Please wait

Inspection on 25/10/07 for Sunbridge Care Centre

Also see our care home review for Sunbridge Care Centre for more information

This is the latest available inspection report for this service, carried out on 25th October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

I found that the needs of the people case tracked were within the range of those specified in the statement of purpose. The statement of purpose also identified the skills and staffing resources that are available to meet the needs of people living at home. All the people case tracked had recently come to live at the home. There were detailed assessments of their needs carried out by care management. A person told the expert by experience that since coming to live at the home, " everything is nice here and I`ve made some good friends." Comprehensive initial assessments make sure that peoples medical, personal and social needs are identified and met in ways that reflect their personal preferences.The expert by experience observed that there were pictures of staff these also showed who they were key working. Staff spoken to understood the needs of the people they key worked. The key worker system allows staff to work on a one-to-one basis and contribute to the care planning for people. The expert by experience noted that notice boards contained details of daily events including keep fit, bingo, music and reminiscence. People with whom the expert by experience spoke confirmed that these activities were provided regularly. People who live in the home are involved in meaningful daytime activities of their choice. Diary notes showed that people living at the home had regular contacts with family, friends and the wider community. People told me they were able to take part in religious services if they wished. People are supported to enjoy a stimulating lifestyle with regular contact with the wider community. The Cook explained that the dietary needs of people from various communities are catered for. I spoke with one person who confirmed the Afro-Caribbean food is provided. The meals provided cater for the varying cultural and dietary needs of people living at the home. People told me that they understood how to make a complaint. A number of people told the expert by experience that they generally had " no complaints" about the service provided by the home. People can be confident that their complaints will be listened to and addressed. There were comprehensive policies on handling abuse and protection. Appropriate measures are in place to make sure that people are protected and safe in the home. I observed that staff were able to effectively meet the needs of people living at home. People living at the home told me that staff are available to meet their needs. One person said, "staff are always around when you need them." The home has sufficient staff available at all times to support the needs, activities and aspirations of people. Training records and certificates showed that staff had received training in all the statutory required areas and dementia care. Staff has completed an indepth course on dementia care. Staff have also completed training in care planning and continence management. The team has a balance of skills, knowledge and experience to meet the needs of people living at the home. The registered manager explained that since the last inspection three members of staff had commenced working at the home. Recruitment procedures ensure the safety of people at the home. The registered manager has extensive experience of working with older people and those with dementia. The registered manager was able to show me that she has introduced effective systems to ensure that people living at the home Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 7received the care they need. The home monitors its own practice to ensure the best outcomes for people. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. I discussed health and safety issues with staff and they demonstrated their understanding. Health and safety procedures and guidance ensure the safety of staff and people living in the home.

What has improved since the last inspection?

There were five areas for improvement identified at the last inspection. I found that these had all been met. Since the last inspection the registered manager had ensured that more detailed information is available on the needs of people. One person case tracked told me, " they know what I need and do things the way I like." Care plans now identified the care and support required by people and was based on their initial assessment. Care planning emphases the individual needs and preferences. At the last inspection the home was asked to produce a plan for the purchase of new furniture. A plan for the redecoration of the home was also required. The registered manager had sent these to me. I found on walking round the home that all the corridors and reception area had been recarpeted. There has been a significant redecoration of many of the public areas. Since the last inspection a report was sent to me from an occupational therapist that establishes that the en suite showers are suitable for the needs of people. The home provides a homely and safe environment for people. Records show that most staff are in the process of completing the National Vocational Qualification in care at level 2. The registered manager explained that after the 16 staff completes this qualification at the end of November 2007 the home would have 75% of staff with this qualification. I spoke with the National Vocational Qualification assessor. He confirmed that this target would be achieved by the end of November 2007. Staff have the skills to support people and met their needs.

What the care home could do better:

No areas for improvement were identified at this key inspection.

