two service users may be accommodated who are over the age of 65 and who are terminally ill. All accommodation is offered on a single-occupancy basis. All bedrooms have en suite facilities. Parking for visitors is limited. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a 4 hour period and was unannounced. The main focus was on those areas not assessed during the previous inspection, so that over both visits all key standards were looked at. Part of the time was spent with the Manager and her deputy, going through the paperwork that has to be kept to show that the home is being run properly. Part of the time was spent observing practice in the main lounges and dining areas. The Inspector had good conversations with three members of staff and five residents. The Inspector spoke to other staff and residents over the course of the inspection. Since the last inspection there has been a change of Manager. The new Manager’s registration with the Commission for Social Care Inspection was in progress at the time of this visit. What the service does well: What has improved since the last inspection? The change of Manager has brought with it a shift in management style that leans heavily towards inclusiveness, improvement and raising standards. The Manager believes that one way to raise standards is to employ a stable workforce that is properly supervised and trained, and that is encouraged to develop. To this end, some formal supervision of staff has begun but informal supervision goes on daily. A training programme had been put in place, and a fuller programme will be developed, based on the outcomes of the appraisals Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 6 that were in progress at the time of this inspection. Staff attendance has improved: there is now very little short term sickness. The systems used to monitor the quality of the service is better, and residents, their supporters, and staff are being encouraged to come forward with their ideas for making the service better. The new telephone and fax system will make communication with the home easier. Information kept at the main reception desk tells visitors which staff are on duty, so a visitor will know whom they need to speak to if they have any queries. 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. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home has a thorough pre-admission process. Residents coming to live at The Acorns can be sure that their needs have been assessed and can be met by the home. EVIDENCE: A sample of three files was looked at that related to residents living at The Acorns, including one for a person who had been admitted as an emergency. Since the last inspection, the information gathered prior to admission has improved. There was evidence to show that the resident or their supporter (such as a family member, social worker or representative from Age Concern) had been involved in the pre-admission assessment process. Where a resident had been transferred from another care facility, discharge documentation had been received. Staff at the home had made efforts to fill in gaps in information, for example, in relation to medical history. If there is any uncertainty, the management of the home will liaise with the CSCI in relation to a person’s admission. This makes sure that the home only admits people for whom care services can be provided, in accordance with its certificate of registration. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8 Recording in care plan documentation has improved, but is still marred by errors and omissions. Residents cannot, therefore, be sure that staff are fully aware of their needs. EVIDENCE: A sample of three care plans was looked at. Some improvement to the documentation had been made, much of it initiated by the new Manager, taking into account the requirement made by the CSCI at the last inspection. The Manager advised that, in the New Year, all residents would be reassessed. At that time, the care plan documentation will also be reviewed so that, by February, she and her staff will have a comprehensive picture of each person’s needs, preferences and expectations. This will also ensure that there is evidence to demonstrate that resident and/or their supporters are involved in the care planning process. Staff training is planned. Letters had been prepared and were being sent to all residents (or their representative) to advise them of the planned re-assessment and review programme. All three records showed that care plans had been reviewed at least monthly, and that changes to the care plan had been made, where appropriate. