Inspection on 17/07/07 for Little Acre Care Home

This inspection was carried out on 17th July 2007.

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

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Littledale Hall Therapeutic Community

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Little Acre Care Home 82 Skinburness Road Silloth Cumbria CA7 4QH Lead Inspector Mrs Margaret Drury Unannounced Inspection 17th July 2007 10:00 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 Acre Care Home DS0000069000.V340089.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 Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Little Acre Care Home Address 82 Skinburness Road Silloth Cumbria CA7 4QH 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) 01697 332105 01697 331719 sarah@littleacrecarehome.co.uk www.littleacrecarehome.co.uk Little Acre Care Home Limited Mrs Sarah Betsworth Care Home 14 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (14) of places Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 14 service users to include: *Up to 14 service users in the category of OP (Old age not falling within any other category). *Up to 6 service users in the category of DE (E) (Dementia over 65 years of age). Date of last inspection Brief Description of the Service: Little Acre is care home providing accommodation, personal and social care for up to fourteen older people, six of whom may have varying forms of dementia. The home is owned by Little Acre Care home Ltd and managed on a day-to-day basis by Mrs Sarah Betsworth. Little Acre is situated two miles from the centre of Silloth and has uninterrupted views over the Solway Firth. The home is single storey and has been extended and adapted for its present use as a care home. The accommodation for residents is on the ground floor, with fourteen single bedrooms, thirteen of which have en-suite toilet facilities. There is a large lounge and well appointed dining room, which give ample communal space for the residents to use. There is a bath, shower and toilet, all of which are suitable for people with a disability. The home has large, well-kept gardens and car parking at the front of the building. The fees at this home range from £373.00 to £434.00 per week as at the date of the inspection. There are extra charges for hairdressing, newspapers, magazines and private chiropody. This home does not provide intermediate care. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first site visit since the home was registered as a limited company and forms part of the key inspection. The visit took place over one day in July and included a tour of the building. Prior to the inspection the manager had completed an Annual Quality Assurance document that outlined the services on offer and the home’s plan for the future. This information, together with that received from residents, visitors and staff during the visit confirmed the findings of this report. The inspector was able to speak with residents, all of whom said how much they enjoyed living in Little Acre. Comments received included, “ I love living here and the girls are so kind”, “you could not find any better place to live” and “I like living here because I can spend time in my own room if I wish”. Later in the visit, time was spent speaking to staff and visitors to the home. Comments from visitors confirmed that the staff provided an extremely high level of care. “They are wonderful” and “they are so caring, nothing is too much trouble” were comments received about the staff and “ I am always made very welcome and can enjoy a cup of tea with my mum” were comments made about the home in general. During the visit the inspector spent time with the registered manager discussing the operation of the home and looking at the administrative procedures. A tour of the building was undertaken, during which the manager discussed work that was shortly to commence on the refurbishment of the dining room. What the service does well: Residents and visitors spoke very highly of the staff and praised the level of care and support provided. The inspector observed warm interaction between staff and residents and visitors said they were “always made welcome and offered tea and biscuits”. The home provides a warm and homely atmosphere with staff supporting residents in their daily life and ensuring the routines within the home are applicable to the needs of those living in the home. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 6 Care plans are well kept with all the monthly reviews up to date. Information on them was relevant and provided sufficient detail for the care staff to meet the assessed needs. Medication records were up to date and correctly completed, with details of all prescribed medication recorded on the care plans. The environment is extremely well kept with all areas decorated to a very high standard. Work is to start shortly on refurbishing the dining room, which will further enhance the quality of life for those living in the home. 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 Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 8 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 Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who choose to use this service and/ or their representatives are provided with the information needed for them to make an informed choice about moving in. EVIDENCE: The home provides a statement of purpose that is specific to the home and outlines the facilities on offer and the resident group that can be cared for. Admissions to Little Acre do not take place until the manager has completed a full assessment of needs. The dependency levels of those already living in the home are also taken into consideration when assessing prospective residents. This ensures that the staffing levels within the home are able to meet the Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 10 needs of all those living there. The manager considers it important for family members to be present during the assessment and this is arranged where appropriate and providing the resident agrees to this arrangement. Prospective residents and/or their families are given the opportunity to visit the home and spend time with the staff and other people living there. Key workers are allocated to each resident to help them settle in and feel comfortable in their new surroundings. This visit also ensures that those coming to live in the home and/or their family members know all the individual needs will be met. All residents are given a contract and statement of terms and conditions of residency that sets out in detail what is included in the fees. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 11 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 7 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on individual needs. The principles of respect, privacy and dignity are upheld at all times. EVIDENCE: Samples of residents care files were looked at during this visit. Individualised care plans are developed from the care needs assessment during the first few weeks of the resident moving into the home. They identify the tasks that residents need assistance with and also what the person is able to do themselves. This helps to ensure that the independence and individuality of people living in this home is promoted and encouraged as much as possible. The manager is currently looking at different formats for the care plans in order to provide more information to enable the staff to deliver an even higher standard of care. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 12 The records also show that people living at Little Acre receive attention from health care professionals such as doctors, community nurses, chiropodists, opticians and hospital staff when required and are supported to attend appointments. The home has policies and procedures in relation to the administration of medication. Those members of staff responsible for administering medication have all undertaken training to ensure that they are competent and able to carry out this task safely. One resident has maintained responsibility for their own medication. This is managed within a risk-assessed framework, which is kept under review. The resident is provided with a safe place in which to store the medication. Samples of medication records were looked at during this visit and were found to be up to date and accurate. It was noted, however, that printed medication sheets are not received from the pharmacy so all records are hand written. It was recommended that a second member of staff checks and signs the records as a further measure to safeguard the residents. One relative commented that there is an “excellent level of care in all aspects and the friendly, helpful and caring staff are wonderful”. One of the residents said ‘that the staff will help with anything but I like to be very independent. I know that if I need or want help I can get it. All the staff are very good”. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 13 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Little Acre are encouraged and enabled to make choices about their daily lives. Activities are available to meet cultural, social and leisure needs of the residents. EVIDENCE: Activities are available in the home and residents choose whether they join in or not. Residents are encouraged and helped to remain active and independent and have shown a great deal of interest in the recently introduced monthly “Little Acre Times”. This “newspaper” contains details and pictures of residents enjoying activities and news about residents who are coming to stay for short breaks. It gives accounts of any birthdays to be celebrated during the month and personal profiles prepared by the “resident of the month”. Also printed is the monthly activities guide that enables residents to choose what activities they would like to take part in. Church services are arranged in the home and again residents choose whether to attend or not and Communion is given to those who wish to receive it. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 14 Visitors to the home are made welcome and residents may choose to see visitors in their own room or in one of the communal areas. Residents said that their visitors are ‘well looked after’ and would be provided with refreshments if they wished. During the visit, discussions took place with the cook who has worked at the home for some time. There is a choice of main meal, the alternative usually being a vegetarian option. The residents who spoke with the inspector all said they enjoyed their meals and “we can choose something else if we want to”. As the visit coincided with the lunch period the inspector was able to observe the meal being served. This was completed in a relaxed and unhurried manner with each resident served individually from a trolley. This ensured each was given as much or as little as they wanted. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Little Acre feel comfortable expressing concerns to the manager knowing they will be listened to and acted upon. EVIDENCE: There is a policy and procedure in place regarding the protection of vulnerable adults. The home has a copy of the local authority’s up to date guidance and procedures on this subject. Staff training records show that the manager ensures staff are aware of the procedures to follow should this be necessary. The manager, using a DVD presentation, provides training in adult protection and this subject is discussed during the induction programme and during staff supervision. There have been no complaints made to The Commission for Social Care Inspection and the manager dealt, immediately, with the one concern raised by a resident. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables the residents to live in a safe, well-maintained and comfortable environment. EVIDENCE: Little Acre is decorated and furnished to a very high standard throughout and all areas were clean and fresh. Residents spoken to during this visit were very satisfied with the environment and very pleased with their own rooms. All rooms have been personalised by the residents with pictures, photographs furniture and ornaments brought from their own homes. Residents are provided with a safe place to store small items of a personal nature or medication in their own rooms if they wish. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 17 All rooms are single and all but one have en-suite toilet and washing facilities. The home has sufficient bathing facilities to meet the assessed needs and all are suitable for people with a disability. All accommodation is provided at ground floor level, which makes movement around the home accessible to all residents. A visitor who spoke with the inspector remarked this and said, “One of the reasons for choosing Little Acre was because my mother would not have any stairs to climb”. The home provides all the required aids to encourage and facilitate independence including, raised toilet seats, hand rails, grab rails and various hoist to assist with mobility. There are garden and patio areas for the residents to enjoy and the lounge provides panoramic views over the Solway Firth. The home does not currently provide designated cleaning staff but the manager is in the process of addressing this. The home was extremely clean and sweet smelling on the day of the visit and when asked about the cleanliness of the home one of the visitors remarked that the home “ always looks beautiful and is always clean”. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 7 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are competent and experienced. This helps to ensure that the needs of people living at the home are met in a safe and appropriate way. EVIDENCE: Samples of staff recruitment and training records were looked at during this visit to the service. Prospective staff are required to complete application forms and undergo special checks such as Criminal Record Bureau (CRB) checks and Protection of Vulnerable Adults (POVA) list checks. This helps to ensure that only suitable people are employed to work at the home. There are currently staff vacancies but the manager is taking steps to address this situation. In the meantime current staff are covering the required hours, which ensures agency staff are not used. Discussions with staff on duty on the day of the visit evidenced that they work closely as a team and support each other. There is a low staff turnover and many have worked at the home for a number of years. This provides continuity of care for those living at the home. Much of the staff training is completed in-house and provided by the manager using a variety of aids. All mandatory training is up to date although the Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 19 training records were not all complete or easy to access. The manager is currently looking at ways to address this as a good practice measure. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35, 36 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of service users by a competent and experienced manager. EVIDENCE: The manager is supported in carrying out her role, by an experienced staff team all working together, to ensure the home is run in the best interests of the residents. The atmosphere in the home was warm and friendly with visitors who spoke to the inspector saying that they were always made very welcome when they visited. Comments made by residents and visitors included, “ Sarah (manager) is so kind and always there to help” and “ the manager is available Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 21 when you want to see her” and “the manager or staff always ring me with information about my mum”. The manager keeps up to date with social care and accesses anything that will be useful in the running of the home. Her husband, as the responsible individual, is also concerned with the home’s operation and residents made many comments about his kindness. The home takes care of some personal allowances (e.g. money for hairdressing, toiletries etc). Individual records are kept and money is kept separately. Two members of staff record and check any transactions and signatures are recorded. This helps to ensure that resident’s finances are protected and managed safely. Residents’ meetings are held, which give opportunity for comments and suggestions. Some family members have indicated that they would be interested in a forming a relatives group and this will be considered in the near future. The manager undertakes staff supervision and records are kept on each individual staff file. Records relating to maintenance, fire safety procedures and equipment were inspected and found to be up to date. All equipment is maintained under annual service contracts. The fire department recently visited the home and confirmed that all the fire risk assessments were in place and in order. Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 22 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 3 3 3 3 3 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 3 3 3 3 3 3 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 3 3 X 3 3 X 3 Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 2 Refer to Standard OP9 OP30 Good Practice Recommendations It is recommended that all hand written medication records be checked and signed by a second member of staff. It is recommended that clearer records of staff training be improved and maintained . Little Acre Care Home DS0000069000.V340089.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Acre Care Home DS0000069000.V340089.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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