CARE HOMES FOR OLDER PEOPLE Sunbridge Care Centre 108 Hickory Close London N9 7PZ Lead Inspector Tony Brennan Key Unannounced Inspection 11:00 25th October 2007 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 Sunbridge Care Centre DS0000010682.V343490.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. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunbridge Care Centre Address 108 Hickory Close London N9 7PZ 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) 020 8804 3354 020 8804 2316 Ashbourne Healthcare Limited Tracey Wilson Care Home 43 Category(ies) of Old age, not falling within any other category registration, with number (43) of places Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Four specified service users who have dementia may remain accommodated in the home. The home must advise the regulating authority at such times as any of the specified service users vacate the home. One specified service user who is under 65 years of age may be accommodated in the home. The home must advise the registering authority at such times as the specified service user attains 65 years or vacates the home. 11th July 2006 Date of last inspection Brief Description of the Service: Sunbridge Care Centre is a modern purpose built care home registered to care for 43 older people. The home has recently become part of the Southern Cross Health Care. All bedrooms are single with en-suite facilities. There are lounge/dining areas on each floor, assisted bathrooms and a shaft lift. The home is in a pleasant residential area of Edmonton near a park and local shops. The fees range between £398 and £460 dependent on the source of funding. This report is available through the internet. Copies may also be obtained from the provider of this service. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was undertaken as part of the annual inspection programme. I sought to confirm that the areas for improvement identified at the last Random Inspection were addressed. The inspection took place over one day. Tracey Wilson, registered Manager assisted me with the inspection. The annual quality assurance assessment was sent us by the service. The annual quality assurance assessment is a self assessment that focuses on how well outcomes are being met for people using the service. I spoke with three people who live at Sunbridge Care Centre whose needs were case tracked. I also spoke with two relatives and four members of staff. I observed care practice and interaction between people living at the home and staff. I toured the building and examined a number of records relating to the care, health and safety and management of the home. As part the inspection planning it was agreed that an expert by experience would accompany me on the inspection visit. The expert by experience (Alan Jeffers) assisted with the inspection by speaking to 18 people. He also observed the care of people living at the home. The expert by experience observations are reflected in this report. I would like to thank Tracey Wilson and all the staff who assisted me by answering questions about the running of the home. I would also like to thank the three people who live at the home who discussed their views of the service they receive. I also like to thank the expert by experience for his assistance on the day the inspection. What the service does well: I found that the needs of the people case tracked were within the range of those specified in the statement of purpose. The statement of purpose also identified the skills and staffing resources that are available to meet the needs of people living at home. All the people case tracked had recently come to live at the home. There were detailed assessments of their needs carried out by care management. A person told the expert by experience that since coming to live at the home, “ everything is nice here and Ive made some good friends.” Comprehensive initial assessments make sure that peoples medical, personal and social needs are identified and met in ways that reflect their personal preferences. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 6 The expert by experience observed that there were pictures of staff these also showed who they were key working. Staff spoken to understood the needs of the people they key worked. The key worker system allows staff to work on a one-to-one basis and contribute to the care planning for people. The expert by experience noted that notice boards contained details of daily events including keep fit, bingo, music and reminiscence. People with whom the expert by experience spoke confirmed that these activities were provided regularly. People who live in the home are involved in meaningful daytime activities of their choice. Diary notes showed that people living at the home had regular contacts with family, friends and the wider community. People told me they were able to take part in religious services if they wished. People are supported to enjoy a stimulating lifestyle with regular contact with the wider community. The Cook explained that the dietary needs of people from various communities are catered for. I spoke with one person who confirmed the Afro-Caribbean food is provided. The meals provided cater for the varying cultural and dietary needs of people living at the home. People told me that they understood how to make a complaint. A number of people told the expert by experience that they generally had “ no complaints” about the service provided by the home. People can be confident that their complaints will be listened to and addressed. There were comprehensive policies on handling abuse and protection. Appropriate measures are in place to make sure that people are protected and safe in the home. I observed that staff were able to effectively meet the needs of people living at home. People living at the home told me that staff are available to meet their needs. One person said, “staff are always around when you need them.” The home has sufficient staff available at all times to support the needs, activities and aspirations of people. Training records and certificates showed that staff had received training in all the statutory required areas and dementia care. Staff has completed an indepth course on dementia care. Staff have also completed training in care planning and continence management. The team has a balance of skills, knowledge and experience to meet the needs of people living at the home. The registered manager explained that since the last inspection three members of staff had commenced working at the home. Recruitment procedures ensure the safety of people at the home. The registered manager has extensive experience of working with older people and those with dementia. The registered manager was able to show me that she has introduced effective systems to ensure that people living at the home Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 7 received the care they need. The home monitors its own practice to ensure the best outcomes for people. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. I discussed health and safety issues with staff and they demonstrated their understanding. Health and safety procedures and guidance ensure the safety of staff and people living in the home. What has improved since the last inspection? There were five areas for improvement identified at the last inspection. I found that these had all been met. Since the last inspection the registered manager had ensured that more detailed information is available on the needs of people. One person case tracked told me, “ they know what I need and do things the way I like.” Care plans now identified the care and support required by people and was based on their initial assessment. Care planning emphases the individual needs and preferences. At the last inspection the home was asked to produce a plan for the purchase of new furniture. A plan for the redecoration of the home was also required. The registered manager had sent these to me. I found on walking round the home that all the corridors and reception area had been recarpeted. There has been a significant redecoration of many of the public areas. Since the last inspection a report was sent to me from an occupational therapist that establishes that the en suite showers are suitable for the needs of people. The home provides a homely and safe environment for people. Records show that most staff are in the process of completing the National Vocational Qualification in care at level 2. The registered manager explained that after the 16 staff completes this qualification at the end of November 2007 the home would have 75 of staff with this qualification. I spoke with the National Vocational Qualification assessor. He confirmed that this target would be achieved by the end of November 2007. Staff have the skills to support people and met their needs. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 8 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. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 9 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 Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 10 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): 13 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The statement of purpose is an accurate description of the service provided. People’s needs are assessed prior to admission to the home to ensure they receive the care and support they require. EVIDENCE: I found that the needs of the people case tracked were within a range of those specified in the statement of purpose. It explained the range of needs that will be met by the home. The statement of purpose also identified the skills and staffing resources that are to be available to meet the needs of people. Staff deliver care and support to people in ways that ensure the aims of the home as set out in a statement purpose are met. The statement of purpose also Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 11 identified the skills and staffing resources that are available to meet the needs of people. The annual quality assurance assessment completed by the registered manager stated, “ prospective service users and their relatives are always encouraged to visit and view the home. They are always given a brochure pack detailing what the home provides.” I spoke with people who live at the home and relatives who informed me that they had received information about the home. People had also visited the home before they were admitted. All the people case tracked had recently come to live at the home. There were detailed initial assessments of peoples needs by care management. As part of the assessment process, information on the persons needs had been obtained from social care and health professionals. The person told me that she had been able to discuss with the registered manager how she wished to be cared for. I found that this was reflected in the persons care plan. Two relatives also confirmed that they had been involved in the initial assessment process to determine how their relative’s needs could best be met. A person told the expert by experience that since coming to live at the home, “ everything is nice here and Ive made some good friends.” The initial assessments for the people case tracked identified their individual, personal care and medical needs. Comprehensive initial assessments make sure that peoples medical, personal and social needs identified and met in ways that reflect their personal preferences. The registered manager told me that she seeks to ensure that peoples diversity and equality is supported. The annual quality assurance assessment stated, “ in recent years we have witnessed an increase in admission of ethnic minorities, predominantly black Caribbean. We have encouraged the recruitment of care staff that reflects this ethnic mix of people living at the home. I spoke to one person who told me, “I get the food that I used to have back home.” I observed that the staff group was ethnically diverse. The home has been adapted to meet the needs of older people with disabilities. Staff have, as part of their National Vocational Qualification, received training in diversity and equality. The initial assessments also provided information on the person’s life history. I found that there are detailed life histories. These were used to identify the personal preferences and interests of people. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 12 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 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s personal, social and medical care needs are fully planned for. People who use the service are fully protected by safe procedures for handling medication. People’s right to privacy is supported. EVIDENCE: The annual quality assurance assessment explained that, “care plans extensively specify the needs of service users in terms of personal care, oral hygiene and social needs. The information is derived the detailed pre admission assessment.” I found that care plans for the people case tracked were detailed and clearly identified how the needs of people would be met. Since the last inspection the registered manager had made sure that more detailed information is available on the needs of people. One person case tracked told me, “ they know what I need and do things the way I like.” Care Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 13 plans now identified the care and support required by people and were based on initial assessment. A social worker who was visiting the