CARE HOMES FOR OLDER PEOPLE
Sunnyside Rest Home Coupland Close Whitworth Lancashire OL12 8QQ Lead Inspector
Mrs Susan Hargreaves Announced Inspection 18th October 2005 09:30 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 Sunnyside Rest Home DS0000009487.V255024.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 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. Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Sunnyside Rest Home Address Coupland Close Whitworth Lancashire OL12 8QQ 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) 01706 659917 Whitworth Elderly And Disabled Care Trust Mrs Glenys Elizabeth Thomson Care Home 11 Category(ies) of Old age, not falling within any other category registration, with number (11) of places Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 4th May 2005 Brief Description of the Service: Sunnyside is a purpose built care home situated near to the local amenities in Whitworth. The home has a small garden for residents who wish to sit outside when the weather permits. There is also a small car park for staff and visitors. Sunnyside offers 24 hour personal care for up to 11 residents. Accommodation is provided in single and twin bedded rooms. Communal rooms include a lounge and dining room. Sunnyside is linked to a busy and thriving day care centre, which plays an active part in the ‘close knit’ local community. Residents from Sunnyside are invited to participate in the activities available at the cay care centre. Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours. One additional visit was made on 24 June 2005 to monitor compliance with the requirements issued at the last unannounced inspection. At the time of this inspection 9 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection?
The pre-admission assessment has been amended and included the required information. This will enable the manager to decide if the needs of a prospective resident can be met at the home. Care planning continues to improve. All care plans were reviewed monthly and updated when necessary. Policies and procedures relating to the protection of vulnerable adults had been amended to clearly state the procedure to be followed if allegations of abuse were made. To make the home safer for residents in the event of a fire self-closing devices have been fitted to the double doors leading to the bedrooms. Sunnyside Rest Home DS0000009487.V255024.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. Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Admission procedures were thorough. A pre-admission assessment was completed for each resident prior to admission. EVIDENCE: Individual records of two residents were inspected. Each contained a detailed pre-admission assessment of need. A senior member of staff visited prospective residents in hospital or their own home prior to admission. The assessment of need provided useful information for the care plan. The manager was advised to confirm in writing to prospective residents that their care needs could be met at the home. Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 Each resident had a clearly written care plan. However, the lack of appropriate risk assessments meant there was the potential for health care needs not to be fully met. Medication was managed efficiently promoting good health. Members of staff were friendly and attentive to the needs of the residents. EVIDENCE: The individual care plans of two residents were inspected. These care plans identified the needs of each resident and explained how these needs were met. However, risk assessments for falls and nutrition had not been carried out for one of these residents. Care plans were reviewed monthly. Although the manager explained that she asked relatives to read the care plan there was no evidence to support this. A written report about the care given to individual residents was completed during each shift. Residents were registered with a GP and had access to other healthcare professionals. Members of staff were observed talking to residents in a friendly and patient manner. At the time of the inspection none of the residents were self-medicating. Appropriately trained members of staff administered all medication. Medication was stored correctly and records were seen to be up to date. However, hand written instructions on the medication administration records should be signed and witnessed.
Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 and 15 The daily routine was flexible in order to meet the needs and preferences of residents. The meals were varied and offered choice. EVIDENCE: The daily routine was flexible in order to meet the needs and preferences of residents. One resident said, “I go to bed when it suits me.” The meal served at lunchtime looked appetising and wholesome. Lunch was a leisurely meal allowing time for residents to chat and enjoy their food. Members of staff offered assistance to residents in a caring and sensitive manner. All the residents consulted said the meals were good. Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Complaints would be taken seriously and investigated. Appropriate procedures and training were in place to ensure the protection of residents at the home. EVIDENCE: A comprehensive complaints procedure was available. No complaints had been made to the home or the commission since the last inspection. Policies and procedures relating to the protection of vulnerable adults were in place. This issue was discussed with two members of staff. They were aware of the procedure and said they would report any concerns immediately. Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The home was clean, comfortable and well maintained. Laundry facilities were appropriate for the size of the home. EVIDENCE: At the time of the inspection the home clean tidy and well maintained. This provided a safe and comfortable environment for the residents. The garden area was well kept and accessible to all residents. Self-closing devices have been fitted to the double doors leading to the bedrooms. This will make the home safer for residents in the event of a fire. Laundry facilities were appropriate for the size of the home. Policies and procedures for the control of infection were in place. Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29 Staffing levels were appropriate to meet the assessed needs of the residents. Recruitment procedures were thorough. Care staff were encouraged to obtain NVQ qualifications. EVIDENCE: Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts to meet the assessed needs of the residents. The files of four members of staff were inspected. Three of these files contained all the required pre-employment checks to ensure protection of the residents. However, only one written reference had been obtained for a care assistant appointed by a temporary manager. It was evident from discussion with two members of staff that training was encouraged. Almost 50 of care assistants had an NVQ level 2 in care. Three care assistants were hoping to do NVQ level 3. Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 37 and 38 Residents and their relatives were encouraged to comment on the care and services provided. Fire drills were not held regularly and up to date training in fire prevention was needed. EVIDENCE: Residents and their relatives were encouraged to give feedback about the care and services provided. A ‘comments book’ had been placed in the entrance hall. Anonymous satisfaction questionnaires had been given to residents earlier in the year. Relatives had also expressed their gratitude by sending ‘thank you’ cards. A selection of these was displayed. The manager was advised to obtain the views of visiting professionals e.g. chiropodist, visiting clergy etc. An annual development plan was not available and the registered provider has not completed reports for the manager or the commission under regulation 26. A district nurse visiting a resident during the inspection said
Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 15 that poorly people were well looked after and staff could be relied upon to do what she asked them. Records of financial transactions involving resident’s money were seen to be well maintained and up to date. Fire alarms and emergency lighting were tested monthly. Records of fire drills stated that the last fire drill had taken place in June 2004. The manager was advised to ensure fire drills took place at regular intervals. Not all members of staff had received up to date training in fire safety. A fire risk assessment was in place. A member of staff qualified to administer first aid was not on duty for all shifts. Records of the routine servicing of equipment were seen. Although the electrical installation certificate had expired in August 2005 the manager said arrangements had been made to get a new one. Appropriate policies and procedures relating to health and safety were available. Safety notices were displayed in the home. Sunnyside Rest Home DS0000009487.V255024.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 Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 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 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X 2 2 Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 17 Are there any outstanding requirements from the last inspection? YES 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. 1 Standard OP3 Regulation 14(1)(d) Requirement The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall have been practicable to do so – (d) the registered person has confirmed in writing to the service user having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. Timescale of 24/6/05 not met. Timescale for action 18/10/05 2 OP7 15(1) Unless it is impracticable to carry 30/12/05 out such consultation, the registered person shall, after consultation with the service user, or a representative of his, prepare a written plan as to how the service user’s needs in respect of his health and welfare are to be met. Residents and or their relatives must be involved in planning care. Timescale of 24/06/05 not met. Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 18 3 OP8 12(1)(a) (b) The registered person shall ensure that the care home is conducted so as (a) to promote and make proper provision for the health and welfare of service users; (b) to make proper provision for the care and, where appropriate treatment, education and supervision of service users. Risk assessments relating to pressure sores and nutrition must be carried out for all residents. Timescale of 24/06/05 not met. Staff files must contain all the information listed in schedule 2 of the Care Homes Regulations 2001. (Timescale of 24 June not met.) The registered person shall maintain in the care home the records specified in Schedule 4. A copy of any report made under regulation 26. A copy of this report must be supplied to the commission. The registered person shall after consultation with the fire authority – (d) make arrangements for persons working at the care home to receive suitable training in fire prevention; and (e) ensure, by means of fire drills and practices at suitable intervals, that the persons working at the care home and, so far as is reasonably practicable, service users, are aware of the procedure to be followed in case of fire, including the procedure for saving life. 25/11/05 4 OP29 19 Schedule 2 25/11/05 5 OP37 17(2) Schedule 4 (5) 30/12/05 6 OP38 23(4)(d) (e) 24/02/06 Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 19 7 OP38 13(4) The registered person shall make 24/02/06 suitable arrangements for the training of staff in first aid. The registered person shall ensure that – (a) all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. An up to date electrical installation certificate must be obtained. 30/12/05 8 OP38 13(4)(a) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP33 Good Practice Recommendations Hand written instructions on the medicines administration records should be signed and witnessed. An annual development plan should be compiled. Sunnyside Rest Home DS0000009487.V255024.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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