Inspection on 25/01/06 for Half Acre House

This inspection was carried out on 25th January 2006.

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

Half Acre House 10/07/07

Half Acre House 01/06/06

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 Bernard Tracey Unannounced Inspection 25th January 2006 09:30 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.V268809.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. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 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 01706 633891 Mrs Anita Lewis Mrs Lesley Rider Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 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 23rd August 2005 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 2storey 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. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not made aware that this inspection was to take place and itwas undertaken over a period of 4.5 hours. During this time the inspector talked with the manager about outstanding issues from the last inspection and how much progress had been made in addressing these. Further time was spent looking at written information and records relating to residents and staff employed in the home. The Inspector talked to 6 people who live at the home, 4 visiting relatives and the staff on duty. Observations were made of the care provided and some residents talked about their personal experiences of life for them in the home. What the service does well: What has improved since the last inspection? What they could do better: There continues to be outstanding issues that the home has failed to put right despite being instructed to and agreeing that they would do. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 6 Of particular concern is the poor standard of the written documents relating to how the care of residents is to be met. The home has been given six weeks from the day of the inspection to provide adequate written care plans. A follow up visit will take place at this time to make sure that the home is complying. The care documentation did not show that residents or their representatives had been involved in the development or reviews and this is another example of the home not putting something right despite being told they should at the last inspection. Recommendations have been again required to improve the record keeping in relation to care documents and hand written medication records. The home needs to provide staff with ongoing training to make sure that they are able to do their job better, as well as providing them with updated training in food hygiene moving and handling and other areas of work important to the well being of the staff as well as the residents. Although the staff are well supervised on a daily basis while working at the home, the manager must ensure that time is made available for all staff to have individual meetings on a regular basis to discuss their job and how the home is running. The home must provide clear guidance on how staff should respond to suspicion or proof of any abuse, should it occur. This guidance should be made with clear reference to the Rochdale Inter Agency Abuse Procedure and supported by training of all staff in the Protection of Vulnerable Adults . The dining room furniture needs a thorough clean. New place mats are needed for all the dining tables. 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 DS0000025474.V268809.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 Half Acre House DS0000025474.V268809.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): The key standards were examined at the last inspection 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 an assessment undertaken before their admission to the home, which gives an assurance to residents that the home can meet their needs. EVIDENCE: The key standards were examined at the last inspection on the 23rd August 2005. All of the key standards were met Half Acre House DS0000025474.V268809.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 8 9 10 Care plans do not always fully demonstrate how aspects of health, personal and social care needs would be met. 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. The home is not consistently good at involving residents or their representative in the development or review of care plans. Personal support is given in the home in a manner that promotes and protects privacy, dignity and independence of the residents. EVIDENCE: Individual plans of care were held for each resident but of three examined none provided adequate information in identifying the needs of the residents or how the assessed needs were being met. One care plan for a recently Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 10 admitted individual was incomplete. The home was informed that this was not acceptable and residents care needs as assessed prior to admission as well as reference to the care manger’s assessment formed the basis of the initial care plan which should then be reviewed at the six week review or in the light of experience to reflect the changing needs of the individual. Following the last inspection the home was required to review 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 in a clear and consistent way. Only very limited progress has been made in introducing new care plan documentation by making files easier to read and in identifying action to be taken to meet the care needs of the residents. The plans examined did not fully encompass health, personal and social care needs. The recording of the involvement of GP, District Nurse and other health professionals, did not provide detailed actions to be taken to ensure that the advice of the GP, for instance, had been followed. An example of this was a resident who had been diagnosed by the GP as having a urinary tract infection, yet following the diagnosis the home failed to record what actions were to be taken to aid recovery. Not all care plans provided written evidence of residents or their representatives being involved in the drawing up and review of