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 10 Residents had seen a range of health and social care professionals, and staff appear to have taken prompt action, as it had become necessary. The records showed where residents had initiated the request to see, for example, the GP. Residents themselves said that if they were unwell, they told staff, who organised a GP visit for them. One lady had seen an ophthalmologist and was waiting for new glasses. Despite the overall improvement in the records, the Inspector identified some gaps and errors in two of the three files making up the sample. In one, accidents had not been properly recorded. In another a weight loss of 3 kg over a three month period had not been followed up in accordance with the home’s policy; there was a gap in entries around the 22nd and 23rd November 2005; around 30th November some information relating to the person’s physical condition was not clear. The person did not have a night time care plan. This would have been appropriate, given the person’s sleeping habit. The Manager agreed to follow up on the matters identified by the Inspector. Many residents living at The Acorns are nursed in bed. However, it was evident at this inspection that care staff routinely call in to see residents to make sure they are comfortable or in need of assistance. As they go about their duties, domestic staff also make conversation with residents who spend time in their own rooms. Domestic and care staff were observed to be reporting back to the nursing staff with any concerns that they had identified or with residents’ requests. This demonstrates that residents nursed or preferring to stay in their own rooms are not isolated and that their general daily care is monitored by staff. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, and 15 Residents enjoy the social life that is offered to them at The Acorns, and say the lifestyle they experience meets their needs and preferences. Residents maintain contact with people, as they wish. Residents like the food that is provided, saying it offers variety and quality. EVIDENCE: The home has an activities organiser who is responsible for scheduling activities and social events inside the home, and excursions from the home to places of interest. The lounge on the top floor has been designated the Activities Lounge. Residents have access to a computer here, as well as music, books, videos, games and puzzles, and arts and crafts. The Activities Organiser has undertaken some relevant training and is currently extending her studies. She has recently joined the home into the NAPA (National Association for Providers of Activities for older people) organisation. Membership of this association should provide ideas and access to resources so that the range and quality of activities provided at the home can be improved. Residents said they very much enjoyed the social gatherings, whether it was a party or listening to an entertainer. Occasionally, residents go to an event at The Acorns’ sister home, The Oaks. Several residents had recently enjoyed a party there. This inspection being close to Christmas, residents said they had Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 12 enjoyed visits by children from a local school who had come to sing for them. They were looking forward to the Christmas Party on 23rd December. During the period of this inspection, one resident went out shopping with a careworker. She said she enjoyed shopping in Hindley: it was not a long walk and the shops had everything she needed. The records showed that a number of residents often go out with family and friends. Visitors are made welcome at the home at any reasonable time. The entrance hall has been changed around so it is a comfortable place to wait. Fresh coffee is available for visitors. A range of information is available here, including the inspection report, a copy of the daily menus, and how to access advocacy services. A recent improvement here has been the introduction of a board that informs visitors who is on duty and who is in charge. Visitors can be clear, therefore, whom they need to speak to if they have any queries. The Manager is looking to expand and further improve this feature in the New Year by including photographs of staff. Several residents were very complimentary about the food provided by the home. One resident said that food was “very good”, there was “lots of variety”, and that “no one thing is served too regularly”. Another resident said she only had a small appetite and that food was served in small quantities for her. Residents had enjoyed a good breakfast from a choice of juice, cereal or porridge, full cooked English breakfast selection, and toast and jam or marmalade. Some residents enjoy particular items such as grapefruit or prunes and these are available each day. The cook and her assistant were interviewed. The cook was able to demonstrate that she had good knowledge about the residents’ conditions, their likes, and their dislikes. She said she very occasionally gets the opportunity to eat with the residents, and finds this beneficial. Menus have been devised with residents, and are changed when something ceases to be popular or a new alternative is discovered. Some residents like traditional food; others are more adventurous and like, for example, lasagne or other pasta dishes. The lunch menu included choices from fruit juice, soup, four types of sandwich, plaice and peas, followed by peach crumble and custard. The main meal is served in the evening. The choices on this day included sausage and onion gravy, potatoes, carrots and turnips or turkey casserole, potatoes and cabbage. Sandwiches were being prepared just before the serving time so they were very fresh. The cook had a list to hand of the lunch-time choices that residents had made. She said there was always enough available of each option to cater for those residents who forgot what they had ordered, or who had changed their mind. Several residents have a soft diet. Their food is served on sectionalised trays, is blended down separately and is enriched so it is nutritionally better. In this Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 13 way, flavours