Inspection on 19/06/07 for Little Acorns

This inspection was carried out on 19th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Little Acorns 03/11/06

Little Acorns 20/06/06

Little Acorns 26/01/06

Little Acorns 20/06/05

Little Acorns 07/12/04

Little Acorns 29/04/04

Little Acorns 13/05/03

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

CARE HOMES FOR OLDER PEOPLE Little Acorns 43 Silverdale Road Eastbourne East Sussex BN20 7AT Lead Inspector Gwyneth Bryant Key Unannounced Inspection 19th June 2007 09:00 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 Little Acorns DS0000021157.V339470.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. Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Acorns Address 43 Silverdale Road Eastbourne East Sussex BN20 7AT 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) 01323 720520 01323 722520 wallis6bn200hz@fsnet.co.uk Mr George Wallis Miss Michelle Levett Miss Michelle Levett Care Home 20 Category(ies) of Dementia - over 65 years of age (20) registration, with number of places Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That a maximum number of twenty (20) service users are to be accommodated. That service users with a dementia type illness are to be accommodated. That service users must be aged 65 (sixty-five) years and over on admission. 19th February 2007 Date of last inspection Brief Description of the Service: Little Acorns registered to provide care to up to twenty older people with a dementia type illness. It is a three storey building situated in the Meads area of Eastbourne, with the seafront and town centre within short walking distance. Access to the upper floors is via stair lifts. Service user accommodation comprises twelve single and four double bedrooms. None of the bedrooms have en-suite toilet facilities but all have a wash handbasin. The home provides a dining room and a lounge that looks out onto a patio area. There is a small visitors room that is also used for storage purposes. The rear garden is not accessible or safe for service users as access is via steep steps. There are two bathrooms, both of which are assisted. Toilet riser seats, hand and grab rails have been fitted to meet individual needs. The service provides prospective service users and their families with a copy of the Service Users Guide, a contract, terms and conditions, the Statement of Purpose. they are directed to the CSCI website for copies of the latest inspection report. periods offered. Fees charged as from 1 April 2007 range from £375 to £480, which includes toiletries, activities, newspapers and small items such as tights. Additional charges are made for hairdressing, chiropody and the manicurist. Intermediate care is not provided. Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over six hours There were fourteen people in residence on the day of the site visit. Three people living in the home were spoken with in addition to discussion with the Registered Manager, one carer, the administrator and the cook. The purpose of the inspection was to check compliance with the requirements made during the last inspection and to inspect other standards. A range of documentation was viewed including service users care plans, personnel files and medication records. A tour of the premises was carried out. Eight surveys of which one was from someone living in the home and seven from relatives of others living in the home and one relative was contacted following the site visit. Comments were positive about the care given with all mentioning that they felt the manager and staff responded promptly to any queries and that the care was good. Comments included: - We are quite satisfied with the care my mother receives. - The nurses are very caring and try to encourage the patients as much as possible. - I have spoken to the home about wishing to be involved and hopefully this will be implemented. - Caring by staff, hands on, including cuddles are meant very well by them. - My mother seems to have a personal connection with them and they are very supportive of me. - It would be nice if more music/poetry could be included and perhaps fresh flowers. - Outstanding caring and loving support for all the residents. - Highly competent staff. - Perhaps soothing classical music instead of loud TV. - I cant fault them. Prior to the site visit information was requested from the provider; this was given and information detailed is used in this report as necessary. What the service does well: Pre-admission documentation has been expanded to ensure all the care needs of those admitted to the home are identified and planned for. The atmosphere of the home is comfortable, homely and relaxed and throughout the site visit staff were observed to engage positively with those living in the home. The home has a core team of staff who have a good understanding of the needs of the people living at the home and they were observed to treat them with care and respect. The décor of the home is good. Systems for dealing with complaints are satisfactory ensuring that people living in the home and relatives feel their concerns are listened to. Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Little Acorns DS0000021157.V339470.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 Little Acorns DS0000021157.V339470.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 4. Standard 6 is not applicable. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Satisfactory pre-admission assessments are carried out prior to people moving into the home, which ensures that their needs can be met, and they or their representatives are provided with detailed information on services provided by the home. EVIDENCE: Pre-admission documentation was viewed for recent admissions and it is evident that these documents are used effectively to ensure the home is able to meet the needs of prospective service users. At the time of admission information is sought from social and healthcare professionals to ensure all needs are clearly identified and planned for. The relative spoken with confirmed a contract was given along with detailed information on the services provided. This relative also said that the manager was able to answer all her questions and put her mind at rest. Intermediate care is not provided. Little Acorns DS0000021157.V339470.