home told me, “ Care plans are good. Family and residents are happy.” The registered manager explained that all care plans had been reviewed in consultation with people who live at home. The registered manager explained that staff have been on care plan training. I found that since the last inspection there had been a general improvement in the quality of information contained in care plans. This is partly due to the introduction of a new care planning system. The expert by experience observed that there were pictures of staff. The pictures showed who they were key working. I spoke with staff that explained that they key worked two people. Staff spoken to understood the needs of the people they key worked. The key worker system allows staff to work on a one-to-one basis and contribute to people’s care plans. Care plans were personalised and referred to the cultural needs of people. This included whether or not they wish to take part in religious worship. There was also information on peoples’ interests and previous occupations. People I spoke to told me that they felt staff understood their needs. I observed that staff took time to understand people. A person told of the expert by experience, “ the staff ask you what you want.” The home involves individuals in the planning of care so that their individual needs are identified. Detailed nutritional, tissue viability, falls and manual handling assessments are in place. Care plans and diary notes confirmed that where necessary district nurses and other health professionals had been consulted about the needs of the people case tracked. I observed where necessary equipment to support peoples independence and prevent pressure sores had been obtained. A person who lives at the home told me, “ the doctor visits regularly and the chiropodist was here this week.” Diary notes showed that the people case tracked had access to their general practitioner when necessary. Diary notes also confirmed that where the general practitioner had recommended specific medical interventions these were followed up and put in place. The records of medicines received, administered and returned to the pharmacist were all complete. Medicines were stored safely. All medicines are stored at the appropriate temperature. Controlled drugs are currently held in the home. The record was in place to show that these medications are administered safely. Changes to medication have been recorded. The general practitioner had signed the changes on the medication administration chart. Medicines held for the people case tracked corresponded with the changes made by the general practitioner. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 14 Training has been provided on the safe administration of medicines. I spoke with staff and found they were clear about their responsibilities and how to handle medicines safely. Training records also contained certificates confirming that this training had taken place. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 15 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 15 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home are provided with varied activities to meet their needs. People living at the home are supported to maintain contact with relatives and other representatives of their choice. People living at the home are able to make choices about how they live in the home. The menu reflects the preferences of people living at the home and offers a balanced diet. EVIDENCE: The annual quality assurance assessment stated that Sunbridge provides, “ a wide range of activities.” The expert by experience noted that notice boards contained details of daily events including keep fit, bingo, music and reminiscence. People with whom the expert by experience spoke confirmed that these activities were regularly provided. I spoke with people who live at the home who told me that they are provided with regular activities. A person told me, “you can join in the regular activities or just sit and relax.” Diary notes referred to individual’s participation in various activities. I observed that Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 16 activities were taking place at various times throughout the day. People spoken to told me that they enjoyed the activities provided by the home. The registered manager explained that she had reviewed the activities programme to ensure that a range of activities was available and that they met the needs of people. The expert by experience had observed that there were times when people were just watching TV and were not being engaged with positively. I raised this with the registered manager who explained to me that she had already identified the need for more staff time to be devoted to the provision of activities. The registered manager has arranged for another member of staff to provide activities. This will double the number of hours provided each day for the provision of activities. The registered manager had identified in the annual quality assurance assessment the need to improve activities by the provision of more musical entertainments and that the introduction of theatre trips earlier in the year had been, “a huge success”. People who live in the home are involved in meaningful daytime activities of their choice. The annual quality assurance assessment emphasised that, “social contact is important.” The expert by experience and I observed that visitors were welcome to the home throughout the day. A visitor told the expert by experience, “its friendly here and you can come and go as you please.” The expert by experience also found that on his arrival, “the introduction to the centre was warm and friendly.” A relative spoken to told me that there were no restrictions on visiting the home. People who live at the home told me that they could see visitors in private if they wish to. Diary notes showed that people living at the home had regular contacts with family, friends and the wider community. People told me they were able to take part in religious services if they wished. The registered manager explained that representatives from the various religious denominations visited the home regularly. People are supported to enjoy a fall in stimulating lifestyle with regular contact with the wider community. The annual quality assurance assessment stated that, “meals provided in the home are wholesome and nutritious and rotated over a four-week cycle. Daily menus are displayed. Mealtimes are not rushed and assistance is also available.” I spoke with the cook who told me that the budget as been increased so that she is able to provide a greater variety of food. The Cook explained that the dietary needs of people from various communities are catered for. I spoke with one person who confirmed that