Inspection on 23/08/05 for Half Acre House

This inspection was carried out on 23rd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 10/07/07

Half Acre House 01/06/06

Half Acre House 25/01/06

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 Bernard Tracey Announced 23 August 2005 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 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 F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Half Acre House Address Roch Valley Way Rochdale Lancashire Ol11 4DB 01706 861098 01706 633891 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Anita Lewis Mrs Lesley Rider CRH Care home only 25 Category(ies) of OP Old Age - 25 registration, with number of places Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total number of places 25 OP 2. Schedule of accommodation must not be varied without written consent. 3.The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 7th March 2005 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 ensuite 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.. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was made aware that this inspection was to take place. Several weeks before the inspection questionnaires were sent out to doctors, social workers and district nurses, as well as to the residents of the home and their relatives. The questionnaires asked what people thought of the care and services provided by the home. The questionnaires completed by visiting professionals asked questions relating to communication, availability of senior staff when visiting, staff having a clear understanding of service users needs, management taking appropriate decisions, management of medication, complaints from service users they may be aware of, and if they are satisfied with the overall care provided by the home. Both of the professional visitors responded positively to the questions, one doctor stating that he felt the care provided was “excellent” The Inspector spent 5 hours at the home. During this time he looked at care and medicine records to ensure that health and care needs were met. He also examined files that contained information about how the care staff were recruited for their jobs, as well as records about staff training. The Inspector also spent time speaking to 5 residents whilst he had lunch with them, and a further 2 residents during the afternoon. He also spoke to 3 care staff, the owner of the home and the business manager. Not all the National Minimum Standards were looked at on this visit. During the next inspection, which will be unannounced, the Inspector will look at the rest of the Standards that are considered to be important for resident safety and wellbeing. What the service does well: Residents at the home said they very satisfied with the way they were looked after and particularly enjoyed the choice of lounges that are available in the home. In this respect one resident described how sometimes she liked to sit in the conservatory and look out to the garden whilst other times spend time talking in one of the main lounges. Meals and mealtimes were considered to be an important part of the residents’ day. The dining room was a nice place to sit, eat and meet with other residents. The residents said that they really enjoyed their meals. They were satisfied with the choice of meals and the way they were cooked and served. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 6 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. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 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 standard(s) 2 3 5. Standard 6 is not applicable to this home. Information provided before admission gives sufficient information for prospective residents to be clear about the services the home provides to meet their needs. All prospective residents have a detailed assessment undertaken before their admission to the home, which gives an assurance to residents that the home can meet their needs. EVIDENCE: Residents are provided with their own Service User Guide: a copy is kept in each bedroom. Each resident is provided with a statement of the main terms and conditions at the point of moving into the home. The document was seen to include the services that are offered and the fees payable, including additional services to be paid for over and above those included in the fee. The Registered Person provides a contract for those residents purchasing their care privately. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 9 For individuals referred through the care management arrangements the home obtains a summary as well as a copy of relevant care plans, both health and social services. Residents spoken with during the inspection all said that their relative had chosen this home for them after visiting several in the area. Their own physical condition did not allow them to be able to visit several homes and therefore they were reliant on their family to do this and then suggest which home was felt most appropriate. All of the residents spoken with said they were happy with the choice of home and had been given the opportunity for a trial stay. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 10 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 standard(s) 7 8 9 The care planning system does not provide staff with adequate information to reflect the changing needs of residents and also fails to ensure that residents care needs are identified and met. EVIDENCE: All the residents spoken with said they felt the staff looked after them well, and that the care staff helped them in whatever way they needed it. The care plan documentation examined during the inspection was fragmented with no obvious order in recording the information collected in relation to the personal details or care needs of the individual. For instance it was not clear on what date residents had been admitted to the home, an expectation being that this information would be at the front of the file rather than contained much later in the documentation. Similarly details of the next of kin, the residents’ doctor, social worker and other essential information must be clearly recorded at the front of the care plan. Care plans had not been signed by the by the residents or their representatives, this included the annual review of care carried out within the home. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 11 Monthly reviews tended to state ‘no change’ but in one care plan significant changes had occurred with the resident eventually being admitted to hospital following two visits from the general practitioner. The care plan for this individual, however, did not record how the person’s health care needs had changed or how the home was planning to meet these needs. One resident had been referred to the Speech and Language Therapist (SALT) for swallowing difficulties following which the home had been advised to continue a ‘soft diet and normal fluids’; however this information had not been included in the care plan and a discussion with the chef confirmed that the resident was receiving a “normal diet on a small plate”. The inspector sat with the resident during her lunchtime meal when she was able to confirm that she always had a ‘normal’ diet and her original difficulties with swallowing had now resolved. The home must therefore ensure that current information is recorded in the care plan to ensure that residents’ needs are being met. Not all residents had risk assessments completed to reflect their needs in relation to moving and handling. The home also needs to complete a risk assessment in relation to each individuals skin care needs and risk of developing pressure sores, known as the Waterlow Scale, as this will help to identify those individuals most at risk. The business manager said he was aware that the care plans varied in the amount of detail provided and was undertaking a review of all the documentation relating to residents’ care needs, in order to provide more consistency and also to provide all of the essential information required for each resident. Examination of the medicine trolley indicated a safe system of storage. It is recommended that when medicines are hand transcribed on to the medicine administration sheet, that these entries are checked and signed by two members of staff in order to minimise errors. The manager informed the inspector that the recommendations made by the Pharmacy Inspector, in March 2005, have been acted upon. The storage of food supplements, e.g. Fresubin must be in accordance with the manufacturers instructions, that is, in a cool dry place. At the inspection these supplements were found on a trolley in the main kitchen. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 12 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 standard(s) None of the key standards were fully assessed on this inspection EVIDENCE: The key standards were not inspected on this occasion. They will be inspected at the next inspection. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 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 standard(s) None of the key standards were fully assessed on this inspection EVIDENCE: The key standards were not inspected on this occasion. They will be inspected at the next inspection. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 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 standard(s) 19 26 The standard of furnishing and fittings within the home was generally good providing a homely, safe, well adapted, clean and comfortable environment for residents. EVIDENCE: The home has a variety of communal spaces – lounge, conservatory, small sitting area on the first floor, and two dining rooms, including one that has additional sitting space. Access to the gardens is either via the conservatory that provides level access, or via the steps from the main door. The garden area has benefited from a project undertaken by a horticultural student who is continuing to develop this as a sensory area through the planting of flowers and shrubs. Two residents commented on how much they appreciated the work that the student has undertaken. Furnishings in communal areas were domestic in character, of good quality and suitable for their purpose. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 15 The carpet that leads from the ground floor staircase to the first floor corridors is now so worn and stained that it needs replacing. During a tour of these areas with the business manager several trip hazards were identified. The inspector received an assurance that these matters would be remedied immediately and the home would provide suitable flooring to the whole of the entrance, stairs and first floor corridors. The bedrooms inspected were furnished and equipped to assure comfort and privacy. All bedrooms have the provision of an en-suite toilet, and 4 bedrooms have the added provision of a shower. One bathroom has a shower and an assisted bath, and the 2nd bathroom contains a medi bath. The Inspector was informed that residents do not like to use the ground floor bathroom that contains the medi bath and was therefore in the process of refitting the bathroom with alternative equipment to allow for assisted bathing. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 29 30 The residents were cared for by sufficient numbers of staff that were suitably recruited and trained and having the knowledge and skills to meet the residents needs. EVIDENCE: Examination of the duty rotas and a discussion with staff identified that there was sufficient staff on duty to meet the needs of the 23 residents. Of the 4 relatives’ questionnaires returned, 2 said that they felt there was enough staff whilst 1 did not and 1 was unsure. A discussion with the residents about this showed that they felt that, on the whole there was enough staff. All of the residents spoken with said they felt well cared for and safe in the home. One written response fro a relative added “ All the staff are always polite and chatty despite being so busy, the manager is a credit to her profession. They always appear to spend time with individuals – I so rarely see them sitting down except when to comfort.” A general practitioner added to his response that the home provided “excellent care” The staff recruitment was in accordance with requirements. The three staff files inspected contained the necessary references and criminal records bureau (CRB) disclosures. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 17 Of the 21 care staff, 14 hold their NVQ 2 that represents 67 of the staff group. Information supplied by the Provider on the pre-inspection questionnaire showed that of a staff group of 21 care staff (not including the managers), 10 are trained to a minimum of NVQ2 and 4 staff are trained to NVQ3. The home provides updates in mandatory training such as moving and handling, infection control, first aid and basic food hygiene. The home must provide access to training in the Protection of Vulnerable Adults for all care staff and managers in the home. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 33 The Manager and staff work hard to maintain an atmosphere where everyone is included and valued. There are systems in place to audit the service, so that improvements are made, and poor practice eradicated, in keeping with residents best interests. EVIDENCE: The manager role is taken on a job share basis. One of the managers has recently retired and her position has been filled through an appointment from within the home. The successful applicant has recently applied to be registered with the Commission for Social Care Inspection. The home has achieved the Investors in People award. Quality assurance systems introduced to the home for this award have continued and includes residents meetings, staff questionnaires, staff meetings and residents questionnaires. A collation of service users views of the home has been included in the service user guide. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 x 3 x x x x x Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 20 NO 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. Standard 7 Regulation 15 Requirement Care plans must be accurate complet and and regularly updated to reflect residents changing needs and current objectives. To ensure that an accurate and agreed care plan is in place there must be evidence of relative/resident involvement in the drawing up of the care plan. Risk assessments of all residents in relation to moving and handling and the risk of developing pressure sores must be carried out. Food supplements received into the home must be stored according to guidelines from the Royal Pharmaceutical Society The carpet on the stairway and first floor corridors must be replaced. There must be adequate assisted bathing facilities within the home All care staff and mangers must be given the opportunity to receive traing in the protection of vulnerable adults. Timescale for action 2nd October 2005 2. 7 15 2nd October 2005 3. 7 13 2nd October 2005 4. 9 13 2nd October 2005 30 December 2005 30 November 2005 30th December 2005. 5. 6. 7. 19 21 30 23 23 12 Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 21 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 9 Good Practice Recommendations Hand transcribed medication should be witnessed by two members of staff to avoid errors being made. Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Half Acre House F56 F06 S25474 Half Acre V221159 230805 Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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