are kept separate and the meal is presented in a way that is attractive. A supply of nutritional supplements are kept in the kitchen in the form of drinks and puddings. The Manager said that supplements are recorded on the resident’s medication chart. Residents who take meals in their own rooms are generally served first. Food is transferred on trays in covered dishes so that hot food remains hot. The cook said that all equipment in the kitchen was working well. There is a separate rota for staffing the kitchen. Kitchen staff are employed in sufficient numbers, so that the need to transfer someone from care to kitchen duties is avoided. The Manager advised that the “big teapot” is being removed from use. In its place, large vacuum hot water flasks have been purchased. Staff will have a supply of teabags, coffee, etc. so that residents can have a drink of their choice, that is made to their preferred strength, at a time when they want it. She felt that this was a positive step, reducing the appearance of institutionalism in the home, and moving to more hotel services. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This section was not assessed on this occasion. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22 and 26 With the exception of two shower rooms, the home is well-maintained. There are sufficient toilets and bathing facilities to meet the needs and preferences of residents, including en suite toilet and sink in each bedroom. Residents have access to a range of specialist equipment, but care needs to be taken to ensure equipment is kept ready for use. With the exception of two shower rooms, the home is kept clean and pleasant throughout. EVIDENCE: Since the last inspection, the owner, Mr. Hall has ordered a new telephone and fax system. It had yet to be installed, but the Manager felt that the new system should make telecommunications in and out of the home better. The Manager advised that, during 2006, Mr. Hall planned to redecorate the whole of the building, including private and communal areas. Those instructional notices aimed at staff have been removed from around the building. Notices that are displayed are for the benefit of residents. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 16 Residents have good sized bedrooms, sufficient to accommodate extra storage drawers or cupboards if residents need them. There was still some evidence of suitcases and other belongings being located on the tops of wardrobes but it was less apparent than at the last inspection. The shower rooms opposite room 14 and room 31 now need some attention. One was being used for storage, the ceiling was water-stained around the manhole cover, and paint was peeling off the walls around the shower tray. There was an unpleasant smell in here, possibly resulting from the water damage. The second shower room had the same problem with peeling paint. The seal around the shower tray was damaged and mould was growing. Health and safety matters relating to these two shower rooms are discussed at Standard 38 in this report. The hot water temperatures were tested in a number of places around the home. Water temperatures were recorded at around 40 degrees, which is acceptable. There was an entry in one care plan, which stated that there had been no hot water on a particular day. The Manager confirmed that there had been a problem on three occasions, following which the engineers had been called to fix the system. The cause of the problem had been different on each occasion. On the most recent occasion, the emersion heaters had been switched on and, after about 45 minutes, there was ample hot water again. The boiler system had been repaired and was functioning properly at the time of this inspection. Heating in the home had not been affected because it runs from a separate system. The Manager is reminded that events such as the loss of hot water throughout the building should be notified to the CSCI under Regulation 37. The home now has a total of three hoists, including one new mini-Oxford hoist that had been delivered in the week prior to this inspection. A stand-aid had also been purchased. Unfortunately, the new hoist had not been put on charge overnight and was not, therefore, ready for use. The Manager said she would look at putting a system in place to make sure all equipment is fully charged overnight. Equipment had been purchased or arranged to bring comfort to residents including a bed cradle, mattress overlay, and specialist mattresses and cushions. Residents had a range of walking aids including walking sticks, zimmer frames, and delta frames. A number of residents had an assisted wheelchair. Storage for equipment and products was being better managed though staff will need to take care not to impede access to fire exits. Signage had been improved on toilet doors so that it was clearer to residents where the toilets were. There is a nurse call system, which residents knew how to use. The call system was in working order on the day of this inspection. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 17 At this inspection, the home was clean throughout and was free from offensive odours. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, and 30. Residents are cared for by sufficient numbers of staff. Staff receive training appropriate to the work they do and are encouraged to develop and expand on their skills and knowledge. Residents can be sure, therefore, that they are cared for by people who are competent. The recruitment process is in line with the home’s policy but is let down by the documentation. Gaps in information could lead to people being employed who are not suitable. EVIDENCE: The home was fully staffed at the time of this inspection: 1 x Registered General Nurse (RGN), 1 x Senior Care Assistant, and 5 (full time equivalent) x Care Assistants covering 8 a.m. to 8 p.m. A health and social care student from Wigan College was working at The Acorns on a week’s placement. Any gaps in the rota had been covered by Bank staff or by permanent staff taking up extra hours. The Manager said that short term sickness is now minimal and any sickness is genuine. There have been some changes to the rota in terms of shifts worked. Keyworkers have been changed around so their skills are put to best use. The Manager explained that a daily allocation sheet had been devised. The RGN on duty would be responsible for telling staff their tasks for the day, and for making sure all floors were properly staffed. The RGN would also be responsible for making sure that there was an escort available for any resident going to an appointment. While this gives the impression that staff might become task orientated rather than applying a person-centred approach to their work, the Manager believes that this practice will reinforce with staff what Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 19 is expected of them. She said that this, together with training, supervision and appraisal, would make a strong and capable workforce. Additionally the home employs ancillary staff including domestics. A new domestic assistant commenced in post on the morning of this inspection. All checks had been made before she began work, and her induction programme began on the first day. Another domestic said she had been in post only a short time. She was able to demonstrate, however, that she had had an induction to the home, and that she had received basic training appropriate to the work she was employed to do. The appraisal programme was in progress at the time of this inspection. Some supervision has taken place but is not yet a regular feature of the management of staff. The Manager said that the training plan has been written to the end of March 2006 which covers the basics of what residents need. A new training programme will be written from April 2006, based on the outcomes of the appraisals. There was evidence that training is in progress, including fire safety, health and safety, individuality and human rights, abuse and whistleblowing, optical awareness and continence awareness. Staff have been invited to attend a series of study days with Wigan Hospice relating to palliative care. A number of staff have expressed their interest in attending these study days. The Manager said that the owner, Mr. Hall, has agreed to fund two nurses on an accredited palliative care course. The personnel files were looked at for two members of staff. One was good; the other a bit haphazard. The Manager explained that she was introducing new file formats from the New Year. The Inspector suggested including an employment checklist, a contents list, and separate sections for recruitment, induction, and training so that information is clearly maintained and any gaps could be clearly identified. The Manager advised that all staff would be issued with new contracts in the New Year, to include their original start date. This was being done to make sure everyone’s contract was up to date, and so that staff had the best information available to them. Residents at The Acorns spoke warmly about the staff. One person said that, “Staff are very good. They will help you with anything.” Another person said that staff let her to be as independent as she can be. The Inspector observed good relationships between residents and staff, and among the staff group itself. One member of staff said she enjoyed working with her colleagues: they all got on and there was a friendly atmosphere. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, and 38 The home is managed by an experienced person. Quality assurance systems are improving and more opportunities are being made available for residents and their relatives to make their views known. Residents can be sure that their financial interests will be looked after in the home. Formal staff supervision is improving; day to day supervision is good. Residents can be sure, therefore, that staff are being monitored so they do their jobs properly. The health, safety, and welfare of residents and staff is generally managed well, but some improvement needs to be made that relate to particular potential hazards. EVIDENCE: The Manager had returned to the post following a period of time away from the home, during which time another nurse managed it. She is a Registered General Nurse. The Manager said she was keen to raise standards at The Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 21 Acorns and to empower residents and staff so that everyone felt they could speak out with confidence. The Manager has lots of ideas for bringing improvements not only to the paperwork, but also to the environment and to the daily lives of residents and staff. She holds an open surgery on Wednesday evening, when anyone can call to see her. She is usually in work every weekday, and can be contacted by staff out of hours. In