Afro-Caribbean food is provided. The meals provided cater for the varying cultural and dietary needs of people living at the home. The menu showed that options are offered at each meal. People who live at the home were generally pleased with the quality of the food provided. The daily menu was on display around the home. The registered manager explained that the home would be introducing the Nutmeg Nutritional Program Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 17 to develop new menus. This will highlight the overall nutritional value of meals. This information will be made available to people living at the home. It will support people to make healthy choices and will confirm that nutritionally balance meals are always provided. The expert by experience received very positive comments about the food provided by the home. These consisted of “the food is nice”, “the food is very good”, and “the food is all right.” Another person told me about the choice of food offered and that staff had “asked about what food I like”. There was specific guidance in individual plans where people had particular dietary needs. I saw that meals were well presented and they were provided in a relaxed manner. Sufficient staff were available, and when necessary, people were being assisted to eat. Meals are well balanced and meet the nutritional needs of people. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 18 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 18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are confident that their complaints will be listened to, taken seriously and acted upon. The home’s procedures protect people from abuse. EVIDENCE: People told me that they understood how to make a complaint. They also felt that any complaints they raised would be dealt with in a sensitive manner. One person told me, “ if you have a problem you can go straight to the manager.” The annual quality assurance assessment stated that, “our complaints procedure is displayed in reception.” I found this to be the case. The complaints policy explained how to make a complaint and how it would be dealt with. The complaints record showed actions taken to resolve complaints. There had been two complaints since the last inspection. Action had been taken to address these complaints. If the complaint highlighted a need for improvement in care practice this had been addressed. A number of people told the expert by experience that they generally had “ no complaints” about the service Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 19 provided by the home. People can be confident that their complaints will be listened to, addressed and action taken to improve the service. Since the last inspection there had been one adult protection allegation. This was found after investigation not to be proven. The registered manager had cooperated fully and openly with the investigation process. There were comprehensive policies on handling abuse and protection. People living at the home felt confident that any concerns they raised would be handled sensitively and appropriately. A person told the expert by experience that she “felt safe” in the home. Training record showed that staff had received training on adult protection issues. Staff spoken to were able to explain the kinds of abuse that people may experience. They could explain the signs of abuse and the way in which alleged abuse should be responded too. Appropriate measures are in place to make sure that people are protected and safe in the home. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 20 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 26 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that provides a safe and homely environment. The home is clean and hygienic. EVIDENCE: I found that since the last key inspection there had been a general and consistent improvement in the home’s environment. At the last inspection it had been required that a plan be developed to replace furniture in the home. A plan for the redecoration of the home was also required. The registered manager had sent copies of these to me. I found on walking round the home that all the corridors and the reception area had been recarpeted. The public Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 21 areas had been redecorated. I saw that there was new furniture in the sitting rooms. The registered manager explained that plans were in place to recarpet the second floor and purchase further items of furniture for peoples bedrooms. The registered manager explained that as a number of people living at the home had expressed the wish to engage in gardening. The gardens, therefore, will be relandscaped. This will be done in a way that enables people to garden with ease and no physical discomfort. The home provides a physical environment that is appropriate to the specific needs of people. I saw that the home had the necessary adaptations such as grab rails, non-slip carpeting and a nurse call system. I observed that people were able to move around the home safely. The maintenance records showed that action was taken to ensure that the environment was safe and all equipment was kept in working order. There were hoists and assisted baths and toilets. Since the last inspection a report was sent to me from an occupational therapist that established that the en suite showers are suitable for the needs of people living at the home. The home provides specialist aids and equipment to meet the needs of people who live there. Bedrooms were personalised with furniture and other items belonging to people living at home. People spoken to confirm that they were happy with their bedrooms. People have been encouraged to personalise their bedroom. Appropriate measures are in place to prevent cross infection. The home has detailed policies on the prevention of cross infection. Staff have received training on infection control measures. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. Appropriate measures are in place to ensure prevention of any risk of cross infection to people. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 22 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 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sufficient staff are available at all times to meet the needs of people who live at the home. Staff do have all the skills to meet all the assessed needs of people who live at the home. People who live at the home are protected by the home’s recruitment practices. EVIDENCE: The annual quality assurance assessment stated that the home “has an adequate staffing level with a good working staff bank system.” I observed that staff were able to effectively meet the needs of people living at home. People living at the home told me that staff are available to meet their needs. One person said, “staff are always around when you need them.” The rota showed that a consistent level of staffing is maintained on each floor. The home has a staffing level of two carers on each floor during all the day shifts and three waking night staff during the night. Staff are always supported by appropriately qualified and competent senior workers. I observed that staff were available at key times of the day (e.g. mealtimes) to assist people. Staff were also observed to spend time with people both individually and in small groups. This allowed more attention to the individual Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 23 needs of people. The home has sufficient staff available at all times to support the needs, activities and aspirations of people. I spoke with staff that were able to explain to me the needs of people living at home and their role in supporting them. Training records and certificates showed that staff had received training in all the statutory required areas. Staff have completed an in-depth course in dementia care. Staff have also completed training in care planning and continence management. The registered manager explained that she is planning to arrange for more staff to attend these courses. I spoke with staff who confirmed that they had this training and they understood the care needs of the people case tracked. The registered manager explained that further training was planned. A training plan was in place. This showed that training is planned to ensure that staff continue to be able to effectively meet the needs of people. There is a diverse staff team that has a balance of skills, knowledge and experience to meet the needs of people living at the home. The annual quality assurance assessment confirmed that staff are encouraged to complete the National Vocational Qualification in care and where possible staff will progress to level 3. Records showed that most staff are in the process of completing the National Vocational Qualification in care at level 2. The registered manager explained that after the 16 staff completes this qualification at the end of November 2007 home would achieved 75 of staff with this qualification. I spoke with the National vocational qualification assessor for the home. He confirmed that this target would be achieved by the end of November 2007. Staff spoken to are confident that they would complete the qualification within this timescale. They felt that it has given them greater insight into the needs of the people who live at the home. The annual quality assurance assessment stated, “all employment decisions are strictly based on CRB, and POVA checks, and to satisfactory references.” The registered manager explained that since the last inspection three members of staff and commenced work at the home. I examined their files and found there was a record of an interview process and CRB/POVA checks. This had been completed before staff commenced working at the home. I observed that there is a culturally diverse staff group. This reflects the cultural and religious backgrounds of people who live at the home. Recruitment procedures ensure the safety of people at the home. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 24 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 38 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Appropriate management structures are in place to ensure that people receive the care they need. People who live at the home are consulted about the quality of the service provided and are encouraged to make suggestions for improvement. People who live at the home and staff are protected by the home’s health and safety procedures. EVIDENCE: Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 25 The registered manager has extensive experience of working with older people and those with dementia. The registered manager is in the process of completing the Registered Managers Award. People and staff spoken to confirm that they found the registered manager to be supportive. A person spoken to said, “the manager comes round and finds out how you are.” The registered manager was able to show me that she has introduced effective systems to ensure that people living at the home received the care that they need. The home has a system for obtaining the views of the quality of the service it provides and ensures that any areas for improvement are addressed. A survey of the views of people who live at the home, relatives and professionals was in place. A report has been prepared outlining how the findings will be responded to. The registered manager explained the monthly quality audits are carried out of all operational areas of the service. Staff meetings are taking place to ensure staff are aware of plans to develop the service. The home monitors its own practice to ensure the best outcomes for people. The home does not hold money for people who live at the home. The home invoices their families or the relevant social service department for any expenditure made on their behalf. A system is in place to ensure receipts are obtained for any expenditure. I randomly checked these records and found that money had been signed for and receipts obtained. People are safeguarded by the homes financial procedures. Fire drills were taking place and the fire alarm was tested regularly. The system had been regularly checked. I found that the fire risk assessment included an assessment of all the potential fire risks in the home. I questioned staff on the fire safety procedures and found that they understood fire safety issues. All health and safety policies were available. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. I discussed health and safety issues with staff and they demonstrated their understanding. The home has an effective system for monitoring accidents to ensure the safety of people who live at the home. The temperature of food cooked was recorded. The temperatures of the fridges and freezers were recorded and within safe limits. Health and safety procedures and guidance ensure the safety of staff and people living in the home. Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 26 Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 27 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 X 3 X 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 Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No 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 Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Harrow Area Office 4th Floor, Aspect Gate 166 College Road Harrow London HA1 1BH 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 Sunbridge Care Centre DS0000010682.V343490.R01.S.doc Version 5.2 Page 30 - 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!