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. All aspects of the health, social and care of those living in the home are identified and planned for enabling staff to deliver care in a structured and consistent manner. EVIDENCE: Four care plans were viewed and were found to clearly identify individual needs including action to demonstrate how those needs were to be met. Care planning documents also included information on meeting healthcare needs such as dental, hearing and eyesight checks and individual preferences for times of getting up and going to bed. Risk assessments had been carried out and they clearly identified the hazards and included sufficient detail for the management of risks. Through direct observation and discussion, it is clear that staff are aware of the care needs of those living in the home and of how to ensure their privacy and dignity is protected. Daily notes are very informative and give a good insight to each individual’s preferred daily routines. Night notes showed that individuals were enabled to get up at night and sit in the communal areas and were given drinks and snacks as requested. Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 10 Comments in surveys included: - They always ring if she has a cold or is not too good - Care varies a little but is generally good - Some (staff) are very caring, some are doing a job, albeit doing it well. - The care home does a 99 good job of looking after (name). For me. I can sleep at night not worrying about her welfare. - My wife appears to get all the attention necessary. I find it quite good on my visits. - My thanks to all the carers. The relative spoken with spoke highly of the care given and said her mother had gained weight and was physically much better since moving into the home. Those living in the home are weighed regularly and records included information on what action staff need to take when weight loss or gain is noted. Medication records and storage arrangements were viewed and systems are effective. Medication administration charts were up to date, accurate and clear. Only staff who have been trained administer medication and this was confirmed by staff spoken with. Medication is stored in a locked cabinet to ensure unauthorised persons cannot access it. Little Acorns DS0000021157.V339470.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home have the opportunity to experience a lifestyle that matches their expectations, choice and preferences in respect of meals and leisure activities. EVIDENCE: The home has developed a daily activity programme based on the preferences of those living in the home. The carer spoken with confirmed that a member of staff is given responsibility for providing an activity during the morning and afternoon periods. In addition one person said how much they enjoyed their walks to the shops. Comments in surveys included: - (name) likes her food and enjoys it – nicely cooked and kindly fed – I’ve been there and seen for myself. Throughout the site visit staff were seen to treat those living in the home with care and respect, offer choices and give gentle encouragement for all activities. As a thank you to staff for the care given to a person who used to live in the home, relatives donated a DVD player and a collection of DVD’s for the enjoyment of others still living in the home. The Registered Manager said how much this generous gift was enjoyed by all those living in the home, especially some of the ‘old’ films. Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 12 Menus were viewed and found to be well balanced and nutritious and discussion with the cook found that she was aware of the importance of good nutrition for this client group. The lunchtime meal was observed and the food was attractively presented and it was clearly enjoyed by those living in the home. It was of particular note how staff engaged positively with people living in the home while assisting with meals. Most of the people living in the home have fruit juice with their main meal but wine is available for those who prefer it as long as it does not interact with medication. Bowls of fresh fruit were seen in the lounge area and those living in the home are offered the fruit during the afternoon or may help themselves at other times. The relative spoken with said that the meals seem good and her also mum says this is so. She added that her mother has put on weight and generally her appetite has improved. This relative confirmed she is welcomed at all times and is offered refreshments or invited to stay for meals. Little Acorns DS0000021157.V339470.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a satisfactory complaints system with evidence that those living in the home, via their relatives felt confident their views would be listened to and further protection is provided by robust adult protection procedures. EVIDENCE: The home has detailed policies and procedures on complaints and all complaints are recorded and include actions taken and outcomes. No complaints have been received by either the home or the CSCI since the last inspection. Comments in surveys included: - I have all the relevant paperwork and phone numbers. - I raised an issue and received a call shortly afterwards and the issue was resolved. - To improve; I feel maybe an eye kept on personal belongings like spectacles etc which are not cheap when they go missing. - Handbags & bits & bobs that are not valuable- but are named, are always walking. The issue of missing items was discussed with the Registered Manager who said she would ensure all staff are more vigilant in future and try to ensure incidents of loss are minimised. Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 14 The home has policies and procedures on adult protection and staff are expected to be familiar with this document. The Registered Manager confirmed that all staff have now received Protection of Vulnerable Adults training to ensure they know what action to take in the event of an issue. Discussion with the manager found she is familiar with adult protection procedures and ensures no one living in the home is at risk. Little Acorns DS0000021157.V339470.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The standard of decor within the home is good, providing a homely, safe and comfortable for those living in the home. EVIDENCE: A tour of the premises was carried out and all parts of the home are now well maintained and attractively decorated. There is a maintenance book in which all necessary repairs are recorded to ensure they are carried out promptly. Good continence management systems, coupled with an effective cleaning programme have eliminated offensive odours ensuring that all parts of the home are pleasant and comfortable. Individuals’ rooms were attractively decorated and it was evident that many had taken the opportunity to personalise their rooms with pictures and ornaments. Laundry facilities are clean and hygienic. Systems are in place for the control of infection and all staff have been trained in this area and were observed to Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 16 be working in ways that minimised the risk of infection, by wearing gloves and aprons when required. Little Acorns DS0000021157.V339470.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are sufficient staff with the skills and knowledge to provide consistent care to those living in the home and recruitment practices are robust and offer further protection to those living in the home. EVIDENCE: Information provided prior to the site visit indicated that there are sufficient care staff on duty to meet the needs of those living in the home. Staff were observed to engage positively with people living in the home, in particular when assisting with meals. It is evident that staff work as a team to ensure consistent and good quality care is provided and discussion with a carer confirmed that routine tasks were addressed only when care needs had been met. In addition to care staff cooks and domestics are employed and two night waking care staff. The cook is knowledgeable about the individual dietary needs of those living in the home and ensures that meals remain of good quality. Of the fourteen care staff, four have already achieved a National Vocational Qualification in care at level 2 and a further four are in the process of gaining this qualification. The Registered Manager confirmed that she has developed a training programme to ensure all staff are able to gain this qualification if they choose to do so. The carer spoken with confirmed that the Registered Manager is supportive and encouraging in respect of staff training making staff feel appreciated and valued. Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 18 The relative spoken with said that staff are competent and well trained to give care. She added that she was so impressed as they knew the right things to say to put her mind at rest. Recruitment records were viewed and it was found that all staff had provided the required information prior to appointment including two written references, employment history and Criminal Records Bureau and Protection of Vulnerable Adults (POVA) first check. Little Acorns DS0000021157.V339470.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from clear leadership and direction and all aspects of their health, safety and welfare are protected and promoted. EVIDENCE: The Registered Manager is due to finish her NVQ 4 in Care within the next few weeks but she does have many years experience in managing a care home. Throughout the site visit it was evident that both staff and those living in the home are comfortable with her and returned surveys also confirmed she was approachable. Comments included: - my wife receives the very good attention from the carers at Little Acorns, backed by the oversee of the proprietor (name) I think she’s great. Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 20 The home does not hold or manage monies on behalf of the people living in the home. Receipts are obtained for items bought on their behalf and the cost is included in the monthly fee invoice. The Registered Manager in her role as Registered Provider carries out a number of quality assurance procedures including providing an audit trail for medication, relative surveys, staff training and supervision and these need to be structured and recorded to formalise the quality monitoring process. Documents relating to Health and Safety were available and found to be satisfactory as were accident records. There were records showing the regular testing of emergency lighting and fire alarms and that fire equipment and systems are regularly serviced. The staff training programme ensures they are trained manual handling, infection control, fire safety, dementia care, food hygiene and first aid. Little Acorns DS0000021157.V339470.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 3 X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action 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 OP33 Good Practice Recommendations That quality monitoring practices are formalised. Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Little Acorns DS0000021157.V339470.R01.S.doc Version 5.2 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!