individual care plans. One care plan had not been reviewed since September 2005 whilst others continue to state “No change” with little effort being made to involve the service user a provide a meaningful monthly review of the care. Four visitors and two residents spoken with during the inspection stated that they had not been asked to review the care plans. Relatives stated though, that the home did keep them informed of any changes that affected the care of the resident and of any significant events. All of the relatives spoken with said they were happy with the level of care provided and if they had a problem were able to approach the manager or one of the care staff. Risk assessments were not in place in all care plans covering such areas as moving and handling, nutrition, pressure care, the use of bed rails and falls. The residents were weighed at least on a monthly basis and the weight recorded on a chart kept in their care plan. A discussion with the manager highlighted the need to complete the implementation of the new documentation for all of the remaining residents, as a matter of urgency. It was agreed that all of the care plans would be reviewed and old documentation replaced with the proposed new format presented at the inspection. A timescale of six weeks from the date of the inspection was agreed, and a further follow up inspection will take place at this time. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 11 The medications system was safe. Medications were securely stored; the prescription administration sheets were filled in accurately and there was an accurate record of medicines received into the home and returned back to the pharmacist. Designated and appropriately trained staff administered medicines. 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 dresser in the dining room. It is recommended that when it is necessary to hand transcribe prescriptions on to the medicine administration sheet, the entry is checked and signed by two members of staff to avoid errors. This recommendation was made at the last inspection but further evidence of staff not following the good practice recommendation or the home’s policy in relation to safe handling of medicines was seen. The Inspectors observed the caring approach of the staff towards the residents and was able to confirm that the practices in the home ensured that residents were treated with respect and their right to privacy was upheld. A regular visitor to the home said she had also observed this. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 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 the following standard(s): 12 13 14 15 The range of leisure activities available in the home was varied, reflecting the diversity of residents and their social, intellectual and physical capacities. Links with the community were good, supporting and enriching service users social opportunities. Staff valued the role, which relatives and friends could continue to play in the lives of service users, and encouraged and enabled such contact. The dietary needs of the residents were well catered for with a balanced and varied selection of food that met the residents’ preferences, tastes and choices. EVIDENCE: An activities person visited the home daily to provide a variety of activities including, craft sessions, exercises, games, quizzes and discussions. In addition musical entertainment was arranged on occasions. Special occasions and birthdays were appropriately celebrated. Residents spoken with said there were a “good mixture between rest and things to do”. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 13 A visitor interviewed considered they were made welcome at the home. They could visit whenever they wished and could see their relative in private. In particular, positive comment was made about the welcoming manner of staff when visiting the home initially. Religious services are held at the home, and representatives of one Christian faith were visiting the home, held a service and offered prayers during the inspection. The choices residents made each day varied, dependent upon their frailty but residents generally chose what time to get up, go to bed, what clothes to wear, what to eat, where to spend their day, whether or not to participate in activities and whether or not they wished to have a key to their rooms The majority of residents chose to have their monies managed by relatives, one managed their own. Residents and relatives had limited involvement in care planning. Resident meetings were held every two months and notes from these meetings are produced with evidence of the home’s response to concerns raised by the residents. Hot and cold drinks were offered to residents on a regular basis throughout the time of the inspection. Breakfast was observed being served and also the lunchtime meal. All of the residents spoken with said that the food was good. One resident said the food was “invariably good, tasty and varied” another resident said that “on the odd occasion I do not want either of the meals on the menu the cook would always happily provide a further alternative” Staff were seen to give appropriate assistance in a pleasant and encouraging manner. Some residents ate their meal in the dining room whilst others were served the meal in their own room or in the lounge area, dependent upon choice. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 14 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 18 There is evidence to show that residents and relatives were able to make their concerns known and they would be acted upon. Management and staff did not have a good knowledge and understanding of adult protection procedures thereby increasing the possible risk of harm or abuse to residents. EVIDENCE: The home has written policies on Adult Protection and Whistle blowing, which staff were aware of. However the home did not relate this to the Local Authorities Vulnerable Adults Procedure and a discussion with care staff and management identified that there were not aware of the procedure to follow in the event of any allegation of abuse. No members of staff had undertaken training in the protection of vulnerable adults. There was evidence of staff recently viewing a video training programme on adult abuse but this did not provide the home with sufficient detailed information and did not relate to local procedures as detailed in the Local Authorities Vulnerable Adults Procedure The manager said that it was her intention to send staff on the course that Rochdale Social Services were providing. There is a written complaints policy and copies of this are posted in prominent positions throughout the home. There have been no recent complaints made to the home, but residents and relatives said they would not hesitate to tell the Manager if they had any concerns. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 15 Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 Whilst most of the accommodation was satisfactorily maintained, not all areas were well maintained, clean or safe 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 and has been planted with flowers and shrubs. Furnishings in communal areas were domestic in character, generally of good quality and suitable for their purpose. However the dining furniture requires cleaning as evidence of dried food and general dust was seen on many of the chairs. The placemats on the dining tables are now so worn that they need replacing with a full set of new ones. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 17 The carpet that leads from the ground floor staircase to the first floor corridors is due to be replaced and the Business Manager assured the Inspector that this will be completed within the next month. The carpet on the upper corridor has recently been replaced. 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. The ground floor bathroom has now been equipped with facilities for assisted bathing through the provision of a corner bath and fixed hoist . Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Staff training needs improving to ensure residents are protected and supported by competent care staff at all times. EVIDENCE: The manager is aware that staff training is not up to date and is presently planning to assess staff training needs. Updates are needed for Food Hygiene, Moving and Handling and various other areas of statutory staff training. The manager should also complete a training overview record, to ensure all staff have appropriate training in place. Staff had a limited knowledge and understanding of adult protection procedures thereby increasing the possible risk of harm or abuse to residents. No members of staff have undertaken training in the protection of vulnerable adults. The home must provide access to training in the Protection of Vulnerable Adults for all care staff and managers in the home. The manager said that it was her intention to send staff on the course that Rochdale Social Services were providing. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 19 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): 31 35 36 38 The Manager and staff work hard to maintain an atmosphere where everyone feels 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 applied to be registered with the Commission for Social Care Inspection and having successfully completed her interview is being registered Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 20 Supervision is not being undertaken. The manager must implement a system of formal supervision within the home in the timescale set. 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. Maintenance of equipment in the home is up to date to ensure that the safety and welfare of the people using the service is promoted. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 21 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 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 1 2 X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 2 X 3 Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 Requirement Timescale for action 10/03/06 2. OP7 15 3. OP7 13 4. OP9 13 Care plans must be accurate complete and regularly updated to reflect residents changing needs and current objectives. (Outstanding requirement in the timescale of 2nd October 2005) To ensure that an accurate and 10/03/06 agreed care plan is in place there must be evidence of relative/resident involvement in the drawing up of the care plan. (Outstanding requirement in the timescale of 2nd October 2005) Risk assessments of all residents 10/03/06 in relation to moving and handling and the risk of developing pressure sores must be carried out.( Outstanding requirement in the timescale of 2nd October 2005) Food supplements received into 10/03/06 the home must be stored according to guidelines from the Royal Pharmaceutical Society. (Outstanding requirement in the timescale of 2nd October 2005) DS0000025474.V268809.R01.S.doc Version 5.1 Half Acre House Page 23 5. 6. OP19 OP30 23 12 7. OP36 18 8. OP30 18 9. 10. OP19 OP26 23 23 The carpet on the stairway and hall must be replaced. All care staff and managers must be given the opportunity to receive training in the protection of vulnerable adults. (Outstanding requirement in the timescale of 30th December 2005) A system of formal supervision system whereby all care staff receive supervision at least 6 times a year must be implemented. A programme of staff training is to be planned and a copy sent to the Commission for Social Care Inspection Replacement table mats must be purchased for the dining tables The dining furniture must be thoroughly cleaned and maintained in a satisfactory state. 30/03/06 30/03/06 30/03/06 10/03/06 10/03/06 10/03/06 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 OP9 Good Practice Recommendations Hand transcribed medication should be witnessed by two members of staff to avoid errors being made. Half Acre House DS0000025474.V268809.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office 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 DS0000025474.V268809.R01.S.doc Version 5.1 Page 25 - 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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