order to get a feel for how the home is running, the Manager has worked on all shifts. Her registration with the CSCI was in progress at the time of this inspection. The home’s quality auditing and monitoring system is being improved. A set of new initiatives is being introduced. The home is audited by the RDB under the star rating system, and the RDB’s visit had taken place in the week prior to the CSCI inspection. Staff meetings have been taking place, the next being scheduled for 22nd December. A quality team has been formed that comprises a relative, the Activities Organiser, an RGN, two care assistants, and the Manager. Two residents were asked to join the quality team but declined the invitation. The first meeting of this group has yet to take place. The Manager has introduced an Employee of the Quarter award as a tool to motivate staff and encourage good performance. A member of staff can be nominated for the award by other staff, by residents, or by relatives. The employee will receive a cash prize, a certificate, and their photograph will be displayed. Staff will be awarded points for good attendance, and for performance over and above their normal duties. Staff had mixed feelings about the award: one person thought it might cause bad feeling. However, relatives had come forward with nominations, so showing that they thought it was a good idea. Money is kept at the home on behalf of a very small number of residents. A computerised cash control system has been developed. This is very new so the paper system is still running while the computerised system proves its worth. A printout will be given to the resident (or their representative) on a monthly basis. Auditing systems are in place where money is spent on behalf of residents, for example, for weekly hairdressing. No staff at the home is an appointee for a resident. The Manager said that residents’ families tend to look after financial matters. One resident told the Inspector she liked having some money left with the Manager and that it was “as good as any Bank.” A number of courses in mandatory training for staff had been held, including fire safety and health and safety. Staff spoke about having received training in CoSHH (Control of Substances Hazardous to Health) and food safety. Infection control and safety procedures do need to be tightened up. In the shower room opposite room 14, the Inspector found un-named toiletries Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 22 (shower gel, shampoo, etc.) in the sink. A bottle of Fairy washing-up liquid was seen on the floor. A block of soap – broken in two – was on a soapholder. In the shower room opposite room 31, again un-named toiletries and soap had been left out, as well as a razor and blade. These items pose different risks to the health and safety of residents, either from physical harm (razor blade, liquid soaps) or infection control (block soap). Research has shown that block soap supports bacterial growth, particularly where it is left damp e.g. in a soap box or on a sink. Residents who have dementia or other cognitive impairment can be harmed by drinking liquid soaps such as washingup liquid and shampoo. Writing the resident’s name on his or her toiletries, or, alternatively, providing a toiletries bag or box for the resident’s own use, would make sure that not only is the resident using toiletries of his or her choice, but also that they are kept together and returned to the resident’s room after bathing. A risk assessment of the security of the premises has been undertaken. Main doors are monitored so residents are less likely to be at risk from intruders. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 X 3 3 X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 24 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. 1. 2. 3. 4. Standard OP7 OP8 OP19 OP38 Regulation 15 12 23 13 Requirement Timescale for action 31/01/06 Care plans must be accurately maintained. Timescale 16th August 2005 not fully met. Care plans must be reviewed and 31/01/06 updated. Timescale 16th August 2005 not fully met. Shower rooms must be clean 28/02/06 and properly maintained. Toiletries, razors, etc. must be 23/12/05 removed from shower rooms and returned to the resident’s bedroom. 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. 2. 3. 4. Refer to Standard OP19 OP19 OP19 OP22 Good Practice Recommendations Storage of equipment and products should be monitored. The new telephone system should be installed as soon as possible. Residents should be offered adequate storage for their personal belongings. A system should be put in place to make sure batteries for DS0000030090.V269881.R01.S.doc Version 5.0 Page 25 Acorns Care Centre 5. 6. 7. OP29 OP30 OP38 aids are fully charged, so equipment is kept ready for use. Personnel files should include an employment checklist, a contents list, and sections for recruitment, induction, and training and development. A full training schedule should be developed based on the outcomes of the appraisal programme and supervision sessions. Toiletry bags or boxes should be provided for each resident or, alternatively, his or her toiletries should be named. Acorns Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 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 Care Centre DS0000030090.V269881.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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