CARE HOME ADULTS 18-65
The Acorns 77 Clifton Avenue Stanley Wakefield West Yorks WF3 4HB Lead Inspector
Tony Railton Unannounced Inspection 21st October 2005 10:00 The Acorns DS0000006245.V259012.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 The Acorns DS0000006245.V259012.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. The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service The Acorns Address 77 Clifton Avenue Stanley Wakefield West Yorks WF3 4HB 01924 824094 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) office@alternativecarelimited.co.uk Mrs Gaynor J Hodgson Mrs Gaynor J Hodgson Care Home 2 Category(ies) of Learning disability (2) registration, with number of places The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2 Residents may also have a mental health problem and/or physical disability 2nd February 2005 Date of last inspection Brief Description of the Service: The Acorns is situated in a residential part of Stanley on the outskirts of Wakefield and continues to provide accommodation and personal care for two people who have learning disabilities. Set back in its own grounds the large detached house provides a comfortable, homely and well maintained environment. The care provided is based on ordinary living principles and there is an expectation that clients do as much for themselves as possible. Clients are assisted to attend day care services and are supported by qualified staff. Clients are also encouraged and supported to take advantage of ordinary community based healthcare and leisure services. The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. At this unannounced inspection there was the opportunity to speak to one service user and the registered manager. There was also the opportunity to look at staff files including recruitment, training and supervision records. It was noted that the home continues to meet all statutory requirements and almost all minimum standards. The inspector would like to take the opportunity to thanks the service user and registered manager for their hospitality and frankness throughout this very positive unannounced inspection. What the service does well: What has improved since the last inspection?
Since the last inspection each client has been provided with a weekly programme of activities which reflects their personal development and social care needs. The manager said that each programme of activities reflects the need to vary clients’ experiences. Clients will benefit from spending time attending local authority and privately run activity centres and ordinary community based leisure services. The manager said that this will give clients the opportunity for choice and to have a custom built programme of activities based on their individual needs. Various parts of the Acorns have been re-decorated and provided with new furniture since the last inspection and in particular the front lounge and the conservatory. It was noted that the service users guide and complaints policy and procedure are now available on audio tape and in a simpler paper format using symbols and pictures. The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 6 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 Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 7 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 The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 8 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 Prospective clients individual aspirations and support needs are assessed before they are admitted to the home. EVIDENCE: Clients records show that they have local authority Integrated Care Management Assessments which are carried out before they were admitted to the home. Alternative Care also have assessments including Person Centred Programme approach documentation which identifies clients hopes and aspirations for the future. The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 9 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 & 9 Clients know that their assessed and changing needs and personal goals are reflected in their individual plan and that these are looked at and updated on a regular basis. EVIDENCE: Clients records show that their personal care and support needs are written down. They show that care plans are put in place which reflect clients care and support needs and that these are reviewed on a monthly basis. Records also show that there are risk assessments to reflect and help minimise any risks to clients trying to live an ordinary lifestyle. Clients records, and in particular, daily records show that they are fully involved and have a say in what happens to them on a day to day basis. The Acorns DS0000006245.V259012.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 & 17 Clients have opportunities for personal development, to participate in age, peer and culturally appropriate activities and to be part of the local community. EVIDENCE: The care and support provided by the home is underpinned by ordinary living principles. Clients records show that they are supported and encouraged to be part of the local community by using ordinary community based healthcare and leisure services. Records show that clients have a weekly programme of activities which involves providing opportunities for personal development in a number of settings including local authority and privately run day centres and community based leisure services. The manager said that clients are supported to ordinary things that you and I would do and that they enjoyed a weeks holiday in Spain this year. There was evidence that clients are encouraged to be involved in baking and cooking and that they are encouraged to participate in food shopping and preparation of meals.
The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 11 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 &20 Clients receive personal support in a way they prefer and require and their physical and emotional health needs are met. EVIDENCE: Clients records show that their personal and healthcare needs are assessed and that care plans are implemented to meet them. Records show that clients are assisted and supported to take full advantage of ordinary community based healthcare services. Clients’ medical records also show that they are also supported by Specialist Social Workers and the Community Learning Disability Team if required. The medical records and staff training records show that clients benefit from having a good policy and procedure for the administration of medicines within the home. The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 12 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): 22 & 23 Clients views are considered and acted upon and clients are protected from abuse, neglect and self harm. EVIDENCE: Discussion with the registered manager indicated that the complaints policy and procedure has been provided in an alternative formats. Along with the Service Users Guide the complaints procedure is now available on audio tape and in plain English using symbols and pictures. The home has not however, received any complaints since the last inspection. Support workers training records indicate that they receive training on adult abuse as part of their induction. It was also noted that the home has a copy of the Wakefield Social Services and Health Multidisciplinary Adult Abuse and Protection Policy and Procedure. The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 13 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): 24 & 30 Clients live in a house which is comfortable, homely, clean and safe. EVIDENCE: Inspection of the lounges, kitchen, bedrooms, toilets, bathroom, dining room and conservatory it was established that all areas of the home are clean, homely and comfortable. Clients have their bedrooms as they want them and are personalised with posters, pictures, photographs and other personal belongings. The main lounge has been decorated since the last inspection and new furniture provided in the conservatory. All areas of the home are decorated and maintained to a very good standard. The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 14 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): 32,34 & 35 Clients are supported by competent and qualified staff team and are protected by the staff selection and recruitment practices. EVIDENCE: Staff records show that all appropriate references and checks are carried out before staff are employed. The manager said that all new staff have induction training which meets Sector Skill Council Workforce training targets. However there was no evidence of induction training found on the day of the inspection. The registered manager said that new staff keep their induction training booklets and copies are not kept on their files. The manager said that she will think of a way of showing what induction training was offered and when it was undertaken by new staff. The training and development plan showed that support workers training needs are identified through line manager supervision and training is planned and provided accordingly. One new support worker has been employed already having a National Vocational Qualification Level 2 in Care. This practice is to be commended. The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 15 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): 37,39 & 42 Clients benefit from living in a well run home in which their rights and best interests are safeguarded and protected. EVIDENCE: The person centred planning reviews show that the clients, their relatives, friends and other stakeholders have the opportunity to comment on the quality of care and support offered by the home. The monthly care plan reviews and daily records show that clients care and support needs are constantly monitored, reviewed and changed if necessary to reflect their current needs. Clients financial records show that they are protected and safeguarded by the homes financial policies, procedures and practices. The staff training and development plan shows that the health, safety and welfare of support workers and clients are promoted and protected. The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 16 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 3 3 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 3 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 3 x 3 2 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Acorns Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 x DS0000006245.V259012.R01.S.doc Version 5.0 Page 17 N/A 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 On the day of the unannounced inspection there was no failure to meet statutory requirements. Timescale for action 21/10/05 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 YA35 Good Practice Recommendations Evidence should be provided in staff records of the type of induction training undertaken by new staff and when the did it. The Acorns DS0000006245.V259012.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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