Inspection on 15/02/06 for Acrefield House

This inspection was carried out on 15th February 2006.

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

The inspector 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

Acrefield House 19/03/07

Acrefield House 02/11/04

Acrefield House 28/07/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Acrefield House 2 Acrefield Road Prenton Birkenhead Wirral CH42 8LD Lead Inspector Peter Cresswell Unannounced Inspection 15th February 2006 09:00 Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 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 Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 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. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Acrefield House Address 2 Acrefield Road Prenton Birkenhead Wirral CH42 8LD 0151 608 0664 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) Diane.Meacock@mentalhealthcare-uk.com Mental Health Care (Wirral) Limited Mrs Diane Beryl Meacock Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The number of persons for whom residential accommodation (with personal care) is provided at any one time shall not exceed twelve Only adults (aged 18 - 64 years) whose primary disability is learning disability maybe accommodated. 3rd August 2005 Date of last inspection Brief Description of the Service: Acrefield House provides accommodation and care for twelve people with learning difficulties. The home is close to a main bus route and about a mile from shops and other community facilities in Prenton, Wirral. Acrefield, a three storey Victorian house with twelve bedrooms, blends in with neighbouring properties and is not identified as a care home. All of the residents have large single bedrooms. There is one main lounge, an activities room and a small ‘quiet room’. A spacious conservatory overlooks the large, well maintained back garden and also serves as the dining room. There is no lift in the home. Car parking space is available at the front of the house. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this unannounced inspection the manager spoke to a number of staff, including the Registered Manager, and most of the residents who were in the home at the time. He toured most of the building, including the kitchen and lounges. The inspector looked at records, in particular the care plans and assessments of two new residents and recruitment files for all new staff. Other records examined included medication, fire safety, accidents, staff meetings, residents meetings and staff training. What the service does well: What has improved since the last inspection? 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. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 6 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 Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4. The home carries out extensive pre-admission assessments and visits, ensuring that residents are appropriately placed, receive care that meets their needs and complement the existing resident group. EVIDENCE: One new resident had been admitted since the last inspection. A further resident was due to be admitted later in the week, but much of the documentation relating to her was available in the home. The vacancies had existed for some time but the Registered Manager said that new people were only admitted if the home was certain it could fully meet their needs and they would be compatible with the existing resident group. All of the care planning and assessment documents were in place for the new resident. The initial referral had been received via the owner’s Placement Officer, who is based at their Head Office in North Wales. The Registered Manager and other staff from the home had visited the resident in his former – temporary – placement as part of the assessment, and a detailed assessment had been completed. It had been judged that a visit to Acrefield before admission would not be appropriate in this case (though it is normal policy to arrange such visits). Instead, staff had shown him the service user guide, which includes some photographs of current residents, and photos of Acrefield and members of staff. An initial review had been held three months following his admission and a detailed activities programme was in place. The assessment document for the resident who was due to arrive later in the week was not on the premises. It had been completed by the Registered Manager and the Placement Officer and was at the owner’s HQ for the time being. The resident had visited Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 8 Acrefield twice as part of the assessment and familiarisation process. A care plan was in place and the resident was due to continue attending her present day service. The Registered Manager described a recent episode where the home had changed the décor in a residents’ room at the request of a member of his family in order to meet particular requirements of his religion. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. Excellent, detailed care planning enables staff to focus on the needs of service users. Residents’ involvement in the affairs of the home helps to develop their independence as far as is possible. EVIDENCE: Acrefield has extensive and detailed care plans for all of its residents. A summary of the plans and relevant risk assessments is printed on daily report sheets for each individual and staff complete three reports each day, ensuring that there is a detailed and relevant record on file to form the basis for future care and reviews. Key workers review the plans every month, with a full review every year that is attended by all relevant people, including other professionals, and (where appropriate) family members. If changes are agreed the plan is rewritten and the old version kept on file for reference. Residents make their own decisions as far as is possible, consistent with their capacity to do so. A senior member of staff supports regular residents’ meetings and keeps a record of the points raised by those who attend. Notes of recent meetings showed that residents had raised a number of issues at recent meetings, ranging from suggestions for trips in the summer to more photos of a favourite member of staff. Appropriate risk assessments are completed for activities; at the moment only one resident goes out of the Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 10 home unaccompanied, and then only on very short expeditions (e.g. to post letters at the end of the road). Confidential documents are securely stored in the home in locked cabinets in offices. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. The home supports and provides appropriate activities to meet the needs and likes of the residents. The balanced, varied menu meets the dietary needs of the residents. EVIDENCE: Acrefield develops individual activity programmes for each resident and they also take part in group activities such as trips out and visits by the music therapist. One resident told the inspector about his enthusiasm for tenpin bowling, in which he takes part at a local bowling centre with other residents and staff. Every resident who wants to go on holiday does so. Residents’ rooms showed evidence of some of their interests and activities. The home has two vehicles which enable residents to go on a variety of expeditions in groups or individually. Families are encouraged to visit their relatives in the home (in accordance with the care plan and the wishes of the residents themselves). The menu comprises meals that the residents are known to enjoy from past experience. It is illustrated with pictures of the meals to help all of the residents to understand what is available. The main meal of the day is served Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 12 in the early evening and usually includes a genuine choice. The chef works five days a week and when she is not there care staff do the cooking; one was coping confidently with lunch on the day of the inspection. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. The home has detailed records of the service users’ personal support needs enabling staff to provide support accordingly, thereby meeting residents’ personal needs effectively and sensitively. Medication is administered accurately and is reviewed regularly, thereby meeting the residents’ medical needs. EVIDENCE: Care plans set out how personal care is to be given and staff ensure that the residents’ dignity is respected. Three lifting devices with electric ceiling tracks have been fitted, two in individual bedrooms and one in a ground floor bathroom to assist in lifting and the provision of personal care. The home also has a mobile electric hoist and has separate sling seats for each resident who uses it. Two residents have specialist beds (paid for by themselves) that can be adjusted by a built in electric motor. All of the residents receive appropriate community and specialist health care services to meet their needs, many of which are highly complex. One resident has a PEG feed and staff have been appropriately trained to use it. The resident’s medication is also administered via the PEG feed. The home uses a monitored dosage system for medication and the samples checked were accurately recorded and securely stored. Medicines requiring refrigeration are kept in a secure, dedicated fridge, the temperature of which is checked and recorded twice a day. General Practitioners attend annual individual medication reviews for each resident. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 14 Medication records include details of any allergies that might affect the administration of any medicines. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The home’s complaints and abuse procedures protect the interests of the residents. EVIDENCE: The Registered Person has well-established complaints and adult abuse policies. No complaints have been received since the last inspection. The complaints leaflet still referred to the National Care Standards Commission rather than the Commission for Social Care Inspection, but this was remedied before the inspection finished. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. The home provides a comfortable, well-maintained and spacious environment for the people who live there. EVIDENCE: Acrefield was clean, well decorated and odour-free on the day of this unannounced inspection. There was a small area in one of the bathrooms where the paint was flaking and needed repainting. The Registered Manager said that minor items such as this are dealt with as they arise by the handyman. Acrefield does not have a shaft lift and the Registered Person has no plans to fit one, given the nature of the building. The Registered Manager ensures that wherever possible residents with any mobility problems have rooms on the ground floor. However, occasionally this is not possible and in those circumstances residents who can no longer cope with the stairs would need to move. Residents’ bedrooms are spacious, well equipped and in most cases highly individual, showing evidence of the occupier’s tastes and background. Some residents have used their own money to pay for improvements in their rooms – one has a large plasma screen television and two have paid for the ceiling track lifting systems in their rooms. The ground floor bathroom has an island bath and electric lifting equipment. Acrefield has a large main lounge, a small ‘quiet room’ and an activities room leading to the conservatory/dining room overlooking the large, attractive garden. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36. Staff recruitment and training procedures help to ensure that well trained, suitable staff are available to meet the needs of the residents. EVIDENCE: Acrefield has a stable, experienced staff team. When staff are first employed they go to the Registered Person’s headquarters in North Wales for extensive induction training. The owners have a wide ranging staff training programme and the Registered Manager has detailed training matrix which illustrates both mandatory and additional training. All senior staff have NVQ3 and six care staff have NVQ2. This is just under 50 so the home does not yet quite meet the target of 50 of care staff with NVQ2 as set out in Standard 32.6 A further six staff are working towards NVQ2 and three of them are due to qualify in April, which means of course that the target will then be met. The home usually has four or five care staff (including a senior) on duty in the daytime, in addition to the manager and ancillary staff. Additional staff may be provided as part of individual care packages and to accompany residents on holidays. Acrefield employs a full time administrator which ensures that the home’s records are efficiently maintained. Support staff are organised in teams, though these are deployed flexibly where necessary. Seven new support staff had been recruited since the last inspection – some to replace staff who were leaving, others to provide additional hours to reflect current levels of need. The owners have a well-established recruitment procedure and files for newly employed staff showed that appropriate checks are taken up before employment, including Criminal Records Bureau checks and POVA Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 18 clearance. One new support worker did not yet have her CRB certificate but had POVA First clearance and was working under close supervision pending receipt of the CRB certificate. Job descriptions are on file; staff receive regular supervision and there are regular staff meetings. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42. The home is well managed, which helps to ensure that the home meets the often complex needs of the residents. Fire and health and safety procedures are up to date, ensuring a safe environment for the service users. EVIDENCE: The highly experienced and competent manager has completed her NVQ4 and is now awaiting her certificate. The atmosphere in the home is relaxed, friendly and open and there is a good relationship between staff and residents. Acrefield’s quality assurance is based on surveys given to residents, family members and visiting professionals. The questionnaires are analysed annually but the manager takes action immediately on any issues raised in them. The QA procedures and returns – other than notes of residents’ meetings, referred to earlier - were not examined on this occasion. A representative of the Registered Person visits the home each month and submits a report of the visit to the Commission for Social Care Inspection. Fire safety records were checked and all were up to date. The kitchen was clean and well organised; food is properly stored and fridge temperatures are regularly checked. Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 20 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 x 2 3 3 3 4 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 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 3 3 3 x x 3 x Acrefield House DS0000018853.V283473.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA32 Good Practice Recommendations The home does not yet meet the standard of 50 of care staff with NVQ2. 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