Inspection on 16/07/07 for Five Acres Nursing Home

This inspection was carried out on 16th July 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

Five Acres Nursing Home 31/05/06

Five Acres Nursing Home 16/12/05

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 Kate Harrison Unannounced Inspection 16th July 2007 09:45 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.V340291.R02.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 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.V340291.R02.S.doc Version 5.2 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 onlyvid@talktalk.net 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.V340291.R02.S.doc Version 5.2 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. 31st May 2006 Date of last inspection Brief Description of the Service: Five Acres is a privately owned care home offering 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. There are dining and lounge areas. The village of Simpson is situated on the outskirts of Milton Keynes, with public transport links into the city centre. There is a registered manager, supported by a team of qualified nurses and carers and the experienced proprietors. Fees as at April 2006 range from £545- £670. Additional charges are made for hairdressing, chiropody, personal transportation and days out. Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09.45 and was in the service for 6 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service, and any information that the Commission has received about the home since the last inspection. The inspector saw all areas of the home, observed staff interactions with the individuals living at the home, spoke to individuals living at the home and staff members and looked at records and documents relating to the care of the individuals. Staff recruitment records were also seen. The registered manager and the registered providers were available on the day and were able to help the inspector gain a full understanding of the service provided. The inspector asked the views of the people who use the services or who responded to questionnaires that the Commission had sent out. Altogether 11 responses were received, from individuals living at the home, relatives and health care professionals, and their views are reflected in this report. There were 28 people living at the home at the time of the inspection visit. The inspector spoke to several residents at the home during the day, and to several visitors. Most of the comments about the care at the home were very positive, especially comments about the staff and about the recent improvements to the home and gardens. What the service does well: What has improved since the last inspection? Care plans have improved, and now contain individualised programmes of activities, based on the preferences of the individual. Several improvements have been made to the home, including refurbishment of the kitchen, individual bedrooms, communal areas and the office areas. New radiator covers are in place and a new boiler has been purchased. Most Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 6 of the beds at the home are now adjustable, so that the needs of the individual’s are more easily met. The garden area has been improved and new furniture purchased. A secure area to the front of the house has been constructed, so that individuals can safely enjoy the garden. An annual quality assurance system is in place to make sure that the home identifies what improvements need to be made. An annual development plan is in place, and is being realised. 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. The summary of this inspection report can be made available in other formats on request. Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 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.V340291.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A nurse carries out a pre-admission assessment before any individual comes to live at the home. EVIDENCE: An experienced nurse carries out a full assessment of need before the individual is admitted to the home. Information is also gathered from other professionals so that all the needs are known, and a judgement can be made that the home will be able to meet the needs of all those admitted. The preadmission assessments seen by the inspector contained all the necessary information about the needs of the individual, but other information also should be included such as the signature of the assessor. To meet regulations the home must send a letter to the individual confirming that their needs can be met at the home before admission, and it is recommended that the nurse assessing the individual should sign the assessment. Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems are in place to make sure that the health and welfare needs of people living at the home are met. EVIDENCE: All the individuals living at the home have care plans showing their personal, social and healthcare needs. The care plans should contain more detail of the actions to be taken so that care staff members know what they need to do, and this has been discussed with the manager. Risk assessments are carried out for important areas of care such as falling and nutritional state. The home is introducing the nutritional assessment tool recommended by the community dieticians. Risk assessments and care plans are reviewed regularly. All the people living at the home have a named general practitioner (GP), and their physical and emotional healthcare needs are monitored and addressed. One GP said, through the Commission’s comment cards, that the overall care provided at the home was satisfactory, and all the people living at the home said that they ‘always’ received the medical support they needed. The care plan includes details about issues of privacy and dignity, and about any particular need the individual has due to culture, religion or race. A local pharmacist has recently assessed the home’s medication system, and as a result a new ordering system is in place. All medications received into the Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 10 home are recorded and a contract is in place to make sure that unwanted medications are disposed of appropriately. Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can choose how to run their lives, and are supported to do so by the staff team. EVIDENCE: The care plans include daily activity plans for individuals, and is a mix of group and individual activities, such as newspaper reading, hands and feet massages and walking in the garden. A programme of events should be available so that individuals will know when the events are scheduled to take place. The home has been trying to recruit an activities organiser, without success. There were several visitors in the home on the day of the inspection visit, and all said that they are encouraged to visit as they wish. Replies to the Commission’s comment cards show that relatives are ‘usually or ‘always’ kept informed of important issues to do with their relative. Individuals living at the home can use the services of the community as they want to, including visits to the pub. One individual said that she/he can choose how to spend time, and the inspector observed staff members supporting the individual to do what she/he wanted. Several individuals told the inspector that they enjoyed their meals at the home, and that they could ask for food not on the day’s menu. The dining room is comfortable and well organized to accommodate different groups of people. The menu shows a good variety of dishes, and vegetarian food is always available. Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are well managed and people living at the home are protected from harm. EVIDENCE: The home has a clear easy to follow complaints procedure, and people living at the home know how to make a complaint if they want to. Although some relatives who replied to the Commission’s questionnaire said that they did not know how to complain, others seen on the day of the inspection visit were clear that they could mention concerns to any member of staff. The manager encourages people to make their views known, and has a proactive approach to concerns. No complaints have been received at the home, and neither has the Commission received any information about complaints since the last inspection. The home has a policy on safeguarding vulnerable people, and staff members know whom to contact if they suspect abuse, or if an allegation is made. Training is provided at induction of new staff and regularly afterwards. Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. 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 clean, safe home, with an improving environment. EVIDENCE: The new providers have started and maintained a refurbishment programme over the past year. Several areas of the home have been updated, including communal and private rooms. The kitchen has been modernised and new equipment purchased. The programme to replace all the beds with adjustable beds is nearing completion. New equipment has been purchased for the garden, and a secure outdoor area with furnishings has been completed. Several individuals living at the home said that they appreciated the recent improvements. Further developments are planned, including a new conservatory. A member of staff is responsible for routine maintenance, and this is managed well and good records are kept. The home has infection control policies and procedures, and protective clothing is provided as necessary. The registered manager is improving the management of the laundry, by providing new equipment to store clean laundry. Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. Care staff members are well trained, enough are available to meet the needs of the people living at the home, and the recruitment procedures have been improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The majority of people living at the home said through the Commission’s questionnaires that staff members were ‘always’ available when they were needed, and that they listened and acted on what they said. The staff rota shows that there is a nurse on duty over the 24 hours, and that there are sufficient care staff members to meet the needs of the people living at the home. Induction training is provided for new staff members to the Skills for Care standards, and care staff members are encouraged to enroll on the National Vocational Qualifications (NVQ) in Care, and 87 of the care staff hold NVQ Level 2 in Care. Overseas staff members are encouraged to attend English language classes, so that they can understand the language used by the people living at the home. All mandatory training is provided, and staff are encouraged to attend the appropriate training for nurses and care staff members. Staff members who manage the kitchen duties have completed the appropriate training courses. All the care staff and some of the household staff members have attended dementia training. Three staff files were seen to check the home’s recruitment procedure. Two individuals from overseas did not have the required two references needed, and the home must require the agency involved to acquire the references before the individual starts work at the home. This requirement was made Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 15 known to the agency at the time of the inspection visit, so the requirement has been met. Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health, welfare and safety of people living at the home are promoted, by the home’s policies and procedures and by the fitness of the manager. EVIDENCE: The registered nurse manager is experienced and skilled at managing the home. She has gained the Registered Manager’s Award since the last inspection visit, works to continually improve the service and encourages the staff members to keep the best interests of the individuals living at the home in mind at all times. She continues to keep abreast of professional developments, and has recently attended equality and diversity training, and training on the requirements of the Mental Capacity Act, so that the needs of the individuals living at the home are met. An annual quality assurance system is in place based on the views of stakeholders, and other quality reviews of the home’s systems take place regularly. An audit exercise was carried out recently regarding the number Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 17 and times of falls in the home, and as a result some shift patterns were changed and the number of falls lessened. Small amounts of petty cash are kept securely for a few individuals, and records are maintained to show incomings and outgoings. The home has a health and safety policy statement, backed up by policies and procedures to keep staff members and people living at the home safe. Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 18 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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 19 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. 1 Standard OP3 Regulation 14 (1)(d) Requirement The home must send a letter to the individual before admission confirming that their needs can be met at the home. The home must require the recruitment agency to acquire two references before the individual starts work at the home. This requirement has been met. Timescale for action 31/07/07 2 OP29 19 (1)(b) 20/07/07 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 Refer to Standard OP3 OP7 OP12 Good Practice Recommendations The assessor should sign the pre-admission assessments, so that an accurate record is available. The care plans should contain more detail of the actions to be taken so that care staff members know what they need to do. A programme of events should be available so that individuals will know when the events are scheduled to take place. DS0000048153.V340291.R02.S.doc Version 5.2 Page 20 Five Acres Nursing Home Five Acres Nursing Home DS0000048153.V340291.R02.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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. 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