Inspection on 10/07/07 for Half Acre House

This inspection was carried out on 10th 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

Half Acre House 01/06/06

Half Acre House 25/01/06

Half Acre House 23/08/05

Half Acre House 07/03/05

Half Acre House 17/09/04

Half Acre House 11/03/04

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

CARE HOMES FOR OLDER PEOPLE Half Acre House Roch Valley Way Rochdale Lancashire OL11 4DB Lead Inspector Tracey Rasmussen Unannounced Inspection 10th July 2007 09:35 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 Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Half Acre House Address Roch Valley Way Rochdale Lancashire OL11 4DB 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) 01706 861098 F/P 01706 633891 Mrs Anita Lewis Mrs Lesley Rider Lynne Kowalski Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 25 service users, to include: Up to 25 service users in the category of OP (Older People) The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 4th October 2006 Date of last inspection Brief Description of the Service: Half-Acre House is a care home providing personal care and accommodation for 25 older people. Nursing care is not provided. The home is located approximately 1.5 miles from the centre of Rochdale and has good transport links to the motorway and several bus routes. Half-Acre House is a large 2-storey building, which has been converted and extended into a residential care home. Bedrooms are located on the ground and first floor and all are single occupancy with en suite facilities. A passenger lift is provided. A variety of communal space is available. The home is situated in its own grounds with ample parking available. A copy of the most recent Commission for Social Care Inspection report is available in the manager’s office. The current weekly fees range from £ 334.98 to £ 427.00 dependent on the package of care required. Further details regarding fees are available from the manager. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced key inspection site visit on the 10th July 2007. This means that the manager and staff in the home did not know that an inspection was to be undertaken. The inspection included a review of all available information received by the Commission for Social Care Inspection (CSCI) about the service provided at the home since the last key inspection. A questionnaire (Annual Quality Assurance Assessment -AQAA) was sent out to the manager at the home about two months before this inspection visit and this provided some additional information to assist the inspection process. All key inspection standards were assessed at the site visit and information was taken from various sources which included observing care practices, talking with people in the home; talking with visitors; interviewing the business manager, deputy manager and other members of the staff team. A tour of the home was also undertaken and a sample of care, employment and health and safety records seen. Comment cards were sent out to people who use the home and comments from returned cards have been included in this report. Three people living in the home were case tracked as part of this inspection visit. This means the care service provided to these people was looked at and this included talking with the people living in the home (where possible) to seek their opinions and looking at their records. A brief explanation of the inspection process was provided to the deputy manager of the home at the beginning of the visit and time was spent at the end of the visit with the business manager and the owner to provide verbal feedback of the findings from the inspection visit. What the service does well: Throughout the visit the home was welcoming, peaceful and relaxed. People living in the home were supported to be independent and their choices and preferences respected. Staff were courteous and friendly and went about their duties in a professional manner. One professional visitor to the home said, ‘there is a lovely atmosphere when you walk into the home-everyone is relaxed and friendly’. People living in the home said, ‘it’s pretty good at the home’; ‘staff are nice’; ‘food is good’ and ‘staff are fine’. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 6 Comments from returned comment cards included, “My mum gets not just care. But she receives love and respect at all times” and “Generally we are quite pleased with Half Acre. They do try”. Activities are provided regularly and one person described the lovely time she had had a few days before at the garden fayre held by the home. A couple of comment cards did state that they thought more activities could be provided. The home was clean and generally odour free and provided single roomed accommodation. Equipment and facilities to meet the different and varied care needs of the people was available. Visitors were welcome into the home. Complaints were treated seriously and investigated properly as the home’s procedures requires. Most staff had had training to ensure people were safeguarded as far as possible from abuse and they knew what to do if they suspected abuse. Staffing levels in the home were appropriate to meet the needs and dependency levels of the people living there. Staff had had general training and NVQ training so that many of the care staff team had gained a qualification. A quality assurance system including audits, regular monitoring and resident, relative and staff meetings were established which means standards of service were monitored and improved when issues were identified. Personal monies were maintained safely and health and safety practices on the whole were safe. What has improved since the last inspection? What they could do better: Recruitment procedures had improved and the management in the home had been checking their records to make sure that the correct information on staff had been obtained; however further improvement was still required. This is needed to make sure only suitable people work in the home. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 7 Assessment information such as the need to weigh someone frequently should be included within the care plan and information about a resident’s involvement in an activity should also be recorded. Medication recording practices need improving and the times that medication is given out should be reviewed. 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. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 8 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 Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 9 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): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs were assessed before they moved into the home and the home could assure new people that it could meet their needs on admission. EVIDENCE: The management team had recently up dated the home’s information guide (Statement of Purpose) and this contained detailed information about the service offered. Each bedroom also had a copy of the Service User Guide which gave people access to information about the home. Copies of previous inspection reports were available from the manager’s office Three care files for people living in the home were seen. These contained detailed information about each persons care needs. The care records included information that indicated that the home had made pre-admission assessments or checks on the new person’s care needs before they came into the home. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 10 This enabled the manager of the home to assess and confirm whether the new person’s care needs could be met properly by the services provided in the home. One newer person to the home confirmed that she had agreed to come into the home, although a relative visited the home first to make sure it was suitable for her. Intermediate care (standard 6) is not provided at the home. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 11 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. People in the home received care and comfort, which respected their personal wishes and promoted their dignity. EVIDENCE: The service provides care and support to older people. The home was warm and welcoming, staff were pleasant and relaxed and interactions with people living in the home were pleasant and polite. People were presentable and dressed according to their preference and moved about the home independently. One visiting professional person said he had never visited the home before but felt he needed to tell the staff that ‘there is a lovely atmosphere when you walk into the home-everyone is relaxed and friendly’. The visiting professional Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 12 said he was satisfied with the level of support his client was receiving in the home. People living in the home said, “it is pretty good at this home’; “Everyone is considerate.” And, “they know what they are doing.” Three care planning records were seen and these contained information regarding the care needs of each person. The information recorded was person centred, which means that the person living in the home or their representative had been consulted about their wished, likes, dislikes and known preferences. Additional care planning information was recorded specifically to promote and protect each person’s rights to privacy, dignity, choice, independence and confidentiality. Evaluations of the care plans had been undertaken fairly regularly and these were detailed and provided a picture of each person’s wellbeing and progress. It is recommended that care plans also include specific information such as the frequency of weighing if there are concerns around the loss of appetite or the type of continence aid required. Records of contact with community health services such as GP, district nurses teams, chiropody and optical support were available. Staff spoken with were positive about working in the home. Staff said they were trained and supported to do their job and several had got a NVQ qualification. Medication practices were reviewed briefly. Medication administration records, controlled drug records, storage and records of receipt and return of medication were all satisfactory. Handwritten additions to medication sheets should be signed and dated by the person writing the medication sheet; it is recommended that a staff signature list is held with the medication records and a review of the times of the medication administration times undertaken. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 13 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. Social activities and stimulation was provided to meet the diverse needs of the people living in the home. A choice at mealtimes was offered and the quality of the food was good and nutritious. EVIDENCE: The home provides a range of activities to meet the different needs and preferences of people living in the home. Sewing group is held on Tuesdays and the residents who joined the group were making cushion covers. One person explained about the summer fayre held in the grounds at the previous weekend. She said; “There was an activity last Saturday. It was very good, the band were wonderful. My husband, nephew and wife and friends all came. It was quite a party it was lovely.” Care staff spoken with confirmed that one staff member had responsibility to undertake activities in the afternoon and this included a range of things from manicures to bingo. One staff member said she tried to ensure that the Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 14 people who had early dementia type illnesses also benefited from one to one support. Two returned comment cards did suggested more activities would benefit the people in the home. Care planning records seen, contained person centred information about each persons interests and hobbies, however care planning records could be developed further to include information about if a person had joined in an activity and if they had enjoyed this. Staff were polite and supportive to the people living in the home. Routines in the home were flexible and one person confirmed that her wishes were respected. She said, “I do go to bed and get up when I want. I do have freedom of choice in here’ Visitor confirmed that they were welcomed into the home. The home has separate dining rooms and the majority of people in the home dined in the dining rooms that were bright, comfortable and sociable. A choice of two main courses was offered at the lunchtime meal. People spoken with said they did not know what the choices were that day. It was later identified that the whiteboard, which detailed the daily menus, had not been filled in. People said about the food, “Food is good, well reasonably good and I am very fussy” and “Food is average to good” Meals were served appropriately and assistance was provided discreetly when required. Minutes of resident meetings were available, which indicated that people were consulted about meals and mealtimes. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 15 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. People in the home can be confident that staff are trained to respond appropriately to suspected abuse and that complaints will be treated seriously. EVIDENCE: Since the last inspection visit the home had received two complaints and these had been responded to according to the home’s complaints procedure. Records were available of the complaints and the actions undertaken in response to these. People living in the home felt confident to voice any worries or concerns and said, “If I had a complaint I would go straight to the office” and “I have no complaints at all. Everything is reasonably good”. Staff spoken with about complaints and protecting people from abuse responded knowledgeably. Staff reported that they had received training in abuse and the protection of vulnerable adults and were able to discuss the content of their training. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 16 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 safe, well maintained home that was clean and generally odour free. Specialist equipment is available which means the different needs of each person could be met promptly. EVIDENCE: The home was clean, tidy and no odours were detected. The housekeeper working at this visit was thorough in undertaking her duties. Bedrooms had benefited from new curtains and bedspreads and vacant rooms had been redecorated and re-carpeted before being made available. Bedrooms had been personalised with mementos, pictures and photographs. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 17 One returned comment card did comment that the home was not as fresh or clean as it used to be. The home is equipped with specialist aids and adaptations to promote people’s independence. A regular audit of the home environment was undertaken and the areas noted for repair or renewal actioned within the home’s maintenance plan. A maintenance person worked in the home and undertook day-to-day repairs and routine maintenance. Maintenance records were kept up to date. Outdoors, flower beds and pots were attractive and the home’s grounds and gardens were maintained. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. In the main, recruitment vetting practices, staffing levels, training and skill mix were appropriate to meet the needs of people in the home and promote their health and safety. EVIDENCE: The home had a welcoming atmosphere and all staff spoken with were pleasant. People in the home said the staff, ‘‘staff are nice’ and “staff are fine, they are alright, they are helpful when needed”. Comments from returned comment cards included, “Very good relationship between staff and those in care. Staff very pleasant and caring”; “They do care about the residents” and “Nothing is too much trouble (for the staff)”. Staff were positive about working in the home. Staff said that they enjoyed working in the home; that they delivered a good quality service and they said they received a good standard of training. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 19 The staffing rotas were available and indicated that staffing levels were maintained at appropriate levels to meet people’s care needs. Three employment files for newer staff to the home were seen. Two of these files had been audited by the home and missing information identified and obtained. However one staff file had evidence that a CRB disclosure had been applied for but had not been received (the worker was a former employee). In such cases the home needs to have a PovaFirst check which if clear allows staff to work supervised in a care setting. The business manager explained that the home had had to join an umbrella organisation to obtain CRB disclosures and was unsure if a PovaFirst had been received for this employee. The business manager provided assurances that this would be addressed immediately. Other areas of improvement include ensuring that references from the new person’s last employer are sought and obtaining full working histories. Records were available to indicate that the home did train staff from the start of employment with induction training to on-going training and NVQ. The home’s induction training was in line with Skills for Care requirements. Other staff members detailed various training courses they had attended and these included food hygiene, infection control, manual handling, first aid, medication and fire awareness. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32 ,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 management of the home promotes the health, safety and wellbeing of the people living there and opportunities are provided for people in the home to contribute to the daily routines and have a say in how the home is run. EVIDENCE: The home benefits from a supportive management structure in that the two part time registered managers receive assistance and support from the business manager and the owner of the home. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 21 Evidence from this inspection identified that systems to improve the quality of service provided in the home were in place. People living in the home felt able to discuss their concerns with the staff and management team. Resident meetings are undertaken and relatives have chaired their own meetings in the home. Staff meetings are also undertaken. Quality assurance questionnaires had been sent out and a report of the results from these was available. All records were in the process of being audited, to check that they were up to date. Where a shortfall had been identified then action to address this had been undertaken. The home environment was comprehensively audited regularly and monthly reports detailing the status of the home had been supplied to the CSCI. Copies of the audits were available in the home. The home does hold personal monies for people in the home. Records of these were being audited and therefore not seen at this visit, however the systems of recording and monitoring of this described by the business manager was appropriate. The home employs a maintenance worker who undertakes routine repairs and monitors equipment to promote the health and safety of people living in the home and staff. Records of maintenance including fire safety were available. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 22 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 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 3 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 x 3 3 x 3 x x 3 Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 23 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 OP29 Regulation 18 Requirement The registered person should ensure PovaFirsts are obtained before any new worker starts in the home without the receipt of a full CRB. This will ensure that new people working in the home are suitable to work with vulnerable people. Timescale for action 15/08/07 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 Refer to Standard OP7 Good Practice Recommendations The manager should ensure that care plans also include specific information about each person’s care needs such as the frequency of weighing if there are concerns around the loss of appetite or the type of continence aid required if incontinent. This will ensure care needs are met efficiently. Handwritten additions to medication sheets should be signed and dated by the person writing the medication sheet; a staff signature list should be recorded and a review of the times of the medication administration times DS0000025474.V339644.R01.S.doc Version 5.2 Page 24 2 OP9 Half Acre House 3 4 OP12 OP29 undertaken so that staff are accountable and people living in the home are safeguarded by safe working practices. The manager should ensure that care plans records include information about which activity each person joined in. The manager should ensure employment references are obtained from the prospective new employees current or last employer and full working histories are obtained and gaps in employment explored so that residents are protected from unsuitable employees. Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Half Acre House DS0000025474.V339644.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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