Inspection on 16/12/05 for Six Acres

This inspection was carried out on 16th December 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

Six Acres 29/05/07

Six Acres 19/07/05

Six Acres 16/12/04

Six Acres 09/06/04

Six Acres 11/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Six Acres 401 Bickershaw Lane Bickershaw Wigan Greater Manchester WN2 5PR Lead Inspector Lindsey Withers Announced Inspection 16th December 2005 09:20 Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 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 Six Acres DS0000005762.V264891.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 Adults 18-65. 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. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Six Acres Address 401 Bickershaw Lane Bickershaw Wigan Greater Manchester WN2 5PR 01942 861113 01942 866933 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) Mr Brian Malcom Smith Mr Brian Malcom Smith Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Six persons with a learning disability Date of last inspection 19th July 2005 Brief Description of the Service: Six Acres is a privately run care home for up to six adults with learning disabilities. Six Acres is a bungalow situated off a busy road in the village of Bickershaw. It is owned and managed by the Smith family. Mr. Brian Smith, Senior, is the Registered Manager. The Home is close to shops and local facilities and is served by public transport. A smallholding is located at the rear of the bungalow. Geese, ducks, hens and a goat provide activity and occupation for the people who live at Six Acres: everyone is involved in maintaining the well-being of the animals. One of the principal aims of Six Acres is to move people into their own or supported accommodation, where they can live more independently. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a 4 hour period and was announced. The main focus was on those areas not assessed during the previous inspection, so that over both visits all key standards were looked at. Part of the time was spent with the Brian Smith Snr and Brian Smith Jnr, going through the paperwork that has to be kept to show that the home is being run properly. The remainder of the time was spent talking with residents in their lounge/dining room and in their private rooms. What the service does well: 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. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Service users can be sure that their aspirations and needs will be assessed before they move into Six Acres. EVIDENCE: The records for all five service users contained pre-admission assessments that had been completed using information from a variety of sources. These included the service user, their family or other supporter, the social worker, and other interested parties from the health and social care field of work. Admission to Six Acres is usually on a slow, phased approach. A service user would normally visit the home several times before making the decision to move in on a long term basis. It was unusual, therefore, to find that a person had recently been admitted on an emergency contract. Speaking with the service user and observing her interaction with other service users and the staff at the home, it was clear that the decision to admit had been taken with care and with the service user’s best interests and safety at heart. The records for each person showed that the initial assessment forms the basis of the service user’s plan of care. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9. Service users can be assured that their assessed and changing needs will be written into their individual plan. Service users say they make decisions about their lives, and get assistance if they need it. Service users are supported to take risks so that they live as independent a life as they would wish. EVIDENCE: The records showed that each person living at Six Acres has a basic plan of care that is adapted and amended according to the person’s changing needs and aspirations. Each person has a set of short term goals: objectives, with planned outcomes. The objectives include those perceived by the service user his or herself, as well as those identified by a member of staff. The plan is in a simple format that residents were able to talk about and describe. The plan is reviewed and updated with the service user and significant professionals, family and friends at least six monthly. Formal reviews with placing authorities also help to inform the plan of care. Two service users told the Inspector who their keyworker was. Keyworkers are chosen by the service user. Service users also knew how to contact an advocate and had access to telephones from which they would make private, uninterrupted telephone calls. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 9 Service users told the Inspector that they were given every opportunity to make decisions about how they lived their lives and that, if they needed help or guidance they knew whom to ask. Service users said they were free to make individual choices about most aspects of daily living. Their files showed that, where a decision had been made on behalf of the service user, the reasons were fully recorded. Service users manage their own day-to-day finances, or are given assistance to do so. Staff at the home do not act as appointee for any person living at Six Acres. The service user’s family or other advocate generally manages this function. The records showed that service users are supported to take responsible risks. Service users were able to describe the types of risk they might take, for example, going out shopping alone, or using a motorised wheelchair safely. Service users are trained so that they have a good understanding of road safety and personal safety, so that each person achieves of good level of independence. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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, 15, 16, and 17. Service users are offered occupation and recreation that is suitable to them. Service users are involved in the life of the local community and are able to form appropriate relationships. Their right to respect and dignity is upheld. Service users can be sure they will be provided with food that makes a healthy diet, and that is to their taste. EVIDENCE: Service users are offered activities, recreation and occupation that is appropriate to each person. One person was enjoying the chance to help with some building work; others had daily chores for which they were responsible either in the home or on the small-holding. From their various roles, service users learn to work in collaboration with others and to take responsibility for their actions. One service user spoke about attending a college and the things he learned there. Each person has a detailed record of daily activities. Residents said they were satisfied with the range of activities that were available to them. Service users are actively involved in the local community. They use the shops, pubs, and other services that are available, and some are confident Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 11 enough to go further afield alone, using public transport. The home’s mini bus is also available to transport service users to places that they wish to visit. Service users maintain links with their families and friends, supported by staff as needed. Knowing that this would be an announced inspection, several relatives had written to express their satisfaction with the service provided by Six Acres, and describing the level of involvement they had in the day to day life of individual service users. Service users said that their bedrooms were their private space where people entered only on invitation. One serevice user reprimanded another for not knocking or seeking permission before he entered. One service user spoke about having a key, which he used to lock his door whenever he went out. Relationships between service users as a group, and between service users and staff appeared good. The atmosphere was light and friendly, and issues were dealt with tactfully, and without demeaning the service user. Service users said they feel valued as individuals. They understood why there were house rules, for example, in relation to smoking. A record of meals taken is kept in each service user’s file, including those that are taken outside of the home. Service users said that the quality of food provided was very good and that it was the type of food that they liked. There were opportunities to have something different on the many excursions out from Six Acres, if that was what somebody wanted. Service users said they had a good breakfast, and a snack lunch, and that the main meal of the day was served at tea-time. Supper was available for those who wanted it, and drinks were readily available at any time. Checks are kept of residents’ weight and general appearance, and a referral to a health specialist would be arranged if staff had any concerns. Staff are on hand to help any resident who requires assistance with eating. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20. Service users are offered the personal support they prefer and need, and are helped to achieve good physical and emotional health. Medication is managed well by the home. Service users are protected by the home’s policies and procedures for dealing with medication. EVIDENCE: Service users living at Six Acres are assisted with personal care. Community nurses provide any nursing care that is required. The main emphasis of care revolves around the needs, expectations, and preferences of each individual person. Service users have the opportunity to choose who cares for them and can request a certain member of staff to be their keyworker. Any restrictions on a person’s activities of daily living are discussed fully and only put in place once all parties have come to an agreement. Service users are encouraged to demonstrate their independence and to express their individuality, and there was good evidence to show that staff support service users so that they work towards achieving their potential. Service users are helped to acquire the technical aids and equipment they need, and to keep them in good order. Referrals to health specialists, such as speech and language therapists, are arranged through the GP. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 13 Service users had recently been to see their doctors for an annual healthcheck and to have the influenza vaccination. This had been a real achievement for one person who had managed this trip for the first time. Medication for service users is kept securely behind several locked doors. The recording of medicines administered is clear and unambiguous. Each member of staff has received medication training and their initials are noted at the top of each record sheet, so that is it clear who has administered the medicines on a particular day. The service user’s photograph has been added to the record sheet. Not all residents receive regular medication as prescribed by the GP. Some do not take any medicines at all. Those that do said that staff bring the medicines to the service user, along with a drink, at the appropriate time of day. The habits of service users that relate to medication are noted in their care plan. So, for example, if someone has a habit of hoarding medicines in the cheek rather than swallowing them straight away, staff will be aware of this and take steps to ensure medicine is taken properly. None of the service users living at Six Acres currently takes controlled medicines. There is, however, a policy in place for dealing with controlled medication. Simple remedies, such as headache tablets, cough medicine, etc. are administered only when prescribed by the GP. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This section was not assessed on this occasion. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This section was not assessed on this occasion. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This section was not assessed on this occasion. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: This section was not assessed on this occasion. Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Six Acres Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000005762.V264891.R01.S.doc Version 5.0 Page 19 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. Refer to Standard Good Practice Recommendations Six Acres DS0000005762.V264891.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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