Inspection on 10/11/05 for Homeacre

This inspection was carried out on 10th November 2005.

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

Homeacre 30/06/09

Homeacre 03/07/08

Homeacre 24/07/07

Homeacre 03/08/06

Homeacre 14/12/04

Homeacre 04/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Homeacre 28 Hayes Road Clacton On Sea Essex CO15 1TX Lead Inspector Ray Finney Unannounced Inspection 10th November 2005 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 Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 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. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Homeacre Address 28 Hayes Road Clacton On Sea Essex CO15 1TX 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) 01255 425365 01245 425365 Mrs Kathleen Curtis Mrs Kathleen Curtis Care Home 4 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (3) of places Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 3 persons) Two persons, aged 65 years and over, who require care by reason of dementia, whose names were provided to the Commission in March 2004 One service user, over the age of 65 years, who requires care by reason of old age only, whose name was made known to the Commission in March 2004. When this service user ceases to be accommodated in the home the Commission must be notified whereupon the registered numbers will revert from 4 to 3 The total number of service users accommodated in the home must not excced 4 persons 19th July 2005 4. Date of last inspection Brief Description of the Service: Homeacre is a care home providing personal care and accommodation for 4 older people, of whom one is a relative of the proprietor. At the time of this inspection, a condition of registration was in place allowing the care of two named individuals who had dementia. Homeacre is a family run establishment, with service users cared for in the family home. The care and support of service users is carried out by Mrs Curtis assisted by a small number of staff, most of whom are family members or family friends. Facilities for the service users consist of four single rooms, lounge and dining room/conservatory. To the rear of the property there is a paved patio area and garden, which is fully accessible. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place on 9th November 2005 for a total of 6 hours. The inspection process included discussions with the manager, members of staff and a relative. The inspection also included a tour of the premises, observations of interactions between service users and members of staff and evidence gathered from samples of records. The atmosphere in the home during the day of the inspection was relaxed and welcoming and the inspector was given every co-operation from support staff and the Registered Manager, Mrs Kathleen Curtis. The inspector was informed that service users in the home like to be referred to as residents, therefore that is the terminology which will be used throughout this report. What the service does well: What has improved since the last inspection? What they could do better: The home operated a monitored dose system for residents’ medication, however controlled drugs needed to have an appropriate storage facility that complied with regulations. Some issues around record keeping and information needed to be improved, particularly around ensuring the commission was informed of major incidents affecting residents such as going into hospital, by submitting a Regulation 37 notification. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 6 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. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 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 Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 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): 3 (Standard 6 is not applicable) Residents’ needs were assessed before admission to the home. EVIDENCE: Three residents’ files were examined and evidence was seen of Com 5 and preadmission assessments. Staff spoken with were familiar with the assessed needs of residents living in the home. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 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 and 11 Residents’ health, personal and social care needs were set out in individual plans of care. The home ensured the health care needs of residents were met. Overall the home’s policies and procedures for dealing with medication protected residents, although greater security was needed around the storage and record keeping relating to controlled drugs. Residents were assured that at the time of their death, staff would treat them and their family with care, sensitivity and respect. EVIDENCE: Three residents’ care plans were examined and contained evidence of daily living needs and health related records such as weight charts, medical information and appointments with health professionals. One resident had a district nurse visit three times a week to change dressings. The inspector observed that the home used appropriate measures to ensure effective infection control when attending to the resident. Gloves, protective aprons and alcohol hand rub were in use. The inspector spoke at length with the resident, who spoke very highly of the care provided by the home. Staff spoken with Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 10 said that relevant health professionals were consulted when required. The manager informed the inspector that the home had a good relationship with local health professionals such as G.P.s and district nurses; a dentist visited the home when required. There was evidence that staff reviewed care plans. At the time of the inspection no residents were self-medicating. Information received from staff spoken with and records examined showed that staff had appropriate training around the administration of medication. A monitored dose system was in place. Medication was stored in a locked cupboard, however there was not appropriate storage available for controlled drugs and the home did not have a controlled drugs register that met with regulations. The inspector discussed the home’s approach to dying and death with the manager, who said that they encouraged relatives to stay and there was a spare room available. The inspector spoke to the relative of a resident who had recently died and was informed that the home had done everything possible to make the resident’s last days comfortable. The relative was highly complimentary about the care given in the previous three years and “could not thank them enough” for what they had done. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 and 15 Residents were satisfied that the home met their expectations and preferences in respect of social and recreational interests and needs. Residents were supported to exercise choice and control over their lives. The home provided a wholesome diet that met the needs of residents. EVIDENCE: The manager informed the inspector that activities in the home included cards, dominoes and they used a video called ‘Exercises for Aging’. The residents enjoyed watching old films; there were a selection of DVDs available and the manager said they had “cinema afternoons”. Two residents went to a local club and also used the public library, which was a few minutes walk away from the home. One resident had lived at the home for a number of years and had been supported to move on. The resident had tried a variety of different places to live and returned to the home when these changes “didn’t work out”. The manager and staff had supported the resident to access advocacy services to try to find alternatives that fulfilled the resident’s wishes. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 12 On the day of the inspection the inspector observed that home cooked food was provided. Residents spoken with were complimentary about the standard of food and said they enjoyed it. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: No evidence was examined for these standards. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home was maintained to a safe standard and had an acceptable standard of cleanliness. EVIDENCE: The stair lift had been serviced since the last inspection. A tour of the premises showed that the home was kept clean and was free from offensive odours. The shower room, bathroom and toilets showed a reasonable standard of cleanliness. The inspector observed that residents’ rooms had evidence of personal property and the manager told the inspector they could choose how the rooms were decorated. Furnishings were observed to be of a domestic nature. Although some of the furniture was older in style, it was clean and in good repair. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 15 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): 27, 28, 29 and 30 The needs of residents were met by the numbers and skill mix of staff, although the home would benefit from greater detail of staff hours being recorded. Residents were supported and protected by the home’s recruitment procedures. Staff ensured the safety of residents and received training to make sure they were competent to do their jobs. EVIDENCE: Discussions with the manager and observations on the day of the inspection showed that the home used its staff team in a flexible manner. A staff rota was in place, but senior staff informed the inspector that it was difficult to put shift times on the rota, as recommended at the last inspection, because the team worked so closely together that times were not always fixed and staff ‘covered’ for one another. The small size of the staff team meant that there were many short notice changes in response to events. The home would benefit from ensuring that a record was kept of the times staff were in the home, even if was not possible to record shift times in advance. The inspector saw evidence in staff files of appropriate documentation around recruitment such as staff photographs, proof of identity, declaration of fitness to work in a care home and Criminal Records Bureau checks. Discussions with the manager and carers indicated that more than 50 of the care team had completed NVQ at level 2. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 16 Staff files examined showed extensive evidence of training that had been undertaken by members of staff, including food hygiene, medication, dealing with aggression, Health & Safety, Counselling for Bereavement, infection control and dementia awareness. Staff files examined also showed evidence of induction training. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 34, 35 and 38 Overall the home was run and managed by a person who was fit to be in charge, although further efforts needed to be made by the manager to acquire a relevant qualification such as NVQ level 4 in management and care. Residents were safeguarded by the accounting and financial procedures in the home and they were appropriately supported with their personal finances. Overall the home promoted and protected the health, safety and welfare of residents, however, the registered person needed to ensure all documentation required by regulations was submitted to the Commission for Social Care Inspection. EVIDENCE: Records in the home showed that the manager had undertaken training courses to update knowledge and skills. The manager had submitted an Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 18 application to enrol on an NVQ Level 4 course, but provided evidence to the inspector that the training provider was then unable to offer the course and the application was returned. The manager informed the inspector that an alternative was being investigated. Records were examined that showed the home had updated its financial recording procedures to include income as well as expenditure in its budgets as required at the last inspection. The home only looked after the finances of one of the residents and records examined showed appropriate documentation of monies spent. Records such as the Regulation 37 notification, which are required by regulation for the protection of residents, had not been submitted for a resident who was in hospital at the time of the inspection. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X 3 3 X X 2 Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 20 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 OP9 Regulation 13(2) 17(1) Sch3(3i) 9(2)(b)(i) Requirement Timescale for action 30/11/05 2 OP31 3 OP38 37(1)(d) The registered manager must ensure appropriate recording and storage of medication, particularly in respect of controlled drugs. The registered manager must 31/12/05 ensure a qualification of NVQ level 4 in management and care (or the equivalent) is obtained. The registered manager must 30/11/05 give notice to the commission of the occurrence of serious illness of a resident, particularly in respect of residents admitted to hospital. 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 OP27 Good Practice Recommendations The registered person should ensure that the times when staff are on duty in the home are recorded. Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Homeacre DS0000017853.V265552.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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