CARE HOME ADULTS 18-65
9 Sunnyfield Avenue 9 Sunnyfield Avenue Morecambe Lancashire LA4 6EU Lead Inspector
Mrs Jennifer Dunkeld Unannounced Inspection 19th February 2006 10:00 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 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 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 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. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service 9 Sunnyfield Avenue Address 9 Sunnyfield Avenue Morecambe Lancashire LA4 6EU 01524 410678 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) Mrs Heather Cottingham Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21st July 2005 Brief Description of the Service: 9 Sunnyfield Ave is situated in the Bare area of Morecambe. It is typical of the houses in that area and as such does not detract from the community presence of the people who live there. It is registered with the Commission for Social Care Inspection to care for up to 6 adults with a learning disability. 9 Sunnyfield Ave is owned and managed by Mrs Heather Cottingham. The bedrooms are all of a single type and reflect the interests and personality of the current occupants. There is a lounge and a separate diner/kitchen. The home has a well-maintained rear/side garden and a small garden to the front of the home. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This home has been inspected against the National Minimum Standards for Adults introduced in April 2002. This was the second visit this year and was unannounced, meaning that neither the residents, service provider nor staff knew the visit was to take place.. The inspection was over a 2hr period on Sunday 19/02/06 and looked at various aspects of care. In the report there are references to the “tracking process”, this is a method whereby the inspector focuses on a small group of residents. All records relating to these individuals are examined, along with the rooms they occupy in the home. Residents are invited to discuss their experiences of the home with the inspector; this is not to the exclusion of the other residents who contributed in many ways. This inspection included discussion with residents, and staff in addition to viewing the home’s required written information such as policies and procedures about various issues for instance ‘Protection from Abuse’. Ann McGarry, a support worker, was in charge of the home at the time of the visit and was most helpful throughout the inspection process. The residents written plans of care known as, Person Centred Plans, were also viewed for 2 people. The person Centred Plan is a document outlining the needs of the individual resident and how these are to be met. They cover all aspects of the individual’s life including health, personal care and social activities. Thereby ensuring people are content in the care they receive. The residents the inspectors spoke with were happy with life at 9, Sunnyfield Avenue. The staff enjoyed their work at 9 Sunnyfield Avenue and spoke to the inspector in a professional manner about the residents. The service at 9 Sunnyfield Avenue is committed to ensuring that people with a learning disability have their right to a quality life that gives fulfilment is met in the most appropriate ways. Comment cards were received from a number of Residents and the inspector spoke with 5 of them during this visit revealing that the Residents are happy with the care they receive. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 6 What the service does well: What has improved since the last inspection?
Since the last inspection the home has continued to assess the needs of the people who live there, ensuring appropriate staffing to meet the identified needs. Extra staffing is provided at times to enable social activities. The advice offered by the pharmacist inspector has been acted upon for the benefit of the residents. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 7 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. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 8 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 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 9 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): None of this group of standards were assessed during this visit as the key standards were met during the previous inspection. EVIDENCE: 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 10 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): 9 The people who live at 9 Sunnyfield Ave. know that their needs will be met and they have a life style of their choosing. They are enabled to take calculated risks in order to develop and achieve their goals. EVIDENCE: The inspector viewed the plans of care for 2 residents as part of the ‘tracking process’, which highlighted their needs, and how they are to be met. The plans reflected that people are consulted about all aspects of their care. Each review of the care plan is written in the first person ensuring that the reader is fully aware of the autonomy of each person. The plans also contained risk assessments as appropriate for each individual. Risks are seen as part of life but are calculated through a risk assessment framework. During the visit one resident was assisting to make the Sunday dinner for the home. She was enjoying being part of the process and the outcome looked and smelled delicious. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 11 Every day residents are enabled to prepare meals, this is indicative of the managements belief that people should be encouraged to be as independent as possible. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 12 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): 15 & 16 The people that live at 9 Sunnyfield Ave are encouraged and enabled to have an active meaningful lifestyle according to individual interests, abilities and age. The management support people to maintain their place in the community and keep contact with family and friends, the residents’ benefit from this. EVIDENCE: The people who live at 9 Sunnyfield Ave are on the Electoral Roll and as such can take up their right as citizens of Morecambe to vote at Election times. The residents said that they each have a key to their bedroom, which they can use to ensure privacy. They also have a key to the homes front door thereby enhancing the feeling that this is their home. The residents said that the staff respect their privacy and encourage them to make choices about their life. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 13 Families and friendships are seen as important and 1 resident spoke of how she sees her sisters and that sometimes they come for tea, especially on occasions such as bar-be-ques. On the day of this visit another resident was having a weekend at her family home. The residents said that their rights are respected. However when questioned 2 people stated they had not been to the ‘Pool Practice’ ready for taking part in the championships in Bridlington for a few weeks. This was because the volunteer who normally brings them home had been away on holiday. They said they don’t like coming home alone in the dark. Perhaps on these occasions staff support could be arranged. They obviously gain much pride from representing the area. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 14 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): 19 The people who live at 9 Sunnyfield Ave are supported to ensure their physical and emotional health needs are met. The staff provide personal support to people in a way that suits the residents needs and preferences meaning that, residents remain satisfied and contented in their care. EVIDENCE: The files viewed as part of the ‘tracking process’ reflected a list of health care professionals involved to meet the individual’s needs. The inspector also viewed the ‘Health Record’ book for each resident, in which is a record of all medical appointments and the outcomes of the appointments. It also has a section covering feelings, such as ‘things that make me feel good’ and ‘things that make me feel upset’ The record also identifies their weekly activities in recognition that fulfilment is part of feeling healthy and good about yourself. The record reflects that people are enabled to see their GP as and when necessary. Similarly dentist and chiropody appointments are arranged to meet the individual’s needs.
9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 15 The residents spoke of how good the staff are that they are happy at the home. They said that their health needs are met stating ‘Heather , service provider’ makes appointments for us when we need to see the Doctor and she arranges for staff to go with us’ 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 16 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): 23 The home provides a homely environment where people are safe. The homes policies and procedures are robust and ensure people are protected from abuse. EVIDENCE: The homes policies in relation to the protection of adults from abuse are in line with the Department of Health Guidance ‘No Secrets’ Risk assessments are carried out to ensure peoples safety. The homes has a whistle blowing policy that is robust and staff are aware of. The homes staff recruitment procedures ensure that appropriate people are employed. The residents form a part of the recruitment process and have their opinion listened to as to whether or not the person should be appointed. At the end of each staff member probation period the residents are consulted as to the suitability of the individual. There has been occasions when staff have not been offered a permanent contract as the residents were not happy with the way in which the member of staff spoke with them. The home has a well written complaints procedure which the residents can access. It would be beneficial if they were given a new copy of the procedure as some of the residents did not have the phone number of the Commission for Social Care Inspection should they wish to contact an inspector to discuss their concerns.
9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 17 A practice adopted by some care homes that has proven to be of value is to give each resident a postcard stamped and pre addressed to the Commission for Social Care Inspection, stating the persons name, where they live and one sentence saying ‘I would like to speak to an inspector about a concern.’ This enables easy access to the Commission for Social Care Inspection. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 18 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): 30 The resident’s benefit from living in a home that is clean and well maintained. EVIDENCE: The residents were keen to show off their bedrooms, albeit one resident ran upstairs to tidy hers first. She was assured that it was not necessary to tidy her room for the Commission for Social Care Inspection, as it is her room. The home was clean throughout and in good decorative order. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 19 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): None of this group of standards were assessed during this visit as the key standards were met during the previous visit to the home. EVIDENCE: 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 20 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): 42 The residents live in a safe environment where there health and welfare is promoted. The residents live in a well managed home. EVIDENCE: The risk assessments seen and the homes policies and procedures are developed to ensure that the residents are protected from abuse. All electrical equipment is tested by people competent to do so. The staff receive appropriate training in relation to ‘protection from abuse’ and ‘Health and Safety’ The home is well maintained and free from hazards. 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 21 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 Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 4 X X X X X X X 3 x 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 22 no 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. 1 Standard YA1616 Regulation 16(2)(m) Requirement The service provider must ensure additional staff support is provided as required to enable residents to follow their chosen hobbies. Timescale for action 30/04/06 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 23 Good Practice Recommendations The service provider should supply each resident with a postcard pre stamped and addressed to the Commission for Social Care Inspection for them to use as and when they have a concern they wish to raise 9 Sunnyfield Avenue DS0000009879.V286404.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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