Inspection on 16/12/05 for Five Acres Nursing Home

This inspection was carried out on 16th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Five Acres Nursing Home 16/07/07

Five Acres Nursing Home 31/05/06

Five Acres Nursing Home 21/06/05

Five Acres Nursing Home 01/03/05

Five Acres Nursing Home 26/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Five Acres Nursing Home Five Acres Simpson Village Milton Keynes Bucks MK6 3AD Lead Inspector Christine Sidwell Unannounced Inspection 16th December 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Five Acres Nursing Home DS0000048153.V274252.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 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. Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Five Acres Nursing Home Address Five Acres Simpson Village Milton Keynes Bucks MK6 3AD 01908 690292 01908 696244 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) Five Acres Nursing Home Ltd Terri Walker Care Home 32 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (22) of places Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. That as of the 21st of October 2005, the home is registered for the admission of service users over the age of 60. 21st June 2005 Date of last inspection Brief Description of the Service: Five Acres is a privately owned care home registered to provide personal and nursing care for thirty-four older people over the age of sixty. Five Acres is an older building set in pleasant grounds in Simpson. There is a combination of single and shared rooms, although most of the shared rooms are currently used as single rooms. The home has a lift and grab rails in some of the corridors and bathrooms. The home has seven toilets, three bathrooms and disabled bathing facilities. There is a dining area and two lounges. The village of Simpson is situated on the outskirts of Milton Keynes, with good public transport links into the city centre. There are qualified nurses, supported by a team of carers, on duty at all times. There is an experienced management team. Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the unannounced inspection undertaken on the 16th December 2005. The purpose of the inspection was to inspect the remaining core standards which were not assessed at the inspection undertaken on the 21st and 22nd of June 2005 and to assess compliance with the requirements arising from that inspection. Policies and procedures were examined. The manager was interviewed. All residents in the home were seen and a number were spoken to. A number of care staff were also spoken to. What the service does well: What has improved since the last inspection? The care plans have improved since the last inspection and now contain more information to guide staff when addressing residents care needs. There are opportunities for further improvement, which should ensure that residents’ needs as identified in the risk assessments, are met. All residents have now had a review by their care manager, where this is appropriate. The infection control procedures have improved. The manager has introduced supervision for staff which will support staff in meeting residents’ needs. All staff are now to undertake accredited dementia care training. Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 6 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. Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 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 Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 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): These standards were not assessed at this inspection but were met or almost met at the inspection undertaken on the 21st and 22nd June 2005. EVIDENCE: Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 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 10 The care plans have improved since the last inspection and now contain more information to guide staff when addressing residents’ care needs. There are opportunities for further improvement which would ensure that residents’ needs are fully met. Carers were observed to respect residents’ privacy and dignity. EVIDENCE: Three care plans were examined and were found to have improved since the last inspection. Both contained full demographic data, comprehensive risk assessments and care plans to meet most identified needs. Residents had had a care management review in the last year. There remains a need to ensure that a care plan is developed to meet all identified needs following the risk assessments. One resident was identified as at high risk of developing pressure damage but did not have a care plan to describe the steps that should be taken to prevent this. The resident concerned however did have a pressure-relieving mattress. One gentleman had a catheter although his care plan did not reflect this. Only one of the care plans contained a social history. The daily entries had been signed and dated. The night staff also made contemporaneous entries to the care plan and dated and signed these. The care plans had been reviewed on a monthly basis. There was evidence in the Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 10 care plans seen that relatives had been involved in the development of the care plan. One resident who has dementia had a plan to reflect this and a social history, which gave carers information about of his previous life and interests. An activity plan had been developed for him. All personal care is given in residents’ bedrooms and the staff were seen to approach residents courteously and to protect their dignity. Residents were wearing their own clothes. There are no shared rooms. Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 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, 14 and 15 The activities in the home help to provide variety and stimulation for residents. Residents are supported to observe their chosen religion if they so wish. Residents are encouraged to make choices and to retain their independence wherever they are able. The menu is varied and meets residents’ nutritional needs. EVIDENCE: The manager said that the routines in the home were flexible and two residents said that they had a choice as to when they got up or went to bed. The chef said that meals could be saved if residents were out, although the main meals of the day are at a set time. The statement of purpose and service users’ guide say that visitors are welcome at any time and this was confirmed by a visitor who was in the home at the time of the inspection. There is an activity programme and a number of activities had been undertaken in the run up to Christmas. A pantomime, carols, movie night and fireworks have been arranged during the last few months. The residents enjoyed the carols and Christmas activities. A local Anglican vicar and Roman Catholic priest visit the home on a regular basis. The home does not manage any residents’ financial affairs. These are usually managed by family members or care managers. There was evidence in residents’ rooms that they are encouraged to bring personal possessions with Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 12 them. Information posted in the entrance area gives details of local advocacy organisations. A requirement was made at the last inspection that the menus should contain five fruit or vegetable portions a day and that the evening menu should have a soft option described. The menus have been revised and this is now in place. The meal on the day was varied and appetising. It was presented well and carers were observed to be helping residents discretely Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 13 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): 16 and 17 The complaints policy and procedures give residents confidence that any concerns they may have will be addressed. Advocacy services are available to support those service users who need help to make their wishes known. EVIDENCE: There is a complaints policy. A record is kept of all complaints and written letters of appreciation. The Commission for Social Care Inspection has not received any complaints since the last inspection. One lady spoken to said that she did not have any formal complaints as she felt that she could always ask for things to be changed and that that this would happen. The manager said that all residents were on the electoral role although few were able to exercise that right. There are local advocacy groups who can help residents and their families if they wish. Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 14 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): 24 and 26 Height adjustable beds should be purchased for those residents requiring nursing care in order that their care needs can be met safely. The improvement in the infection control policies helps to protect residents from infection and the relocation of the waste bins improves their environment. EVIDENCE: At the previous inspection a requirement was made that the proprietors should agree a programme with The Commission for Social Care Inspection to provide height adjustable beds for all residents requiring nursing care. The home currently has 10 height adjustable beds and a programme to replace the remaining divan beds with height adjustable beds, which are attractive to look at, should be agreed with the Commission for Social Care Inspection. The general and clinical waste bins are now stored discretely away from the main entrance. The clinical waste bin was locked on the day of the inspection. The catheter care policies have now been reviewed and the infection control policies updated. The laundry floors have yet to made impermeable. Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 15 Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 16 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): 30 The home’s induction process should be reviewed to ensure that essential knowledge and skills are assessed in a timely way in order that staff can safely commence caring for residents. The focus on dementia care training this year will give staff the knowledge and skills necessary to care for this group of residents. EVIDENCE: There is an induction policy. The induction records of newly appointed staff were seen. Not all staff had completed the full induction programme and the records had not been dated nor signed. The induction programme and check list is not clear as to when certain aspects of induction should be completed. Not all staff had had manual training prior to commencing work. The manager stated that two members of staff would be undertaking the five-day induction programme run by Buckinghamshire County Council. The home’s induction process should be reviewed to ensure that essential knowledge and skills are assessed in a timely way. All staff are undertaking City and Guilds accredited dementia care training with Milton Keynes College. The first cohort of twenty staff have commenced the course and the second cohort will be undertaking training in 2006. The home has also been accredited to take nursing students from Northampton University on placement during their training. Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 17 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): 33, 36 and 38 The home’s quality assurance processes should be improved if the proprietor and manager are to be certain that a high standard of care is maintained for residents. The home’s approach to supervision supports staff caring for vulnerable residents. The Health and Safety procedures help to ensure that residents and staff are protected from harm. EVIDENCE: The proprietors are considering the approach to quality assurance but have not yet decided upon and shared with the Commission for Social Care Inspection the way in which this will be carried out. The requirement to do so will be repeated in this report. The proprietor who is not in day-to-day control of the home, although visits very regularly, does not supply the Commission for Social Care Inspection with reports of monthly quality assurance visits, and these must now be implemented. The outstanding requirements of the previous inspection, which are repeated in this report, must also be addressed. Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 18 The manager has implemented a systematic approach to supervision and the staff spoken to said that they found the process helpful. A systematic approach to inspecting the premises has been implemented to ensure that potential health and safety problems are identified and addressed. The manager is intending to use the self-assessment criteria identified by the Health and Safety Executive to ensure that health and safety policies and procedures and the steps taken to protect residents and staff are adequate. This should be undertaken to the timescale set at the previous inspection. The requirements of the last Environmental Health Officers report have been addressed. Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 19 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 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x X X X X X 2 X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 1 X X 3 X 2 Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 20 yes 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 Standard OP7 OP7 OP24 Regulation 15 15 23 Requirement The care residents require following risk assessment should be described in the care plan. A social history and residents preferences for activities should be recorded in all care plans. The proprietors should agree a programme to provide height adjustable beds for all residents requiring nursing care over a period of time with the Commission for Social Care Inspection. This is an unmet requirement of the previous report and a new timetable has been set. The laundry floor should be made level and impermeable. This is an unmet requirement of the previous report and a new timetable has been set. The induction programme should be reviewed to identify the order and timescales in which induction topics are to be undertaken to ensure that staff and residents are not put at risk. The proprietors should agree and implement a systematic quality DS0000048153.V274252.R01.S.doc Timescale for action 31/03/06 31/03/06 31/03/06 4 OP26 16 31/03/06 5 OP30 18 31/03/06 6 OP33 24 31/03/06 Five Acres Nursing Home Version 5.1 Page 21 7 OP33 26 8 OP38 13 assurance programme. This is an unmet requirement of the previous report and a new timetable has been set. The proprietors should undertake 31/03/06 monthly quality assurance visits and supply The Commission for Social Care Inspection with a report following these visits. The proprietors and manager 31/03/06 should undertake a health and safety audit against the criteria identified by the Health and Safety Executive and develop a plan to address any deficits. This is an unmet requirement of the previous report and a new timetable has been set. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Five Acres Nursing Home DS0000048153.V274252.R01.S.doc Version 5.1 Page 23 - 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. 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