Inspection on 03/08/06 for Homeacre

This inspection was carried out on 3rd August 2006.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Homeacre 30/06/09

Homeacre 03/07/08

Homeacre 24/07/07

Homeacre 10/11/05

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 Final Unannounced Inspection 09:30 3rd August 2006 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.V300248.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. Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 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.V300248.R01.S.doc Version 5.2 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 exceed 4 persons 10th November 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. Homeacre is a family run establishment, with service users cared for in a homely environment. 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. The home charges £367.15 per week. Additional charges for items such as personal toiletries and newspapers are at normal retail costs; hairdresser is available at a cost of approximately £7.00 for a set. This information was provided to the commission in May 2006. Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was looked at when compiling this report. The manager of the home provided information in a pre-inspection questionnaire and documentary evidence was examined, such as care plans and staff files. A visit to the home took place on 3rd August 2006; this included a tour of the premises, discussions with the management team, discussions with staff and observations of interactions between service users and members of staff. On the day of the inspector’s visit the atmosphere in the home was relaxed and welcoming and the inspector was given every co-operation from the registered manager, Mrs Kathleen Curtis and senior carers. What the service does well: What has improved since the last inspection? What they could do better: Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 6 Although the fences in the back garden have been repainted and a new storage shed has been installed, there is scope for improving this area. The manager has plans for developing the back garden. Although there are a variety of planned activities, the activities planner could be made more accessible to service users, for example by being displayed in a communal area. Also, the activities planner should be in a format that is easy for service users to understand and could be improved by using large print and pictures. Although the views of service users, their relatives and staff are sought and valued, the Quality Assurance system needs to be developed further so that the home can demonstrate that these views are used to develop the service. These views need to be put together into a report that is made available to the Commission and other interested parties. 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.V300248.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (standard 6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures the needs of prospective service users are assessed. EVIDENCE: There have been no new admissions to the home since the last inspection visit. As reported previously, the home has an appropriate assessment process in place. Service users’ records examined contain evidence of assessment of their needs. The manager and senior staff spoken with are able to demonstrate a good awareness of the needs of service users living in the home. Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that the service user’s health, personal and social care needs are set out in a plan of care and service users are supported to make decisions about their lives with assistance and within the limitations of their abilities. Service users are protected by the home’s policies and procedures for dealing with medicines. The home ensures that service users are treated with dignity and 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. EVIDENCE: Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 10 At the inspection visit, the records of two service users were sampled. Both care plans examined contained well-detailed information on how service users like to receive personal care. The manager and senior carers were also able to demonstrate a high level of awareness of service users needs, likes and dislikes. Care plans contain evidence of daily living needs and a variety of health related records, e.g. weight charts and mobility assessments. As reported at the previous inspection, local health professionals such as G.P.s, district nurses and a dentist visit the home when required. Care plans contained evidence that they were reviewed to meet changing needs. Discussions with the management team and records examined show that the needs of service users living in the home are changing as a result of the aging process and a deterioration in mental health is noted. At the time of compiling this report, the home has submitted an application to vary their registration to enable them to care for service users with dementia. As at the last inspection visit, no service users are self-medicating. Storage facilities have improved and medication is kept in a locked cupboard with an additional locked box inside. The home operates a Monitored Dose System (MDS). Staff records examined show that staff have received medication training within the last year provided by the supplier of the MDS. In addition, some senior staff have completed the BTEC advanced award ‘Principles of Administration and Control’. One service user had ceased a medication on the instructions of the G.P. but it was still on the current Medicine Administration Record (MAR) sheet. The manager is to contact the G.P. to ensure it is removed from the next repeat prescription. Quantities of drugs delivered are recorded on MAR sheets. Staff have a file containing information about medication, side effects etc that they can refer to. At the time of the inspection visit, insulin was being kept in the fridge in the kitchen, but the manager stated that a new small fridge has been purchased for the storage of insulin. Observations on the day of the inspection visit show that members of staff treat service users with respect. Evidence was seen of very positive comments from relatives about the care provided. Staff spoken with are able to demonstrate a good awareness of the importance of treating service users with respect and maintaining their dignity when providing personal care. Evidence was seen at the last inspection of the home’s supportive and empathetic approach to supporting service users who are in the final stages of their lives. Relatives spoken with at the time were highly complimentary about the care given by the home. At the time of this inspection visit, a service user had recently died and staff were able to explain in detail how they had supported this service user and how they had provided positive support to the service user’s next of kin. The ‘family’ nature of the service is evident in the way staff were involved in supporting the service user’s next of kin with the funeral arrangements. Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. 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. Overall the lifestyle experienced by service users in the home satisfies their expectations and preferences in respect of social and recreational interests and needs, although a more accessible activities planner would improve choice for service users. The home ensures service users are supported to maintain contact with family and friends. The home supports service users to exercise choice and control over their lives. Service users are provided with a wholesome, appealing diet that they enjoy. EVIDENCE: The home has an activities book that documents the activities available in the home. Activities include cards, dominos and an exercise video called ‘Exercises for Ageing’. One service user likes to visit the local ‘betting shop’. The manager explained that they use ‘play doh’ because it exercises the hands and Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 12 helps with mobility. Service users enjoy watching DVDs and the home has now installed a satellite receiver so that service users can enjoy films. The home is situated very close to the town and service users are supported to access local facilities such as the library. Although activities are recorded in the daily records and the activities book, service users would benefit from being able to see what activities are available by displaying an activities planner in an accessible communal area. This planner should be in a format that meets the needs of the elderly service users in the home, with large print and clear pictures. Information received from relatives and observations at the previous inspection show that the home makes it a priority to maintain and promote links with service users’ families. The home supports service users to make choices where possible. At the previous inspection, one service user who had lived at the home for a number of years and then moved on, had returned to the home. The manager and senior staff are currently supporting this person to find alternative accommodation. Sample menus examined show that a variety of home cooked food is available. As at the last inspection visit, inspector observed that home cooked food is provided. Food is traditional ‘home cooking’ with dishes such as boiled ham, vegetables and potatoes being served and staff spoken with are able to demonstrate a knowledge of service users likes and dislikes. Drinks and snacks are available regularly throughout the day. Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the home has a complaints procedure that ensures complaints will be taken seriously, listened to and acted upon, although no complaints were on record. Procedures in the home ensure service users are protected from abuse. EVIDENCE: The home has an appropriate complaints procedure in place that gives timescales for responding to complaints. Information provided in a preinspection questionnaire states that no complaints have been received in the past 12 months. No complaints have been received by the commission. The strong links the home maintains with families of service users ensures that minor concerns will be raised and addressed promptly. The manager and staff are always available to discuss issues with the representatives of service users. Since the last inspection there have been some improvements in processes to ensure the protection of service users. A visitors’ book has been introduced to record who is coming into the home. Staff records examined show that staff attended a Protection of Vulnerable Adults training course in July 2006. Two staff files were sampled and both contained appropriate Criminal Record Bureau (CRB) checks. Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 14 Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the environment is safe and is reasonably well maintained, although planned developments to the garden area would improve the environment for service users. Overall the home is clean and hygienic. EVIDENCE: As reported at the last inspection, the home is kept clean and free from offensive odours and the bathroom and toilets show a reasonable standard of cleanliness. Since the last visit the dining room has been repainted and on the day of the inspection the front lounge was in the process of being redecorated. A new settee and chairs have been purchased for the lounge. Some improvements have been made to the outside of the property; new fences and flowerbeds are in place to the front of the home and fences have Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 16 been repainted and a new storage shed installed in the rear garden area. The manager informed the inspector that further improvements were planned to develop the rear patio area and make it more pleasant for service users. Since the last inspection visit a new carbon monoxide monitor has been installed. Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of service users are met by the numbers and skill mix of staff. Although the home ensures service users are in safe hands, the home needs to continue to pursue training providers to ensure the recommended percentage of care staff have appropriate training. The home’s recruitment policy and procedures ensures the protection of service users. The home’s training programme ensures staff are trained and competent to do their jobs. EVIDENCE: At the last inspection it was reported that the home uses its staff team in a flexible manner and this was not always documented on a rota. Improvements have now been made in recording staff times. The small staff team work closely together in a flexible manner so that they can respond to the needs of service users. Two senior members of staff have now enrolled on NVQ Level 4 in care and have commenced working towards the award. Two members of staff have submitted applications for NVQ Level 3 and one person has applied for NVQ Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 18 Level 2. Although the 50 of care staff with NVQ has not been achieved (as recommended in National Minimum Standard 28) evidence was seen that staff have enrolled on the courses and some units have been completed. Unfortunately the training provider has ceased trading and the manager is now pursuing alternative providers to ensure staff are supported to complete their awards. Two staff files were sampled and, as at the last inspection visit, there is evidence 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 (CRB) checks. Staff spoken with say that they have access to ‘all sorts’ of training. Evidence was seen in staff files of courses on Managing Aggression, Safety in the Workplace, Infection Control, Manual Handling, Fire Safety, Counselling for Bereavement, First Aid, Falls Prevention, Diabetes, Health & Safety and Risk Awareness. Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 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, 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. Overall the home is well run, although the manager should continue to develop management skills and complete management qualifications. The home is run in the best interests of service users and their views are taken into account, however the quality assurance system needs further development. The home ensures the financial interests of service users are protected. The home ensures the health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 20 At the last inspection visit records examined show that the manager has undertaken training courses to update knowledge and skills. The manager had submitted an 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. Since the last inspection, the manager has delegated much of the day to day running of the home to the two senior members of staff who now act in the capacity of deputy and assistant manager. The manager explained that she anticipated that the management role would eventually be taken by one of the senior staff and she would be able to withdraw from her current role. Both senior carers have enrolled on NVQ level 4 courses. For the interim period, the registered manager remains in charge of the home. The manager is able to explain what the home does to get the opinions of service users and other interested parties and how this information is used to make decisions direct practices within the home. The manager has an ‘open door’ policy and actively seeks the views of relatives and other interested parties. The management team are able to demonstrate that there is good communication with service users and every effort is made to find out likes, dislikes and wishes. Overall the home was able to demonstrate some good practices around seeking the views of service users and other interested parties, however, the system needs to be more structured and documented. The information obtained from staff, service users or their representatives needs to be collated into a report and a copy submitted to the Commission. None of the service users in the home has the capacity to manage their own finances; this is carried out by relatives. The home only looks after the finances of one service user, who is also a relative of the manager. Records examined show appropriate documentation of monies spent. The manager ensures safe working practices that include appropriate staff training (see evidence for National Minimum Standard 30). The home is maintained to a standard that ensures the health and safety of service users and staff (see evidence for NMS 19 and 26). The home records any accidents, injuries and incidents of illness and reports them to the Commission for Social Care Inspection, although Regulation 37 reports need to be sent to the Commission without undue delay. Service user records examined show that risk assessments are in place. Information submitted to the Commission in a pre-inspection questionnaire and documents examined at the inspection visit show that maintenance associated with Health & Safety is carried out. Portable Appliance Testing (PAT) was carried out in September 2005, fire equipment was examined in September 2005, the stair lift was serviced on 30/08/05 and the gas boiler and electrics had maintenance certificates dated 23/04/04 and 01/02/04. Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 1. OP31 9(2)(b)(i) 2. OP33 24(1)(a) (b)(2)(3) 37(1)(d) 3. OP38 The registered manager must 31/12/06 ensure a qualification of NVQ level 4 in management and care (or the equivalent) is obtained. (Timescale of 31/12/06 not met) The registered manager must 31/12/06 ensure that an effective Quality Assurance system is implemented. The registered manager must 31/08/06 ensure that Reg 37 notices of the occurrence of incidents are sent to the Commission in a timely manner. 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 OP12 Good Practice Recommendations The registered person should ensure that service users have access to information about planned activities in a DS0000017853.V300248.R01.S.doc Version 5.2 Page 23 Homeacre 2. OP28 format suitable to their capacities. The registered person should continue to pursue alternative training providers to ensure staff are able to complete their NVQ awards. Homeacre DS0000017853.V300248.R01.S.doc Version 5.2 Page 24 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.V300248.R01.S.doc Version 5.2 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. 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